My sister has been reading Malcolm Gladwell, chanced across his piece on Million-Dollar Murray, and asked me if it rang true to my experiences with homeless services in Kansas City. In it, he argues that “homeless may be easier to solve than to manage.” I’d add “more humane” and “more affordable” to that, and I think he’d agree.
“We came up with three names that were some of our chronic inebriates in the downtown area, that got arrested the most often … One of the guys had been in jail previously, so he’d only been on the streets for six months. In those six months, he had accumulated a bill of a hundred thousand dollars—and that’s at the smaller of the two hospitals near downtown Reno. It’s pretty reasonable to assume that the other hospital had an even larger bill… [This person] was Murray Barr, and Johns and O’Bryan realized that if you totted up all his hospital bills for the ten years that he had been on the streets—as well as substance-abuse-treatment costs, doctors’ fees, and other expenses—Murray Barr probably ran up a medical bill as large as anyone in the state of Nevada.
“It cost us one million dollars not to do something about Murray,” O’Bryan said.
A trusted source here locally tells me that they have a client who called the ambulance 126 times in 2012. At $700 per call, that’s $88,200 in services in one year before adding any medical treatment or other emergency services. In comparison, a conservative estimate of the cost of one unit of permanent supportive housing is $6,500 per year. That’s not to say that a person in supportive housing won’t ever need an ambulance, but they certainly won’t need one every third day.
Why do we use our resources this way? As human beings, why aren’t we insisting on safe, appropriate housing for everyone? As taxpayers, why aren’t we demanding more permanent supportive housing? Gladwell says it’s because the answers don’t conform to our moral intuitions.
Power-law solutions [ED: Power law at Wikipedia] have little appeal to the right, because they involve special treatment for people who do not deserve special treatment; and they have little appeal to the left, because their emphasis on efficiency over fairness suggests the cold number-crunching of Chicago-school cost-benefit analysis … In Denver, John Hickenlooper, the city’s enormously popular mayor, has worked on the homelessness issue tirelessly during the past couple of years … He has commissioned studies to show what a drain on the city’s resources the homeless population has become. But, he says, “there are still people who stop me going into the supermarket and say, ‘I can’t believe you’re going to help those homeless people, those bums.’”
So, how do we frame developing permanent supportive housing units to voters, funders, and elected officials?