Thursday, November 29, 2012

Symptoms

We hear it all the time. Treat the cause not the symptoms.


Dated 2009 and specifically asking about the relationship with the recession, some aspects of the article are unhelpful. But PBS is actually pretty damn good at giving numbers.

So let's start there.

Some figures quoted below:
What are the greatest causes of homelessness?

For persons in families, the three most commonly cited causes, according to a 2008 U.S. Conference of Mayors study (pdf) are:
  • Lack of affordable housing
  • Poverty
  • Unemployment
For singles, the three most commonly cited causes of homelessness are:
  • Substance abuse
  • Lack of affordable housing
  • Mental illness
Are veterans more likely than other populations to be homeless?

Yes. About 40% of homeless men are veterans, although veterans comprise only 34 percent of the general adult male population, according to research on veterans by the National Coalition for Homeless. On any given night, 200,000 veterans are homeless.

People who are homeless frequently report health problems.
  • 38% report alcohol use problems
  • 26% report other drug use problems
  • 39% report some form of mental health problems (20-25% meet criteria for serious mental illness)
  • 66% report either substance use and/or mental health problems
  • 3% report having HIV/AIDS
  • 26% report acute health problems other than HIV/AIDS such as tuberculosis, pneumonia, or sexually transmitted diseases
  • 46% report chronic health conditions such as high blood pressure, diabetes, or cancer
Note: The above figures are based on 1996 data from Samhsha's National Mental Health Information Center.”
Take a close look at that. What does it say to you? To me it says that the guy asking me for change is a product of a confluence of problems we as a society have failed to address. I'll take on a couple of the numbers. How about this one, let's eliminate 40% of all male homeless. I bet a robust VA jobs bill would do something to help alleviate that.


The gist of it is that we have had a few put on the table, but they've been filibustered because it was not economically responsible. I don't want to pick too many bones about this suffice it to say that we used some accounting tricks to defer (read hide) the costs of two wars that created a huge population of veterans and cost hundreds of billions of dollars (possibly trillions), and we won't spend a meager sum (fraction of 1%) of that cost to clean up the mess we made. You buy the booze for the party and you pay for the maid to clean up the place the next morning. Or you get on your hands and knees and do it yourself.

Let me be clear, the people that vote for war should take just as much responsibility with our survivors of war. There is no excuse for leaving them out in the cold if you can at least attempt to rectify the sin of sending children to kill other children. Make no mistake—we are all children.

Ok, now, what about adequate mental health services? In a nation with 40 million uninsured and costs that are through the roof on unregulated state-by-state markets with only a few vendors, there is no such thing as competition. Health providers in a given state, due to lack of competition and dubious pricing schemes are able to keep only the healthiest patients while raising costs for procedures that are ultimately foisted back onto the customers. So, how about opening up the state markets so that companies can work across state borders? How about forcing costs to be standardized by tethering them to a tangible price schedule? How about adding 40 million Americans to the pool of insured, bringing down the cost burden on hospitals which lowers the cost of procedures overall? How about requiring this insurance on a national level? How about as part of this coverage, comprehensive mental healthcare with a focus on creating productive members of society?

Instead of say, homeless people without coverage left in the rain without the resources to deal with their mental health issues.

I wish that could happen. Too bad it's been labeled a socialist agenda that creates free loaders somehow. Oh wait, Obamacare wasn't repealed and won't be. Hmmm...maybe it will help with homelessness. Just a pipe dream perhaps, yet.

So—I don't think there's much I can say that is conclusive. What I can say is that by addressing HOW people become homeless instead of focusing on the otherness of the homeless we will be far more receptive to how the canaries in our American coal mine are really faring. Make no mistake, those most vulnerable to the woes of this country are those that are most vulnerable period. And if we do not protect them, we risk sacrificing ourselves.