The nation's 636,000 homeless people include many who refuse to stay in homeless shelters or use other services to help them find permanent housing. Well, c'est la vie, no?
No, at least not according a recent Journal of Housing and Community Development article (available in the Legislative Library). Chronically homeless people who refuse shelter and other services eventually use other more costly services, such as ambulance, hospital, emergency room, police, jail, judicial, fire department, and code compliance. To back up their claims, the authors cite research from Canada showing "that planned costs for quality housing and service delivery to the homeless save the taxpayer about 54 cents on the dollars."
This outcome is an example of a "policy paradox," a term political scientist Deborah Stone coined to describe situations that challenge economists' rational, quantitative models designed to give bottom line costs and benefits of competing policy options. These models, according to Stone, often miss the fact that in the real world, cold hard numbers often give way to conflicting interests, political compromises, and goals other than efficiency.
Author Malcolm Gladwell spotlighted those conflicting interests, compromises, and goals in his 2006 New Yorker article, "Million Dollar Murray: Why Problems Like Homelessness May be Easier to Solve Than Manage." Murray was chronically alcoholic and homeless, and when the Reno police officers who, for 10 years delivered him to the city's hospitals, tallied Murray's medical bills, they discovered that it "cost us one million not to do something about Murray." But that's only part of the story. The other part is that Murray did well when he was in treatment, holding down a job and saving money. But when the treatment ended, he was back on the street.
Murray's experience suggests that permanently housing chronically homeless people with disabilities in supervised apartments avoids repeated visits to hospital emergency rooms and rehabilitation centers. "From an economic perspective, the approach makes perfect sense. But from a moral perspective it doesn't seem fair." There are thousands of people who work two or three jobs to make ends meet and "no one offers them the key to a new apartment," Gladwell wrote.
Placing people like Murray in long-term supportive housing has little appeal to conservatives and liberals, according to Gladwell. It doesn't appeal to the former because it involves "special treatment for people who do not deserve special treatment." Nor does it appeal to latter because it emphasizes efficiency over fairness, which smacks of the "cold number-crunching of Chicago-school cost-benefit analysis."
