Quote: Harold Pollack on Housing and Medicaid

Read Harold Pollacks’s piece yesterday over at Wonkblog. He addresses some of the ways in which a more coordinated, multi-level assistance structure for “frequent-fliers”—patients, who are often destitute, in the health care system that make up a disproportionate share of spending—can, in some cases, be less-expensive than the status-quo. The following paragraph is one small part of his examination, which primarily focuses on housing. In my view it also shouldn’t be an accurate description of reality in a wealthy country.

[…] Such studies are important, since there isn’t enough supportive housing to go around. HUD budgets have taken a hit in recent years. America’s egalitarian and compassionate impulses are narrowly targeted to the domain of health — narrow to the point of self-defeating in serving such needy groups.

I am continually struck by this contrast. Patients secure impressive support from Medicaid when they need acute medical services. That’s as it should be. Yet it’s surprisingly hard and surprisingly controversial to provide more modest forms of help that are often more beneficial and cost-effective. In Chicago, it costs about $9,000 to house someone for a year in a plain but decent apartment. That’s less than the typical cost of one hospital stay. This $9,000 is hard to find.

The rest is well-worth reading, including the profiles of two people who’ve benefited from the type of care Pollack is highlighting. His advocacy strikes the right balance, I think, between evidence and empathy. As I’ve written in the past we need more verstehen, not only in how we approach the politics of poverty policy but in this case, perhaps, how we might think about the solutions. Which is to say; humanely and effectively.


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