How Utah Reduced Chronic Homelessness • Hacker News Board

Re: How Utah Reduced Chronic Homelessness

#131

Post by ska » Fri, Mar 17, 2017, 6:45 PM UTC

Consultant32452 wrote: post #113

Joof wrote: post #67

Earlier quoted context omitted.

Hasn't worked for single payer healthcare yet. Nobody brings up that almost every other country's government pays less than the US.

If you're a wealthy person anywhere in the world and you have a really terrible disease you're probably going to come to the US to get care. Why? Because we have the highest quality healthcare in the world. There's a reason why there was some mild drama over Danny Williams (Premier of Canadian province) hopped the border to have heart surgery in the US. We're the best. What we lack is healthcare access for the poor.…

   Why? Because we have the highest quality healthcare in the world.

This is one of those statements that kind-of true, but not in the sense that people bringing it up mostly mean.

In fact "best in the world" care depends largely on disease, in many cases the best teams in the world are in the US, in others they are not. If you are (globally) rich, you go wherever the best care is. But that typically isn't "the US", that's far too broad. It is a particular team, at a particular hospital, in the US. Or maybe there are 3 to choose from.

So sure, if you are rich enough to go anywhere, and have enough social capital to get in, you can have amazing care for most conditions in the US. And in some cases you would go to France, say, instead - because they were better for what you have.

But that doesn't mean that the average person in the US in the average hospital, say, is getting the "best care". As far as we can see (and it's difficult) mostly what they are getting is roughly equivalent care for higher costs. It's a complicated issue as to why, of course. Particularly if you are looking at outcomes, rather than procedures. On top of that, access for 10's of millions of Americans is sub-par, in comparison to peer systems.

Re: How Utah Reduced Chronic Homelessness

#132

Post by notatoad » Fri, Mar 17, 2017, 6:45 PM UTC

tjpaudio wrote: post #118

ljf wrote: post #48

Earlier quoted context omitted.

Totally this - I read once that is costs around £16000 a year per rough sleeper in central London, through policing, clean up, emergency care, and other costs. And that at the end of the year (if the person hadn't died) they were no less likely to be a rough sleeper than at the start. It just seems crazy that we can't better funnel that money to intervene and support people, to plan on removing that cost over the lon…

The general problem isn't convincing people that housing them would be more cost effective, it's that a large portion of the population is worried about incentivizing people to not work. Whether or not that is a valid concern is up for debate, but it's definitely the main driver why programs like this in the US rarely get funded.

Worrying about incentivizing people not to work is one thing, but i think a larger part of that concern is people worrying that somebody else is getting something for free when they have to pay for it.

Free-housing programs are seen as unfair by people who have to pay for their housing. If you take half the $16k that gets spent on policing and cleaning up after a homeless person and spend that on providing housing for them instead, somebody who works a minimum wage full time job and spends the same amount out of their own pocket on housing is going to be rightfully annoyed. Which inevitably brings us around to the basic income debate.

Re: How Utah Reduced Chronic Homelessness

#133

Post by otterley » Fri, Mar 17, 2017, 6:48 PM UTC

Consultant32452 wrote: post #113

Joof wrote: post #67

Earlier quoted context omitted.

Hasn't worked for single payer healthcare yet. Nobody brings up that almost every other country's government pays less than the US.

If you're a wealthy person anywhere in the world and you have a really terrible disease you're probably going to come to the US to get care. Why? Because we have the highest quality healthcare in the world. There's a reason why there was some mild drama over Danny Williams (Premier of Canadian province) hopped the border to have heart surgery in the US. We're the best. What we lack is healthcare access for the poor.…

Single-payer health care establishes a floor, not a ceiling of coverage. That in itself is a reason to do it, because it reduces overall costs due to the amortization effect of preventive medicine that people have a right to access.

Single-payer coverage doesn't necessarily dry up the market for private insurance, either. Citizens of Canada and other countries have access to additional coverage that covers faster access to medical care and more expensive procedures. So yes, you can have your cake and eat it, too, if you set things up right.

Re: How Utah Reduced Chronic Homelessness

#134

Post by DanBC » Fri, Mar 17, 2017, 6:48 PM UTC

Consultant32452 wrote: post #113

Joof wrote: post #67

Earlier quoted context omitted.

Hasn't worked for single payer healthcare yet. Nobody brings up that almost every other country's government pays less than the US.

If you're a wealthy person anywhere in the world and you have a really terrible disease you're probably going to come to the US to get care. Why? Because we have the highest quality healthcare in the world. There's a reason why there was some mild drama over Danny Williams (Premier of Canadian province) hopped the border to have heart surgery in the US. We're the best. What we lack is healthcare access for the poor.…

> Why? Because we have the highest quality healthcare in the world.

If we ignore the fact that the US is in the 10 OECD nations with lowest life expectancy.

There's a bunch of over-testing, over-diagnosis, and over-treatment in the US. These make customers feel like they're getting good service, even though they're being harmed by it.

Re: How Utah Reduced Chronic Homelessness

#135

Post by Consultant32452 » Fri, Mar 17, 2017, 6:50 PM UTC

and0 wrote: post #130

Consultant32452 wrote: post #113

Earlier quoted context omitted.

If you're a wealthy person anywhere in the world and you have a really terrible disease you're probably going to come to the US to get care. Why? Because we have the highest quality healthcare in the world. There's a reason why there was some mild drama over Danny Williams (Premier of Canadian province) hopped the border to have heart surgery in the US. We're the best. What we lack is healthcare access for the poor.…

I'd have to look into this, but I'd imagine the fact that the best doctors preside a.) in the richest country in the world with b.) the most lucrative health industry has a lot to do with the former as well as the latter. Danny Williams also claimed he traveled to the US to see a specific specialist, not because no one in his own province could do the surgery, although we can't know for sure. To make your arguments a…

>the most lucrative health industry

Yes, that's the whole point of my argument. We have the best because it's lucrative. The health care plans people tend to put forth to fix our system would make our healthcare system less lucrative.

>Danny Williams also claimed he traveled to the US to see a specific specialist, not because no one in his own province could do the surgery, although we can't know for sure.

Right, he went to where he believed the best specialist was. In the US.

> not take all that into consideration also seems disingenuous.

I didn't not take all that into consideration. In fact, it was the entirety of my consideration.

Re: How Utah Reduced Chronic Homelessness

#136

Post by vidarh » Fri, Mar 17, 2017, 6:53 PM UTC

grasshopperpurp wrote: post #116

Consultant32452 wrote: post #108

Earlier quoted context omitted.

I'm a libertarian that supports unions. If you can get enough of the labor force together to demand higher wages or better benefits, more power to you. I don't think the government should be involved in that. I'm even happy to support socialist style businesses where the workers share ownership. If someone can make that work and be successful/competitive? Awesome. Again, I just don't think the government has any busi…

Appreciate the response and POV. Based on the info you shared here, I think you're someone who could definitely work with more left-leaning people to find common ground, which is sadly missing from the people actually making decisions. My question would be: without government intervention, what incentive do mega corporations have to allow unions to continue? What prevents them from making their own rules, which preve…

It's noting that a significant factor in the creation of US-style right-wing libertarianism was an attempt by economically right-wing individualists to straddle the political left-wing gap by reaching out to left-libertarians on shared issues (left wing libertarianism pre-dates right-wing libertarianism by almost a century). E.g. Rothbard being a prominent example, with his "Left and Right - A Journal of Libertarian Thought":

https://en.wikipedia.org/wiki/Left_and_Right:_A_Journal_of_L...

Re: How Utah Reduced Chronic Homelessness

#137

Post by edavis » Fri, Mar 17, 2017, 6:53 PM UTC

mabbo wrote: post #42

The 'Housing First' model was really pushed hard by Stephen Harper as Prime Minister of Canada. It was weird because he is such a staunch right-wing kind of guy, yet here he was putting money towards what seems like a very left-wing socialist idea. But he, like Lloyd Pendleton in this article, apparently figured out that it saves a lot of money, ideology be damned. Maybe that's a good example of how to get right-wing…

> Maybe that's a good example of how to get right-wing politicians to agree to some left-wing ideals: prove that it will save money and let them lower taxes.

I think this is a fine approach for the left to take, as long as the moral foundation is never sacrificed.

In other words, it should always be "we should do this because it's the right/moral/dignified thing to do (and if it saves money too, great)" rather than "we should do this because it saves money." Because what if new research comes out saying it _doesn't_ save money?

(See https://www.currentaffairs.org/2017/02/even-when-it-doesnt-s... for a more fleshed out version of this argument.)

Re: How Utah Reduced Chronic Homelessness

#138

Post by JustSomeNobody » Fri, Mar 17, 2017, 6:55 PM UTC

mabbo wrote: post #42

The 'Housing First' model was really pushed hard by Stephen Harper as Prime Minister of Canada. It was weird because he is such a staunch right-wing kind of guy, yet here he was putting money towards what seems like a very left-wing socialist idea. But he, like Lloyd Pendleton in this article, apparently figured out that it saves a lot of money, ideology be damned. Maybe that's a good example of how to get right-wing…

Now, how do you get a left-wing politician to agree to some right-wing ideals?

I mean, just to be fair, right?

Re: How Utah Reduced Chronic Homelessness

#139

Post by Forbo » Fri, Mar 17, 2017, 6:55 PM UTC

nsnick wrote: post #25

austenallred wrote: post #8

I'm confused by this. My brother has an office in downtown SLC near the Rio Grande building, and it's pretty clear when I visit him that there are hundreds of homeless people living in that neighborhood alone. Pioneer Park is also covered in homeless people. If that is less than 200 people either I don't understand what "homeless" means or something is... off. How does one define "chronic homelessness?" I really want…

Salt Lake City has a lot of seasonal homeless, people who come for the summer and leave for the winter. Seasonal homeless are not counted as chronic homeless. There are no homeless people anywhere else in the state so the ones you see in Salt Lake are it. Not all panhandlers are homeless. Most of the homeless in Salt Lake City seem to disappear at night. There are no massive homeless camps like you see in San Francis…

The homeless population in Provo is starting to become more visible, particularly around University & Center. I've encountered a few tent encampments around the city, as well as witnessed people sleeping overnight in Provo's Pioneer Park (Center & 5th West, not to be confused with SLC's Pioneer Park).

Edit: I just remembered a city ordinance was passed specifically in response to the tent camping. I'll see if I can dig up a link for reference. Many homeless advocacy groups were quite upset with the decision.

Edit 2: Found an article. This is much more recent that the OP article, which dates from 2015.

http://www.sltrib.com/home/4976771-155/provo-city-ordinance-...

Re: How Utah Reduced Chronic Homelessness

#140

Post by Consultant32452 » Fri, Mar 17, 2017, 6:56 PM UTC

otterley wrote: post #133

Consultant32452 wrote: post #113

Earlier quoted context omitted.

If you're a wealthy person anywhere in the world and you have a really terrible disease you're probably going to come to the US to get care. Why? Because we have the highest quality healthcare in the world. There's a reason why there was some mild drama over Danny Williams (Premier of Canadian province) hopped the border to have heart surgery in the US. We're the best. What we lack is healthcare access for the poor.…

Single-payer health care establishes a floor , not a ceiling of coverage. That in itself is a reason to do it, because it reduces overall costs due to the amortization effect of preventive medicine that people have a right to access. Single-payer coverage doesn't necessarily dry up the market for private insurance, either. Citizens of Canada and other countries have access to additional coverage that covers faster ac…

>That in itself is a reason to do it, because it reduces overall costs due to the amortization effect of preventive medicine that people have a right to access.

Reducing the over-all cost isn't necessarily the only goal. One goal could also be to have the highest quality care in the world, which we have today.

>Single-payer coverage doesn't necessarily dry up the market for private insurance, either.

Comparing the private insurance industry in the US and Canada or UK is laughable. The fact that it exists is not the same as saying it isn't dried up.