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The City of Palliative Care

jayriverlong.github.io

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Re: The City of Palliative Care

#2
With a spouse that works in palliative medicine, I really wish the author had chosen a different phrase. Please don’t get the idea that palliative care is only for the dying. Everything else about the article is spot on.

Re: The City of Palliative Care

#3

With a spouse that works in palliative medicine, I really wish the author had chosen a different phrase. Please don’t get the idea that palliative care is only for the dying. Everything else about the article is spot on.

Sorry, I wasn't aware of that. I was under the impression that palliative care is (at least generally) end-of-life comfort for the dying. I wish I had chosen a more appropriate term.

Re: The City of Palliative Care

#4
> To get to this number, I averaged the number of annual homeless in San Francisco since 2013, which is 6,864, and averaged the city’s homeless budgets from 2016 through 2023 (I could not find prior budgets), which is $486 million per year. That’s $632,000 per homeless person per year

No, that's $486M/6864 = $70,800 per homeless person per year. It's only after multiplying by the 9 years she lived in SF do you get $630k. It's a lot, and probably poorly spent, but probably only 10x what is reasonable.

Re: The City of Palliative Care

#5

> To get to this number, I averaged the number of annual homeless in San Francisco since 2013, which is 6,864, and averaged the city’s homeless budgets from 2016 through 2023 (I could not find prior budgets), which is $486 million per year. That’s $632,000 per homeless person per year No, that's $486M/6864 = $70,800 per homeless person per year. It's only after multiplying by the 9 years she lived in SF do you get $6…

Sorry, that was a typo on my end. I'll push a fix momentarily. (Do note that the math for $630k over 9y was right.)

Re: The City of Palliative Care

#6
“The city is way too easy for people with nothing to get by,” she said. “That’s why I’m still here nine years later. You get by with doing drugs and suffer no consequences. I like it here.”

No doubt, chronic homelessness is a problem in San Francisco. And there's truth in this quote, from a fentanyl-addicted homeless person.

But I hesitate to base my entire view on the situation from a hot take of conversation with someone deep into drug abuse. They will feed the addiction first, and only then go on to address their other needs.

The article leaves me wanting to hear from people in recovery. Perhaps they are harder to find. Or perhaps (even more likely) I misread the article.

Nevertheless, I hang on to the real money quote:

The bitter joke of the story is that in San Francisco, the mother works full-time, drains her savings, but still can’t make ends meet and is forced to move away.

Re: The City of Palliative Care

#7

With a spouse that works in palliative medicine, I really wish the author had chosen a different phrase. Please don’t get the idea that palliative care is only for the dying. Everything else about the article is spot on.

It’s quite offensive, as somebody who nearly died from sepsis (a couple of months ago), like the drug user in the article, but for different reasons. In my case it was from an infected portacath, that was carelessly flushed during routine maintenance and care.

Also, I cost more, on a per year basis, than the individual in the article, as I require an orphan drug and will for the rest of my life.

I am American but fortunately live abroad so I don’t have to put up with people writing BS narratives and stories that “link” arbitrary statistics together, which people with economics backgrounds tend to do. All in all, this is clickbait.

The solution to the “problem” in the article is houses, regardless of drug usage status.

Re: The City of Palliative Care

#8

With a spouse that works in palliative medicine, I really wish the author had chosen a different phrase. Please don’t get the idea that palliative care is only for the dying. Everything else about the article is spot on.

Sorry, I wasn't aware of that. I was under the impression that palliative care is (at least generally) end-of-life comfort for the dying. I wish I had chosen a more appropriate term.

It’s ok, not the first time someone has gotten that impression about palliative care. It’s something that my spouse has to constantly reinforce with her patients and their families. Thanks for sharing the article. The point you’re making is important.

Re: The City of Palliative Care

#9

> To get to this number, I averaged the number of annual homeless in San Francisco since 2013, which is 6,864, and averaged the city’s homeless budgets from 2016 through 2023 (I could not find prior budgets), which is $486 million per year. That’s $632,000 per homeless person per year No, that's $486M/6864 = $70,800 per homeless person per year. It's only after multiplying by the 9 years she lived in SF do you get $6…

70k per year is less than we spend keeping someone in prison, which is where many people believe we should put drug addicts. The truth is it’s not about the money, people just don’t want to see other people suffering where they live.

As a society, even spending all this money, we are failing to help some of our most vulnerable citizens. It’s quite telling that conversations about social safety nets always become about money rather than reducing harm effectively.

Re: The City of Palliative Care

#10

> To get to this number, I averaged the number of annual homeless in San Francisco since 2013, which is 6,864, and averaged the city’s homeless budgets from 2016 through 2023 (I could not find prior budgets), which is $486 million per year. That’s $632,000 per homeless person per year No, that's $486M/6864 = $70,800 per homeless person per year. It's only after multiplying by the 9 years she lived in SF do you get $6…

Sorry, that was a typo on my end. I'll push a fix momentarily. (Do note that the math for $630k over 9y was right.)

A point in time count isn’t a good denominator to understand cost per person given an annual budget.

This article sheds some light: https://missionlocal.org/2019/07/in-san-francisco-we-obsess-...

> the Department of Homelessness itself applies a multiplier of 2.89 to the PIT count to estimate how many individuals are homeless not just on one day but throughout the entire year.

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