Getting our house in order: the false competition between the homeless and the refugees.

I’m seeing a whole lotta nonsense out there about how it is morally reprehensible to go offering help to refugees when we have so many homeless. Leave aside that the people bitching the loudest are also the same people who tell us not to give to the poor because it “enables them” to buy booze or whatever they deem unworthy of the “lower classes”. Also probably the same people trying to cut food stamps and whatnot. Let’s just say the credibility of people who say, “but but but HOMELESS VETS” or “HUNGRY CHILDREN” is not high with me because I suspect they care very little for either, truly.

The fact of the matter is that if we got our shit together and did the things that science and research and public policy data say are the most effective at caring for people, we could actually solve a whole bunch of problems and spend less money than we spend now.

I’m not exaggerating. I’m not making shit up here. This is well supported by data.

1. “Homeless people here should get our resources, not homeless people from overseas!”

Many places in the US are currently experimenting with providing the chronically homeless with housing and case management as a way to help keep people out of the overstressed, overused legal system. Why pay thousands of dollars on a public defender to get a guy off from a robbery charge that stems from them finding an open door and sleeping in a warm building rather than out in the cold, when you could spend hundreds of dollars on rent for a small apartment?

For more on this, see Politifact.

So from that data, and rounding for the sake of easy math since no one has really accurate current figures, say, conservatively, that it costs $40,000 to keep a homeless person on the street in various services/jail/etc. And it costs about $20,000 to house them. That’s a ballpark, some people might be more expensive to house, but they’d probably be more expensive on the street too. So we build housing for all the homeless, Oprah style! You get a home! And you! And you!

HUD says that there were about 600,000 people homeless in their 2013 report. Of those, almost 400,000 were in some kind of temporary shelter. So even though it is probably true that giving them permanent shelter would be cheaper, we’ll say VERY conservatively, that we just housed 200,000 people. It used to cost $40,000 (ish) per to keep them homeless. To punish them for being poor, or mentally ill, or simply incapable of the kind of executive function that it takes to adult well enough to stay housed, by jailing them and restricting access to health care to overworked emergency departments.

Now it costs $20,000 to put them in an apartment and give them a case manager and access to other resources (that are also more efficient than the emergency room, etc.)

I don’t even have to add it up to realize that if we’re saving as much as it costs to keep one person in basic housing, then every single homeless person we house is one refugee we can afford to help.

House 200,000 homeless people and with the money we save we can help 200,000 refugees. The high estimate for the US is about 185,000 in the next couple years. We currently have a few thousand from Syria.

2. BUT WHAT ABOUT THE CHILDRENNNNNNN?

I’m a parent. I’m biased. But I’m biased not because I’m a parent but because I’m a human being and I live in this country and I like having well educated people around me who aren’t starving. Oh wait, that’s not bias, or even privilege talking, that’s compassionate self-interest. I want the people who live here to have access to education and food. You can’t separate the two, because it is impossible to learn when your basic needs are not met.

I used to take a lot of tests in high school and I was really good at taking tests. Like amazing at it. My mom joked that I never seemed to hear very well right up until someone gave me a hearing test, but because it was a test I got 100%.

I took one test my senior year where I placed in the 50th percentile instead of the 97-99th percentiles. Why? Because I spent the entire test REALLY HAVING TO PEE. It was incredibly distracting. Luckily it was one test that didn’t really matter all that much in the grand scheme of things. Just one test.

Ever try to concentrate when you were really hungry? When you were super stressed due to your home situation for some reason? That’s a lot more than one test. That’s an entire education down the tube. Kids feel the effects of hunger even worse than adults, and learning is more vital to them. Nourish a child in their formative years and provide them access to education, and they will do better on every possible indicator. They’ll stay in school longer. They’ll have babies later. They’ll do fewer drugs. They’ll do less crime. They’ll be more likely to go to college, get a job, pay taxes and support you in your dotage. Good deal, no? Educate the crap out of people, it’s worth it. Countries who provide better support for children, better support for education, cheaper or free college, better medical care (I’ll get to that) spend less than we do for those things with far better results. And they’re taking in more refugees than we are. They live longer, their babies and mothers die less, they get fewer abortions even if the abortions are legal. They have fewer babies. Which is a complex social issue I’ll get to in a minute.

But more, we know what happens when children are not valued, when education is not well supported. When food is not readily available. In the short term, crime goes up. Life gets “cheaper” and not in a good way. More girls and women are raped. (More boys and men, too, in many places, but no one talks about it enough to have clear data.) And people get desperate.

Fanaticism, cruelty and totalitarianism can come out of two major driving forces… fear, and desperation.  Those two things can be created by actual events and real dangers, or they can be politically manufactured via propaganda. Make a populace hungry enough, take away their power, their hope, their voice, and they will be afraid and desperate and ready for anyone who offers them a glimmer of hope to lead them.

Or… you can grind away at them in small ways and then convince them that someone worse off than them is going to take what they have, and you can manufacture the same emotions. This is why people keep harping on income inequality as a driving force for social upheaval. People who are afraid and desperate, for whatever reason, tend to go into survival mode, and in survival mode, a whole lot of the things that make us civilized seem a lot less important. And leaves the door open for regime change and political movements which wouldn’t stand a chance with a more educated and secure population.

This is why people who want to be in charge try to make you afraid of people who are different from you.

It’s bullshit. Yes, there are bad people in the world. Evil exists, I’ve seen it.

But in a place of fear, people forget how to count. They lose the ability to accurately evaluate risks and benefits. They are remarkably open to people who yell loudly about danger, because human beings who are in fight, fly or freeze mode are uniquely primed to listen to people who sound like they know what the solution is. It’s evolutionary. And in this case, wildly unhelpful.

Which brings us to the last part I’ll address here about getting our collective shit together on these topics. (There’s far more to discuss but it is late and I’m tired.)

3. Health care. We waste vast resources on health care. We could get far better health care for everyone, citizen, immigrant, refugee, rich, poor, literally EVERYONE if we made two major sea changes in our public funding efforts. The first is to shift to single-payer health care. But the way this works best, the way we don’t have so many wait lists and problems accessing care? Is if there are sufficient doctors and nurses, and that means making it a hell of a lot easier to go to medical or nursing school. College needs to be free. Medical school needs to be free, not all the way up through the specialties, except in shortage areas. You need more people in emergency medicine and fewer in plastic surgery? You make people pay to get to the point of the plastic surgery specialty and you make an emergency medicine specialty free, and give people better pay for working in an emergency room.

(While you’re at it, change medical school and the practice of medicine to make sure doctors and nurses get enough sleep. Because we deserve rested care providers, and lots of people don’t go into medicine because they don’t like the idea of being that tired all the time. I certainly know I”m not up to it, and I’d be an awesome medical researcher if the hours were better.)

Why does this save money? Well, for one thing, all those doctors coming out of medical school aren’t saddled with enormous student debt AND they don’t have to hire three billing people instead of one part-timer, because instead of dealing with 60 different insurance plans across five or ten or twenty insurance companies, they’re dealing with one. They know how much everything reimburses. They KNOW they’ll get paid, because literally everyone gets paid for. And you’ll have a lot more people available to go become doctors and nurses because they won’t be working for the damned insurance companies. More students equals more teachers, look, we replaced tons of those lost jobs with new jobs in a related field! The competition to get into nursing school is fierce in my area, yet there’s a huge shortage of nurses. So open some more schools while you’re at it, and make them all free of tuition. All the undergrad programs should be free. Whether or not a graduate program is tuition free, or how high the tuition is, might depend on the actual need for people in those professions…. Pay the teachers better, and you get better teachers. Make becoming a doctor or nurse less of a pain in the ass, and you get more people becoming doctors or nurses.

I’m not poor. I’ve got outstanding insurance compared to most people who don’t get it through their employer. And I still end up waiting hours in the ER, or months for a doctor’s appointment. I can afford them, because I can afford a premium that makes those things affordable. But even with the Affordable Care Act, there are still people struggling to go to the doctor even when they have insurance because high deductibles mean people are afraid to actually use that insurance. It is better than it was, but still utterly broken, and we spend way too much money. If we spent our money differently, for less money we could have more access to health care, and that saved money could go a long way towards easing shortages of health care professionals, while completely stopping the vicious upward spiral of of student loan debt. Our current system quite literally cripples us and leaves us unable to imagine being able to help. We need to think out of the box we’ve been coaxed, pushed and lied into, and start thinking about what actually needs to happen to make things better.

Better health care for everyone. Housing for the homeless. Food for the hungry. Safety for those in danger. We don’t just live in our country, we live on a very large planet, and we can and have been profoundly affected by allowing people elsewhere to suffer without hope. We don’t have to fix the whole world, but if we start fixing the broken things, while it might be temporarily expensive, in the long run we will reap rewards on every level.

Kids who are not worried about where they will sleep or where their next meal will come from can pay better attention in class and learn more.

Kids who learn more are better able to learn lessons like “If you work hard and stay in school, you could become a doctor or nurse or engineer or teacher some day.”

Kids who have proper health care miss fewer days of school. Food and housing help them stay healthy too.

Kids who know they can afford to college don’t give up as easily in high school.

They don’t have as many babies when they’re super young.

Fewer babies are born premature. Lowering the percentage of babies born premature saves upwards of a million dollars per baby. It doesn’t take much of a reduction to have a huge fiscal impact on medicaid.

When you take away the stress of “Can I pay for college” and ‘What if I get sick” people are much better able to make long term plans, start businesses, hire more people, and the economy improves.

A better economy can easily support those refugees you’re feeling so stingy about.

One more thing. It may sound like cold equations or brutal math, but people forget the real numbers here.

Most terrorist attacks are relatively small. They hurt dozens of people. Paris and 9/11  were outliers, Paris at over 100 and the WTC at about 3000. Paris was actually a large number of smaller attacks.

What if people are right, and by letting refugees in, we let in terrorists?

Say we let in 100,000 in the next year, and in that year there is one Paris-sized attack where 100 people or so die? Roughly 85 people die from guns in the US per day. Maybe we let in 200,000, and in 5 years there’s another 9/11 sized attack? 3000 people in 5 years? Is far, far less than the 11,000+ who will be murdered with guns, on average, in a single year.

And that is beside the point. If we let people in, we may lose a relatively small number of people. It could be someone you know. It could be a family member or a loved one. But the chances are very, very low in a country this size, that it would be that personal to you, the individual reader.

If we send them back or alienate them to go back…. we can be sure that many, many more than that will die. Already, so many have.

If people are forced to return to a country in which ISIS, a totalitarian, fanatic terrorist organization is in charge, they will join or they will suffer. ISIS wants us to turn them away. They probably will try to sneak people through, simply to put fear in our hearts. But the thing you forget when you fear the refugees? They also sneak people through in other ways. We can focus so hard on “protecting” what is “ours” and “protecting our own” that we completely miss that by allowing people to be hungry, homeless and hopeless anywhere, we allow fear and desperation to take root, and ISIS and similar organizations have made significant efforts at recruiting locally, in ways that are much harder to detect.

Make it better here so people don’t turn to the voice that yells the loudest. Help people have the resources they need to get out of survival mode and into a place where they can thrive.

It will never, ever diminish us to help others and treat them with basic kindness, humanity and compassion.

We cannot prevent every disaster.

But it is within our means, within our ability to get our house in order if we can find the political will to do so.

And that’s not going to happen if we huddle in our individual little piles of resources and shoot anyone who reaches for a discarded crust.

Reach out. Say yes. Say, “Be my neighbor.” Say, “We all deserve health care. We all deserve shelter. We all deserve food. We all deserve an education.”

There is so much more to living than those things. Making those things guaranteed in no way limits us from the endless opportunity of human endeavor. It simply stops a whole bunch of unnecessary waste and opens the doors, for real, for everyone.

It will be okay. We are all in this together. You lose nothing helping someone. With the correct application of wit and will, helping someone can help us all.

 

PS. About the fewer babies thing… So birth rates are dropping. They’re dropping the most in younger women due to wide availability of contraception. When people can choose when to have their children, they tend to have fewer children, and they tend to be able to afford them better. Good deal! But… because of how our country pays for social security, the system relies in great part on current workers to pay the pensions of those who paid in earlier. Their money went to the ones who were before then. The thing that bolsters our population so that we don’t actually lose population when enough people are well educated and have access to adequate health care, including birth control?

Immigration. Refugees aren’t immigrants in the traditional sense, btw, but for this purpose and the numbers we’re talking about it kind of matters. Only kind of, because we used to have about 4 million babies born per year, and that number dropped for a long time during the recession (as it does) and has only recently rebounded a little bit. But not enough, we aren’t reproducing at a replacement rate anymore. But we really don’t need the population of the US to drop. We have enough room. We have plenty of food, just inefficiently distributed. We make up the difference in immigration, which means that those refugees everyone is so worried about? Yeah, it will be money out for a few years, but in the long run we will be greater for the influx. Which is actually not as much as we really need to keep our population level stable, but it’s a start.

It’s not that there’s no danger, or no cost… it’s that the alternative is more dangerous and more costly.