The cost of supporting the hard-core homeless

This is just outrageous.

According to this, people who use homeless shelters are of three kinds:
  • One or two nights only. These people get on their feet and never come back. About 80% of people.
  • People who come periodically and stay for several weeks at a time. Mostly druggies.
  • Hard-core homeless, keep coming back all the time. About 2,500 of them.
Well, it turns out that the cost of that humble cot those hard-core homeless sleep in every night is about $66 dollars per night. So each one of those 2,500 hard-core homeless causes New York City damage to the tune of $24,000 a year - just for the cot alone.

But it gets worse.
Boston Health Care for the Homeless Program, a leading service group for the homeless in Boston, recently tracked the medical expenses of a hundred and nineteen chronically homeless people. In the course of five years, thirty-three people died and seven more were sent to nursing homes, and the group still accounted for 18,834 emergency-room visits--at a minimum cost of a thousand dollars a visit.
That's 30 visits per chronically homeless person per year on average, for a total of $30,000 each in medical expenses. There's more:
The University of California, San Diego Medical Center followed fifteen chronically homeless inebriates and found that over eighteen months those fifteen people were treated at the hospital's emergency room four hundred and seventeen times, and ran up bills that averaged a hundred thousand dollars each.
Megan McArdle supports a government program that attempts to address the social burden that these people cause by giving them free apartments. The hope is that this will help them get on their feet and, I guess, not come to hospitals so much.

This will not work. An important reason why most people avoid seeing the inside of a homeless shelter is because they know that homelessness is tough. If being homeless ceases to be tough - and in particular, if apartments are being given away for free! - this will increase the number of homeless people, as homelessness starts to be seen not only not-so-tough, but even advantageous.

But as the article describes, the tough sort of homelessness that we have now is hugely expensive when coupled with free shelter and medical help that is currently being given to these people free of charge.

The true solution is: Stop treating people as though everyone is equally valuable!

These people are not equally valuable! Those who are chronically homeless can never be expected to contribute anything of use, and they generally haven't done anything useful in the past to qualify them for anyone's largesse, either.

Anyone who becomes homeless on accident, gets off the streets fast.

The only fact that separates the chronically homeless from stray dogs is the bare fact that they are people.

In the calculus of "get what you deserve", merely being born as homo sapiens is not enough. You have to show effort, will, potential, creativity. These people are showing none.

Bail them out of homeless shelters after a few weeks. Is it freezing in the winter? Tough. Invite the guy into your apartment if you like. Not inclined to? Then why should the taxpayers?

Above all, don't give these people medical assistance. If they're dying from inhaling their own vomit in a drunken stupor, let them die. They don't care. They've already shown that. You shouldn't care either. But if you really can't stop caring - why don't you pay for their bills?!

It makes more sense to house 1,000 kittens in a pet shelter than to waste resources on these people.

Comments

pizorn said…
Although I couldn't agree more with you about inequalities among people (also refering to your recent post about IQ vs race) most people would probably call you a fascist.
This is how democracy works and there's nothing anybody could do. People who make such decisions (politicians, obviously) are elected by people. Not only smart ones but also stupid ones. In fact, vast majority of people falls into the average area - you should know what capabilities those have. And of course, stupid people would always vote for candidates who support equalities and care for everyone -- this is the only way they can feel they make a difference somehow. So your ideas could perhaps work in some autocratic system (in a good way) such as Singapore but not in the USA or any other democratic country.
Anonymous said…
Problem I see is: where will the next radical mind draw the line ? If you decide not to take care of those hard-core homeless.. fine.. but who is going to be targeted by the following generation hard line ? People who chose wrong career ? Wrong city to live in ? And if so.. is the next generation going to select who's to get education based on some genetics markers(almost wrote markups) ?
Drastic measures seem fine to some point.. heck, I would even agree with your approach to hard-core homelessness. But there is a line to draw before the one you aren't willing to cross because if you don't the next one will just say "our predecessors made a hard choice that seemd immoral at that time but now we have to make another one". I am all for transhumanism but there are some path of action that will influence the wrong kind of people. That's like torture. I believe we can't allow anybody to torture anyone, even if this is the only solution.. because nothing could prevent the next idiot-in-line to do it for the wrong reasons.
So we have to take care of everyone, I guess. (I got a little side-tracked with the torture thing, hope you get my point)
jožek said…
Denis, you disregard the fact that people are not given equal chances by birth. Some are born rich, others poor; some are born with an IQ of 180 (like you), others are not. Therefore, it is perfectly possible that a person A puts in much more effort in his life than person B, but it is still person A who becomes homeless, simply because of his unfortunate initial conditions.

You wrote that it's not enough to be born as a member of the Homo Sapiens species. But it certainly is enough to be born into a rich Homo Sapiens family. Someone born into such a family doesn't need to show any creativity, effort, vigor, etc. to survive. Such a person, even if utterly "worthless" (in the sense of contributing to society), will survive simply because of what he was endowed with at birth.

On the other hand, a person born into a poor family will have to demonstrate exceptional abilities in order to get by. If he becomes homeless, this is most often not a sign of his laziness, but of his unfortunate origin.
denis bider said…
jožek: "Some are born rich, others poor; some are born with an IQ of 180 (like you), others are not. Therefore, it is perfectly possible that a person A puts in much more effort in his life than person B, but it is still person A who becomes homeless, simply because of his unfortunate initial conditions."

This is a common argument. The counterargument is to paraphrase it like this: "Some creatures are born as humans, while others are born as chicken. It is perfectly possible for creature A, a chicken, to put much more effort in her life than creature B, a human - but it is still creature A who gets eaten, simply because of her unfortunate initial conditions."

There are two ways to make this logically consistent:

One, either humans must take on responsibility to help all creatures, and go so far as to protect plankton from being eaten by small fish, and then protect small fish from being eaten by larger fish, all the while still somehow ensuring the survival of all these creatures; or,

Two, humans do not take on the responsibility to help all of the creatures in the animal kingdom, and therefore don't take on responsibility to help fellow humans, either.

These are two possible rational outcomes. Most people, unfortunately, choose an irrational third: they draw an artificial dividing line between homo sapiens and animals, i.e., "we don't need to care about them".

unfortunately, this dividing line is awfully misplaced. It puts us in a position where we feel compelled to help more than a billion of people in Africa, who cannot ever reach our level, not without genetic engineering, or eugenics on a vast scale, to cause their children to be smart.

Another thing that "we're all equal" policies do is, they promote the multiplication of inferior-capability genes at the expense of superior-capability genes in the human gene pool. This doesn't matter in the short run as far as we individuals are concerned, but it matters for the gene pool in the long run. See the movie Idiocracy for a farcical impression of what a future might look like when it's full of retards.

All of this can be corrected if we simply enforce the silver rule: "Don't do to anyone else what you don't want to be done to yourself." You wouldn't want people to take the fruits of your efforts away by force; so don't force that on others.

This is equitable, fair, and good for the community in the long run.
denis bider said…
pizorn: "So your ideas could perhaps work in some autocratic system (in a good way) such as Singapore but not in the USA or any other democratic country."

I think the current "we're all equal" meme is the result of an overdone inoculation against the causes of nazi violence that's gone from:

"Thou shalt not harm people because they're different"

and into:

"Not only should you not harm others because they're different, but we're all equal!"

This is obviously nonsense. I believe that people can see the light and realize this, if only they stop being indoctrinated by clueless leftist idealists in schools.

In the end, I think a sensible attitude can prevail in a democracy, because most people can be taught to respect the Silver rule, and to see it as an equitable principle to live by.
denis bider said…
Anonymous: "Problem I see is: where will the next radical mind draw the line?"

It's simple. The line is at: "Thou shall not harm others because they're different." The line is at the Silver rule: "Don't do to others what you don't want to be done to you."

While I'm using allusions from cruel nature to show why the "we're all equal" meme is nonsense, what I actually espouse is people living by the Silver rule, and this results in a far from dog-eat-dog society. It results in an equitable society where most everyone is taken care of, and people in need are helped voluntarily by those who see reason in doing so.

Strictly following the Silver rule does, however, also result in a society where some people are not helped, because no one cares enough about them. The people's classical reaction is: "Someone should help." Well, if someone should, then why don't you?

People who cannot fit into society, who no one cares for, should be left to cope as any other creature does, outside.

This is all.
lteiexpc said…
You're right - it is outrageous. Don't blame only the homeless, blame shameless stealing of tax money in every step of the process. There's no way costs are $66 per night per homeless. It can be done for $6 or less. There is no way a minimum cost is $1000 per emergency room visit. Theft in every step of the process. Stop the theft and the cost of supporting the homeless and abandoned animals becomes negligible.

There are other problems with your line of thinking as well. Who will judge who gets help and who doesn't? Fair judgment process would probably cost more than admitting everybody. And remember that there is always a free accommodation available to everyone at all times:
prison. See the law of unintended consequences coming?

Solution? Voluntary taxes, where each tax payer decides where his money goes (and if would pay taxes at all). Incentive to pay taxes already exist - companies brag about donations all the time and unwillingness to contribute back to society may soon become fatal in increasingly competitive world.
boris_kolar said…
That "lteiexpc" in the last comment was me. Sorry for the mistake.
denis bider said…
boris: "There's no way costs are $66 per night per homeless. It can be done for $6 or less."

It doesn't matter what the actual figure is. Even if it's 60 cents - I don't want to pay it. I don't see how someone else's concern about their lives compels me to do so. If someone else is so concerned, they should pay it.


boris: "There is no way a minimum cost is $1000 per emergency room visit. Theft in every step of the process."

Check out the article I linked to, and you'll see how it adds up. These people come in with serious problems that they pick up by living on the street.

In addition, even if they came in with a cough, occupying the time of a team of qualified people, who went through years of medical school, and who could have attended to paying customers if they didn't have to look after a non-paying homeless person, is costly.

Money is a form of rationing. We ration because there isn't enough. Where things aren't rationed by money, they are rationed according to other principles. Those other principles are more unfair than money, because money is evidence that you have performed services to people in your life, services which qualify you to receive a favor in return. If you, being a person with money, are denied service in favor of a person with no money; then this is grossly unfair, because the other person has no evidence that they provided any services in the past.

However, you are free to tribute the favors you are due to people who do not have title to those favors. I don't encourage it; I think it's foolhardy. But as far as I'm concerned, anyone should feel free to go ahead and do so.


boris: "Who will judge who gets help and who doesn't?"

The person who chooses to give, judges who they will offer their help to. Those who get help, live. Those who don't get help, and cannot help themselves, die. It's nice, it's fair, it's simple.


boris: "And remember that there is always a free accommodation available to everyone at all times: prison. See the law of unintended consequences coming?"

In point of fact, they used to have such people as today are hard core homeless, in a certain type of prison. These people are, for the most part, mentally challenged, and they were previously committed in mental clinics from which they could not leave.

A movement in the 1970s, however, managed to change the relevant policies so that people cannot any more be kept committed unless they are a threat to others or themselves.

One could argue that this might have been a reasonable idea in principle. It prevents abuse on behalf of those who would keep people interred; perhaps people who did not need to be interred in the first place.

Whatever the case, these people are now out. If they commit a crime, they'll go back to the institution, in this case with clear evidence that they belong there. Arguably, the cost of supporting them will then be lower, because they will be healthier in a controlled environment.


boris: "Voluntary taxes, where each tax payer decides where his money goes (and if would pay taxes at all). Incentive to pay taxes already exist - companies brag about donations all the time and unwillingness to contribute back to society may soon become fatal in increasingly competitive world."

I am completely in favor of everything voluntary, and strongly encourage such things.

However, I feel obliged to point out that companies have already contributed to society. Unless their revenue was forcefully extracted out of people's pockets in collusion with politicians, their contributions to society are the reason they have money.

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