
Million-Dollar Murray: Homelessness may be easier to solve than to manage - skushch
http://www.gladwell.com/2006/2006_02_13_a_murray.html
======
anamax
> An efficiency apartment in Denver averages $376 a month, or just over forty-
> five hundred a year, which means that you can house and care for a
> chronically homeless person for at most fifteen thousand dollars, or about a
> third of what he or she would cost on the street.

That assumes renters who don't try to destroy the place. However, some renters
are considerably more destructive than others.

However, the big problem is that it assumes that homelessness is solely due to
a lack of resources to obtain a home. If that were true, SF would have far
fewer homeless and the shelters would be full.

Yet, many of SF's shelter beds are empty and folks who could be in the are on
the street. Yes, they know about the beds - they prefer the street.

Are you really sure that they'd take an efficiency apartment? Are you sure
that they wouldn't try to destroy it?

Someone pitching that as a solution should not only be aware of the
possibilities but have reasons better than "an apartment is better than the
street" because that's clearly not true for a large fraction of the relevant
population.

~~~
jbz
Did you read the article in full? I know its a rude question to ask but it
really seems like you didnt because youre falling prey to exactly the type of
thinking it highlights as the problem. The solution doesnt "feel" right, and
we humans are without peer in justifying our discomfort avoidance in cloaks of
righteousness, truth, etc. That the correct solution just happens to coincide
with the solution that avoids self-doubting discomfort is serendipity. Even
this serendipity is so rarely noticed, let alone questioned, doesn't this seem
odd?

Take for instance healthcare, its spiraling costs. A doctor ordering what some
would call excessive tests for a patient is doing the right thing. It is
better to be safe than sorry after all. The trial lawyers, insurance
companies, government handouts and so on are the reason its skyrocketing.

What about the human fault of judging ones own immoral actions and impropriety
on a relative scale of those around us? What about compounding that by
generally giving everyone an "i am a good person" foundational belief. To
examine it with no intention of challenging it will cause most people to feel
a tangible unease because they're treading on some dangerous ground, a sense
of fear that its best not to mess around in this place in case you break
something accidentally. Each human with an intact "i am good" core applies
goodness to all their actions by default, meaning if a person is not truly
judging their motives or reasoning they are deemed to be "good" actions with
pure motives because they are good and nothing specifically shows they're
doing "bad" right that moment.

When the city with one of the fastest rising health costs in the US was
examined it was found that the rising costs had a partner along for the trip,
medical procedures and tests were rising as well. The doctors were doing
nothing illegal, and obviously none of them thought they were doing anything
wrong. So why the rise? It was just doctors increasingly exploring that grey
area that doesn't challenge your central belief of your own goodness. Patient
complains of headaches, and worries about something they read online about
brain tumors, the doctor thinks its unlikely but its better safe than sorry,
and imagine if he does have a brain tumor not only would i have missed it i
might be sued too. Repeat this process over and over and goalposts move, more
behavior is acceptable such as "ok so maybe she didnt need hip replacement
surgery right now, but she definitely would have needed it soon, and im a far
cry from Doctor EvilCompetitor, i cant believe he talked that poor shmuck into
allowing brain surgery!".

Consider the complicated medical conditions that homeless contract on the
streets with illness on top of illness requiring weeklong ICU visits, it
becomes drastically reduced if a person is living in a home. A single avoided
hospital visit of that kind alone can justify the free apartment for year or
two or three.

Im trying to find that article again, will post link when i find it.

~~~
anamax
> Did you read the article in full?

My point is that the article doesn't contain all relevant data.

> A doctor ordering what some would call excessive tests for a patient is
> doing the right thing.

May be doing the right thing. Some people think that my life is worth $X.
Who's to say that they're correct?

> Consider the complicated medical conditions that homeless contract on the
> streets with illness on top of illness requiring weeklong ICU visits, it
> becomes drastically reduced if a person is living in a home.

Assumes behavior not in evidence. Homeless in SF have "not street" options
that they refuse. What makes you think that they'll take different options AND
that their risks will chance correspondingly.

I note that lots of folks with homes manage to get "street illnesses" so it's
not true that homes solve disease. There's a decent correlation for current
"homed" populations, but that doesn't tell us what would happen if we "homed"
other populations.

------
commanda
"Power-law solutions 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."

This is exactly why programs like these won't take off. It's hard to present
this kind of complex analysis of the behavior of a system to the tax payers
for exactly this reason. The average person probably votes their conscience,
not what makes the most sense from scientific studies, which are generally not
widely published anyway. There's no simple moral argument to be made for
giving homeless people free apartments that they don't deserve, and most
voters won't think through a proof that has more than like two steps.

~~~
gyardley
_Power-law solutions 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._

What a bizarre thing for Gladwell to write. He's inexplicably generalized from
one particular power-law solution, giving free apartments to the chronically
homeless, to state that all power-law solutions are politically unpalatable.

In the case of the tiny minority of excessively violent LAPD officers - a
simple power-law solution would just be to assign them to useful
administrative jobs. I can't really see how that particular power-law solution
would aggravate the right or the left.

~~~
yummyfajitas
That solution would aggravate people who view the police as being part of
their "tribe". Assigning some police officers to admin work lowers their
status, and in effect the status of your entire tribe. This would aggravate
authoritarians on both the right (e.g. Gonzales) and left (e.g. Biden).

This is also the objection to giving free stuff to the homeless - it elevates
the status of another tribe (do-gooders/bleeding hearts, the people handing
out the free stuff) at the expense of your tribe (hard working/god fearing).

You could almost certainly get conservatives behind such a plan and get
liberals to oppose it, if you did it in a way that elevated the status of a
right-leaning tribe (e.g., boot camp/military living for the homeless).

------
jbeda
Seattle actually put this into practice. The city funds and supports homeless
housing for the most expensive homeless in the city. There is no requirement
for sobriety. The project is called 1811 Eastlake
(<http://www.google.com/search?q=1811+eastlake>) and it is not without
controversy. Studies of the outcomes and cost analysis has been published in
JAMA. Here is a summary:
<http://www.desc.org/documents/DESC_1811_JAMA_info.pdf>.

My wife is an ER attending at Harborview, the hospital that sees most of these
patients. Anecdotally, she has seen great outcomes out of the project, has
toured it and is a big fan.

(Interestingly, Dr. Michael Copass, the patriarch of the Harborview ED and a
pioneer in modern medical response calls these individuals "urban nomads")

------
Mz
_"...It is very much ingrained in me that you do not manage a social wrong.
You should be ending it."_

Lots of good stuff in this article. I had a class on homelessness and an
internship at a homeless shelter. A lot of what I have seen written about it
is pretty stupid. But the ideas presented here have potential.

~~~
harscoat
I remember a homeless called Lounis (after my studies, I joined Paris
Firefighter Brigade), we collected him regularly because people would complain
he was staying at their frontdoor. On our way to the hospital, he would sing
with us in the truck, he would even do air guitar. The day some of my
colleagues came back to the fire station after they collected his body on the
street, we all felt like the police officers did for Murray.

------
petercooper
The crux of the matter:

 _The cost of services comes to about ten thousand dollars per homeless client
per year. An efficiency apartment in Denver averages $376 a month, or just
over forty-five hundred a year, which means that you can house and care for a
chronically homeless person for at most fifteen thousand dollars, or about a
third of what he or she would cost on the street._

I believe similar observations have been made in subsidizing the price of
fruit and vegetables (or even bikes and gym memberships) vs the medical costs
of bad diets and lack of exercise, too.

~~~
buro9
It's not as simple as just throwing money at the problem and managing things
differently.

I've been homeless before and it's not pretty, a lot of the people who I met
on the street during that time would not have been able to just take an
apartment and that would be their problem solved.

They are on the street for a reason and if the reason was purely financial
then perhaps the apartment would help, but a lot of the time the reasons can
be associated to mental health, poverty, drugs, alcoholism... and giving
someone an apartment in those cases is unlikely to add anything to the
solution.

What those people need is real support and care. And an apartment will just
isolate them and risks exacerbating the problems for them.

~~~
JadeNB
> What those people need is real support and care. And an apartment will just
> isolate them and risks exacerbating the problems for them.

Not to say that I think that giving a homeless person a home will magically
solve all his or her problems, but how does giving someone an apartment
isolate him or her in a way that being on the street does not? (It's not a
snide question; I've never been homeless, and maybe there's a stronger
community than I see—but it seems unlikely that that community can provide the
real mental and physical care that such an afflicted person would need, and
that the people who _can_ provide it find it easier to ignore a dirty person
on the street than their next-door neighbours.)

~~~
buro9
On the street you're likely to congregate at points where people offer some
basic assistance or there is security. This means things like food wagons,
shelters, drop-in health centres and places where other homeless hang-out and
you can pass a little time.

In those places a lot of voluntary help is given, workers chat to you,
sometimes you'll even be given some new clothes, but nearly always you get to
interact with others.

I cannot emphasise how hard being homeless and without a network is. You have
no-one to talk to ever except for these people who by necessity you come into
contact to. I also cannot emphasise just what happens if you have too much
time alone and yet live in fear, hunger and with some problem (mental health,
an addiction, etc).

Some of the people I knew from the streets wouldn't have survived in a house.
They needed their contact as much as they needed their next drink, it was all
they had and the only thing that prevented them from losing themselves
totally.

The isolation from giving them an apartment is that no-one will visit, and if
they do then not enough.

And the problems they'll have are worse and will go to basics such as hygiene.
On the streets they never had to clear litter, pick up dirty clothes, and
clean their environment... they would just move on if it was bad enough. In a
flat most of the people I knew I believe would've just rotted and allowed the
space around them to become full of junk and to also rot.

They'd need to be taught how to care for themselves. How to cook safely. How
to budget and make money stretch (there is little thought of the future on the
street, you spend what you have pretty quick in case you lose it. You wouldn't
think of bills and taxes).

And to learn those things you'd need them to have sound mental health,
alertness, awareness of their surroundings. You'd need to help them to shake
off their addictions, and to respect themselves. You'd likely have to counsell
them and provide support for mental health problems.

And if you achieved all of that. Then they would be devastatingly lonely. They
won't have what you take for granted, there are no friends for them to call
upon, family to visit, money to go sit and bar and chat. They'd be alone and
desperately wanting to rid themselves of that loneliness.

In all likelihood they'd go back to the streets where they have contact,
interaction and community. Where they didn't have to put in all this effort to
care for themselves when apparently that amounts to loneliness and isolation.

It takes far more than a roof to stop someone being homeless. Homelessness is
a state that encapsulates far more problems than just the lack of a house. To
solve it, you need to address all of those problems and not just the lack of a
roof.

~~~
jerf
We need a word different than "homeless", really. You say: "Homelessness is a
state that encapsulates far more problems than just the lack of a house." But
the word itself dates from a time when many people truly were simply
_homeless_ , and the concept itself of course predates English. Historically
speaking (going back a ways, but covering a lot of centuries) one popular way
to homelessness was simply to become a widow and lose your husband. (Which is
why the Old Testament goes on at length about taking care of widows; it's not
about having emotional compassion for one who lost their spouse, though that
won't hurt, it's about supporting someone who now has no economic income.)
Civilization has not always been as wealthy as it is now; someone says
"homeless" and the very word itself invites them to think the old, simple
case, not the modern complicated stuff you talk about.

Today we've pretty much solved the basic home problem in the civilized world.
Perhaps not 100%, but nothing is ever solved 100%. What's left are the hard
cases, which is what you are describing. Our cultural attitudes haven't
updated for this fact, and so when people hear about the homelessness problem
they naturally think the problem is simply... homelessness. Unfortunately it's
a harder problem than that, and we make it even harder by misunderstanding it.

~~~
Mz
_We need a word different than "homeless", really._

 _Today we've pretty much solved the basic home problem in the civilized
world._

\----------------

Some data on American housing and such, that may not be 100% accurate but
should paint a general picture:

Around 60 years ago, the average new home was about 1200 sq ft and housed a
family of 5 (2 parents, 3 kids). Today, it is over 2000 sq ft and houses a
family of 3 (2 parents, 1 kid). This difference and other factors has helped
create a widening gap between the haves and have-nots: Those who can afford a
new home live like kings. Those who can't may be perpetually one paycheck away
from homelessness. Most of the financing instruments we have are aimed at
single family suburban homes designed to meet the needs of a 1950's-style
nuclear family. Meanwhile, our demographics have changed and very few people
fit that bill. The housing industry has been terribly slow to adapt to the
changing needs of our changing demographics.

Also, historically, it was more common to live with extended family. This was
more manageable back when more than half the American population lived and
worked on a farm. You could always put someone to work on the farm to help
cover the cost of feeding and housing them. But a more city-centric lifestyle
means that if you have no job, you typically aren't viewed as a contributing
member of the household and it is much harder for people to extend generosity
in that regard unless they are truly wealthy. We also had more SRO housing and
boarding houses -- just the sort of supportive environment that the Murray's
of the world seem to need. This was part and parcel of the culture and was not
considered some kind of "special service" for problem individuals who couldn't
adapt. It was also cheaper than a stand-alone apartment. Apartments designed
for a nuclear family or houses designed for a nuclear family make up the
majority of housing stock in the US and it is financially out of reach for
many single individuals. College students often get multiple roommates to make
it work but it really isn't designed to work for them. The Murray's of the
world lack the ability to force the current housing situation to serve them
adequately and mostly don't have other options which did exist not that many
decades ago.

I have a lot more thoughts and information on the subject but I don't care to
beat it to death. The current housing situation really is a factor in why
homelessness has been on the rise in recent years. Yes, it is one of many. But
I don't think it can be lightly dismissed.

~~~
jerf
When I say the literal homelessness problem is mostly solved, I don't mean
that everybody gets what they want. I mean that anybody with the basic ability
to work, who is not insane, who is not for some reason simply unable to
function in what we are pleased to call civilization for whatever reason, is
able in a first-world country to put a roof over their head, even if that
means accepting charity, or government handouts, or taking a roommate or
three, or quite possibly moving away from where you are to go somewhere else
and do some combination of the above. The current economic issues do make that
challenging at this exact instant but on the scale of time I'm considering
it's still just a blip. And the trend line remains clear; for instance, I'm
pretty much ready to call this a Depression, yet it is of a different
character than the previous ones, no soup lines, and there are many and good
reasons for that, mostly revolving around the generally higher level of wealth
the whole society has, even if you _feel_ poor right now.

It is very tempting, whenever considering progress, to look ahead at how much
work remains to be done, all the more tempting because it is a valid
viewpoint, after all. But I think it is also helpful to honestly consider how
far we have come, too, without constantly self-flagellating about the fact we
haven't gotten to perfection yet. The problems you describe are not of the
same order of magnitude of the problems that buro9 described.

~~~
Mz
_But I think it is also helpful to honestly consider how far we have come,
too, without constantly self-flagellating about the fact we haven't gotten to
perfection yet. The problems you describe are not of the same order of
magnitude of the problems that buro9 described._

I had a class on homelessness and did volunteer work in a homeless shelter and
I have lived with the kind of stubborn personal problems that typically lead
to homelessness. I am well aware of the personal factors involved. I don't
think it is self-flagellation to realistically assess the impact the current
housing situation has on the availability of suitable, affordable housing and
how that relates to increased homelessness in recent years.

------
nathanmarz
The Delancey Street Foundation is an organization that has recuperated
thousands of people who have hit rock bottom. And they do it without any
government funding (they're self-supporting). One of the best examples of
social entrepreneurship out there.

<http://www.delanceystreetfoundation.org/>

And if you're interested in the details of how the organization operates, I
did some research and wrote about the organization on my blog:

[http://nathanmarz.com/blog/mimi-silbert-the-greatest-
hacker-...](http://nathanmarz.com/blog/mimi-silbert-the-greatest-hacker-in-
the-world.html)

------
joe_the_user
What I would ask about these "power law" situations: Do we have any idea what
moves someone from bad cop to really bad cop or homeless to homeless-and-
totally-down-and-out?

While only a small number reach the "really bad" level, it seems plausible
that there's a larger population who could move into that level if the
competition or bad examples or whatever other restraining factors were
removed?

Sure, only a tiny minority is flagrantly offending at a given point but if one
doesn't understand how this minority arises, one doesn't really understand the
situation.

------
chunkbot
I believe that homelessness is _cheaper_ to solve than to manage.

However, it may be _easier_ to manage (ignore) the problem than to solve.

~~~
ritonlajoie
Yep, that's generally how that kind of problem are solved..Close the eyes on
it!

------
Herring
The article is a bit too well written, if theres such a thing. I got about
halfway without pausing.

