19 ms·

America’s Largest Health Insurer Is Giving Apartments to Homeless People

167 points by SQL2219 7y ago

elil17 7y ago
This whole situation is just really messed up. What’s happening with this company is great, but we should not be in a position as a society where a homeless person can’t get housing until living on the street has made them so sick that it’s profitable for an insurance company to buy them an apartment. This particular solution is definitely a positive thing, it’s just a small bandage over a massive wound.
- claudeganon 7y ago
  The end stage of neoliberal technocracy is this kind of Rube Goldberg management of suffering.
ceejayoz 7y ago
How long before getting one of these requires accepting smart home monitoring of things like your medication compliance? "Our cameras caught you smoking, we're revoking your housing and your health insurance for lying about being a non-smoker."
- pjc50 7y ago
  Quite likely. People are very keen on this kind of thing for punitive reasons - being on the street will of course kill someone far quicker than smoking. "You have to give up smoking for the good of your health or we'll hasten your death" is the sort of thing Kafkaesque systems are built from.
  - ianai 7y ago
    Here’s hoping that’s not how it goes. But maybe blow back from that sort of homeless fleecing and privacy invasion would result in proper governmental homeless assistance. (But people currently have a high tolerance for privacy invasion so...)
    - pjc50 7y ago
      There's definitely a faction demanding more cruelty to the homeless; they routinely have their property taken and destroyed as a sort of extra-legal punishment for being homeless in the "wrong" place.
- asdfman123 7y ago
  "We're willing to help the homeless, but only if we're allowed to control them to satisfy our own mistaken notions of what helps people (and more subliminally, our egos)."
Gunax 7y ago
> This is just sad. This is just stupid,” Brenner says. “Why do we let this go on?” Because this is practically textbook definition of a perverse incentive. What about healthy homeless people? Do they get homes? We are encouraging people to be sick and to a abuse the ER. And what about all of the working poor who are doing the right thing, but still have to pay half of their income in rent? The reason we don't provide homes is you can never just provide homes to the ones who'would have abused the ER' but instead have to provide them to all homeless. Also, as sad as it is to admit, there is a portion of homeless who you could literally buy a house for, and they will still end up homeless. I hope I am wrong and this program works out.
- pjc50 7y ago
  > The reason we don't provide homes is you can never just provide homes to the ones who would have abused the ER' but instead have to provide them to all homeless. This is the exact reason more sensible systems do, in fact, try to provide homes to everyone. And various sorts of topup payments to those unable to afford their rent.
  - jonfw 7y ago
    > more sensible systems Can you give me an example of one of these systems?
    - ceejayoz 7y ago
      https://en.wikipedia.org/wiki/Public_housing_in_the_United_Kingdom https://en.wikipedia.org/wiki/Public_housing_in_the_United_K...
    - claudeganon 7y ago
      Social housing in the rest of the developed world? It’s more or less the norm relative to the US’ punitive deprivation.
    - nradov 7y ago
      Salt Lake City had that policy for a while, but funding is running out. https://www.reuters.com/article/us-usa-homelessness-housing/once-a-national-model-utah-struggles-with-homelessness-idUSKCN1P41EQ https://www.reuters.com/article/us-usa-homelessness-housing/...
munherty 7y ago
Im going to go against the grain here but I think it might be good to be able to get good data on homeless populations. Much data now is not accurate. At the very least this will provide key data points that could help resolve and better serve these populations
- DanTheManPR 7y ago
  One major issue with counting the number of people who are homeless is that most of them are not on the street, but are instead relying on friends and family for shelter. The people who live on the street are the spear tip of a much larger and broader group of people who are facing various degrees of crisis in finding housing. It is difficult to come up with a method that captures data about all the people who, for example, were evicted and spent several months living on couches and in their car.
  - papln 7y ago
    Why is that a major issue? The regular Census can capture information like "did you provide transient housing in the past year" , and "if you hae had a transient resident living with you, please contact XXXXX so we can directly include that person in the Census"
  - tathougies 7y ago
    Right, this is because the homelessness industry needs to justify its existence with ever inflated numbers. Someone down on their luck and staying with parents or siblings is not homeless and does not need intervention for shelter. In general, we should encourage extended family living as its economically easy and socially good. These 'homeless' need economic help, not shelter, and its likely that, due to their proximity to family or friends, this help can be provided in large part by the private sector as long as government policy encouraged the creation of jobs. Really, when civilians say homeless they mean what researchers call unsheltered, the subset of homeless living on the street. This group has much higher needs, typically around mental health and drugs
- smileysteve 7y ago
  There's a small portion of chronically homeless that don't want to be in any systems though; whether it's because they are paranoid, have a criminal history, have a debt or potential of, etc.
mc32 7y ago
Homelessness is not going to be fixed till it is addressed at the federal level. There are difficulties: there are different homeless population types characterized by Mental health, substance abuse, cost of living, unemployment, etc. Also because of a reaction to heavy handed policies of the past, it’s difficult to institutionalize those who need mental health intervention. That said we could at least tackle the easier population whose issue is an economic one.
- jvagner 7y ago
  I’m back in SF after a few years away. I had developed some thoughts about the homelessness challenges that Reno was facing, but when I landed in SF/Oakland it was immediately overwhelming, occurring on such a different scale and with such visibility. I have no solid ideas of what “we need to do” but I know that in the European cities I frequent, it’s not like this. Other comments in this discussion touch on the social infrastructure that we’ve forsaken... the things that cost money, require continuity and depth in the community, and which... in other cultures, seem reasonable and required for their humans. That said, I wonder about what the infrastructure looks like that helps people months before they hit the homeless force functions. There’s a funnel in the descent of resources... the homelessness activists can’t fix the infrastructure of social support and the economic cliff son many people teeter on. I just spent a couple of months traveling, living in quarters not my own. Had a very minor health issue that was difficult to treat outside of my home base. It was inconvenient, then challenging, then debilitating, and ultimately pretty deflating. I had the resources to fix things, but if I had been financially constrained, my confidence and autonomy and self-esteem could have plummeted to hard-to-recover levels. I could feel how vulnerable other people probably would have been. And I know my friends in other countries would’ve shaken their head and muttered something about our system here in the US.
  - rthomas6 7y ago
    When you consider that it costs over $3000/month for a single bedroom apartment, the local government prevents the building of high-rise buildings, and the climate is comfortable outdoors year-round, it makes sense. It will continue to be this way as long as high density low income apartment high rises are not allowed to be built in large numbers in west SF.
matheusmoreira 7y ago
> Brenner shows me data on a patient named Steve, a 54-year-old with multiple sclerosis, cerebral palsy, heart disease, and diabetes. No patient confidentiality?
- brewdad 7y ago
  Steve who? No PII has been compromised here. One would hope that "Steve" is a pseudonym but I wouldn't count on Bloomberg to do the responsible thing in this case.
  - ceejayoz 7y ago
    The combination of homelessness, first name, age, insurer, rough location, and a laundry list of major diseases is absolutely PII. https://dataprivacylab.org/projects/identifiability/paper1.pdf https://dataprivacylab.org/projects/identifiability/paper1.p... > It was found that 87% (216 million of 248 million) of the population in the United States had reported characteristics that likely made them unique based only on {5-digit ZIP, gender, date of birth}. About half of the U.S. population (132 million of 248 million or 53%) are likely to be uniquely identified by only {place, gender, date of birth}, where place is basically the city, town, or municipality in which the person resides. And even at the county level, {county, gender, date of birth} are likely to uniquely identify 18% of the U.S. population. In general, few characteristics are needed to uniquely identify a person.
  - matheusmoreira 7y ago
    How many 54-year-old Steves exist? How many of those have multiple sclerosis, cerebral palsy, heart disease, and diabetes at the same time? How many were homeless? I've seen people identify patients using far less information than that. It's a small world.
    - drewbug 7y ago
      Doesn't MS cause the rest of those?
- deleted 7y ago
hpoe 7y ago
Wait why are so many people shitting on this idea. This seems to me to be exactly what people are always comparing about, "big companies only care about the bottom line they don't care at all about suffering." Right here there is a private company trying to help ease the homeless problem and everyone is just shitting on them for not doing the way they think they should or are getting angry at them for making a profit on it. If we constantly dump on every person and company who makes any attempt to help address a social problem simply because it doesn't solve the whole problem or because they don't do it in the way we want or think is effecient, people are going to stop trying to do anything. Sure maybe this program didn't solve homelessness in Phoenix and maybe it didn't help significantly reduce the percentage of people that are homeless but you know whose life it did significantly help? Steve and every other person who got a home, so sure maybe this didn't change homelessness in America radically but it did radically change homelessness for those people.
- appleflaxen 7y ago
  Right here there is a private company trying to help ease the homeless problem That's not true: they are making an investment in housing, based on economical considerations, that they expect to cover by reducing the health liabilities of the covered individuals. I don't think this means that they should be shit on, or that the situation is bad. On the contrary: it looks like health externalities (homelessness) have been appropriately internalized, and it is enabling correct match-up between resources and needs. But it just sounds silly when you say they are "trying to help ease the homeless problem"
  - hpoe 7y ago
    Sure maybe their motive is economic rather than altruistic but to quote my mother "if it's stupid and it works it isn't that stupid" I mean Steve Jobs didn't care about anything but the profits when launching the iPhone but it was arguably a significant factor in getting us to the state where we are at today where pretty much everyone has an internet enabled smart phone. It just sometimes there is the group think on HN that all companies and big corporations are always evil and are some sort of malevolent force and so we can't give them credit for any good they do because they don't meet our moral standard. I mean that's like saying Lincoln's role in freeing the slaves was fundamentally evil because he didn't also extend everyone the same protections enshrined in the Civil Rights act. Ultimately in my years of software engineering I have become convinced that big huge grand programs are almost always bloated ineffective and full of bugs whereas most real value derives from incremental improvements.
arnonejoe 7y ago
UHC still made 12.68 billion net income in 2018. https://www.google.com/search?q=unitedhealth+net+income https://www.google.com/search?q=unitedhealth+net+income
- mk_net_safer1 7y ago
  A lot people become Homeless because of the high price of health insurance. That's ridiculous .
skizm 7y ago
I want all the insurance companies to get together and go a calculation and see if banding together and opening a nationwide series of no questions asked homeless shelters with meals would bring down their costs at all. They could each contribute an amount that was proportional to their market share or something similar. Off the top of my head I want to say it wouldn't be worth it, but if this article is accurate, and the costs for insurance companies are actually going down, then who knows.
- ianai 7y ago
  Conversely, if this helps one portion of the economy that greatly then it will surely benefit the entire economy even more - or at least equally. Precisely why I would say this should be a governmental system of bare essentials living and housing. Every dollar spent on people with nothing will be spent by those people and increase aggregate demand, economically, and health, at a societal level.
tehjoker 7y ago
This is the sort of thing Tim Faust talks about in the concept of health justice. If we move people into a single payer system that takes care of them long term, it will suddenly be obvious that we need to do more stuff like this as it's more expensive and stupid not to.
jawns 7y ago
Nitpick: Title should read "America's Largest Private Health Insurer." America's largest health insurer is the government, via Medicare, Medicaid, and similar programs. I'm interested in seeing how this corporate-funded/corporate-managed program compares to the many housing assistance programs that are funded by public funds or private donations. I'm sure there are plenty of businesses out there that already help fund such programs indirectly by donating to charities that run affordable-housing programs. But it will be interesting to see what happens when the businesses are running the programs directly, cutting out the nonprofits as a middleman. My somewhat pessimistic take is that any efficiencies that might be gained by applying more rigorous business methods will be offset by lack of domain knowledge and for-profit perspective -- seeing a homeless person as a problem to be solved rather than a person to be served. That said, I'm all for large corporations trying their best to address homelessness and housing insecurity, even if they do so imperfectly.
- azernik 7y ago
  To nitpick your nitpick - this "private" insurer is actually a government contractor, administering Medicaid for individual states. > The research and development lab for this experiment is a pair of apartment complexes in a down-at-the-heels corner of Phoenix called Maryvale. Here, Brenner is using UnitedHealth’s money to pay for housing and support services for roughly 60 formerly homeless recipients of Medicaid, the safety-net insurance program for low-income people. Most states outsource their Medicaid programs to private companies such as UnitedHealth, paying the insurer a per-head monthly fee—typically $500 to $1,000—to manage members’ care. The company’s 6 million Medicaid members produced $43 billion in 2018, almost 20% of total revenue. ... > To keep down costs and avoid the difficulty of running a health-care system, most states contract with UnitedHealth and its competitors to establish what are called Medicaid managed-care programs. In 2017, $264 billion, almost 50¢ of every Medicaid dollar, went toward care for the 54 million people on private Medicaid plans.
Animats 7y ago
"In 1986, Congress enacted a law to bar hospitals from turning away patients who are unable to pay. Any hospital with an emergency room that participates in federal health programs must evaluate and stabilize every patient who comes through the door, including those who are uninsured, indigent, addicted to drugs, or mentally ill." That's part of what pushed the price of health care up - huge numbers of people going to fully equipped emergency rooms for problems that could be handled by a GP or a nurse-practitioner. It's free health care for all, done all wrong.
shmerl 7y ago
Smart idea, that actually saves them money.
carapace 7y ago
Dr.: "Hello, Mr. Smith, here's your Rx: one home." If that's the reframe it takes, more power to ya. It's uneconomical to let the homeless remain homeless. Such a blindingly simple fact.
gok 7y ago
I could have guessed it was UnitedHealthcare before I clicked the link. Maybe instead of buying apartments they could spend a little money on their billing system, which has literally fucked up every single medical expense I've ever had.
solidsnack9000 7y ago
This actually makes a lot of sense. A large insurer is in a position to actually see the end-to-end costs and since they are regulated in such a way as to have to pay them, this turns out to be the best way to run their company.
EricE 7y ago
What a brilliant idea - focus on prevention and not just putting the fire out. It makes far too much sense to ever gain popularity - and whoops, I just looked at the majority of comments in this thread and am not disappointed :(

167 points by SQL2219 7y ago

This whole situation is just really messed up. What’s happening with this company is great, but we should not be in a position as a society where a homeless person can’t get housing until living on the street has made them so sick that it’s profitable for an insurance company to buy them an apartment. This particular solution is definitely a positive thing, it’s just a small bandage over a massive wound.

claudeganon 7y ago
The end stage of neoliberal technocracy is this kind of Rube Goldberg management of suffering.

ceejayoz 7y ago

How long before getting one of these requires accepting smart home monitoring of things like your medication compliance? "Our cameras caught you smoking, we're revoking your housing and your health insurance for lying about being a non-smoker."

pjc50 7y ago
Quite likely. People are very keen on this kind of thing for punitive reasons - being on the street will of course kill someone far quicker than smoking. "You have to give up smoking for the good of your health or we'll hasten your death" is the sort of thing Kafkaesque systems are built from.
- ianai 7y ago
  Here’s hoping that’s not how it goes. But maybe blow back from that sort of homeless fleecing and privacy invasion would result in proper governmental homeless assistance. (But people currently have a high tolerance for privacy invasion so...)
  - pjc50 7y ago
    There's definitely a faction demanding more cruelty to the homeless; they routinely have their property taken and destroyed as a sort of extra-legal punishment for being homeless in the "wrong" place.
asdfman123 7y ago
"We're willing to help the homeless, but only if we're allowed to control them to satisfy our own mistaken notions of what helps people (and more subliminally, our egos)."

Gunax 7y ago

> This is just sad. This is just stupid,” Brenner says. “Why do we let this go on?” Because this is practically textbook definition of a perverse incentive. What about healthy homeless people? Do they get homes? We are encouraging people to be sick and to a abuse the ER. And what about all of the working poor who are doing the right thing, but still have to pay half of their income in rent? The reason we don't provide homes is you can never just provide homes to the ones who'would have abused the ER' but instead have to provide them to all homeless. Also, as sad as it is to admit, there is a portion of homeless who you could literally buy a house for, and they will still end up homeless. I hope I am wrong and this program works out.

pjc50 7y ago
> The reason we don't provide homes is you can never just provide homes to the ones who would have abused the ER' but instead have to provide them to all homeless. This is the exact reason more sensible systems do, in fact, try to provide homes to everyone. And various sorts of topup payments to those unable to afford their rent.
- jonfw 7y ago
  > more sensible systems Can you give me an example of one of these systems?
  - ceejayoz 7y ago
    https://en.wikipedia.org/wiki/Public_housing_in_the_United_Kingdom https://en.wikipedia.org/wiki/Public_housing_in_the_United_K...
  - claudeganon 7y ago
    Social housing in the rest of the developed world? It’s more or less the norm relative to the US’ punitive deprivation.
  - nradov 7y ago
    Salt Lake City had that policy for a while, but funding is running out. https://www.reuters.com/article/us-usa-homelessness-housing/once-a-national-model-utah-struggles-with-homelessness-idUSKCN1P41EQ https://www.reuters.com/article/us-usa-homelessness-housing/...

munherty 7y ago

Im going to go against the grain here but I think it might be good to be able to get good data on homeless populations. Much data now is not accurate. At the very least this will provide key data points that could help resolve and better serve these populations

DanTheManPR 7y ago
One major issue with counting the number of people who are homeless is that most of them are not on the street, but are instead relying on friends and family for shelter. The people who live on the street are the spear tip of a much larger and broader group of people who are facing various degrees of crisis in finding housing. It is difficult to come up with a method that captures data about all the people who, for example, were evicted and spent several months living on couches and in their car.
- papln 7y ago
  Why is that a major issue? The regular Census can capture information like "did you provide transient housing in the past year" , and "if you hae had a transient resident living with you, please contact XXXXX so we can directly include that person in the Census"
- tathougies 7y ago
  Right, this is because the homelessness industry needs to justify its existence with ever inflated numbers. Someone down on their luck and staying with parents or siblings is not homeless and does not need intervention for shelter. In general, we should encourage extended family living as its economically easy and socially good. These 'homeless' need economic help, not shelter, and its likely that, due to their proximity to family or friends, this help can be provided in large part by the private sector as long as government policy encouraged the creation of jobs. Really, when civilians say homeless they mean what researchers call unsheltered, the subset of homeless living on the street. This group has much higher needs, typically around mental health and drugs
smileysteve 7y ago
There's a small portion of chronically homeless that don't want to be in any systems though; whether it's because they are paranoid, have a criminal history, have a debt or potential of, etc.

mc32 7y ago

Homelessness is not going to be fixed till it is addressed at the federal level. There are difficulties: there are different homeless population types characterized by Mental health, substance abuse, cost of living, unemployment, etc. Also because of a reaction to heavy handed policies of the past, it’s difficult to institutionalize those who need mental health intervention. That said we could at least tackle the easier population whose issue is an economic one.

jvagner 7y ago
I’m back in SF after a few years away. I had developed some thoughts about the homelessness challenges that Reno was facing, but when I landed in SF/Oakland it was immediately overwhelming, occurring on such a different scale and with such visibility. I have no solid ideas of what “we need to do” but I know that in the European cities I frequent, it’s not like this. Other comments in this discussion touch on the social infrastructure that we’ve forsaken... the things that cost money, require continuity and depth in the community, and which... in other cultures, seem reasonable and required for their humans. That said, I wonder about what the infrastructure looks like that helps people months before they hit the homeless force functions. There’s a funnel in the descent of resources... the homelessness activists can’t fix the infrastructure of social support and the economic cliff son many people teeter on. I just spent a couple of months traveling, living in quarters not my own. Had a very minor health issue that was difficult to treat outside of my home base. It was inconvenient, then challenging, then debilitating, and ultimately pretty deflating. I had the resources to fix things, but if I had been financially constrained, my confidence and autonomy and self-esteem could have plummeted to hard-to-recover levels. I could feel how vulnerable other people probably would have been. And I know my friends in other countries would’ve shaken their head and muttered something about our system here in the US.
- rthomas6 7y ago
  When you consider that it costs over $3000/month for a single bedroom apartment, the local government prevents the building of high-rise buildings, and the climate is comfortable outdoors year-round, it makes sense. It will continue to be this way as long as high density low income apartment high rises are not allowed to be built in large numbers in west SF.

matheusmoreira 7y ago

> Brenner shows me data on a patient named Steve, a 54-year-old with multiple sclerosis, cerebral palsy, heart disease, and diabetes. No patient confidentiality?

brewdad 7y ago
Steve who? No PII has been compromised here. One would hope that "Steve" is a pseudonym but I wouldn't count on Bloomberg to do the responsible thing in this case.
- ceejayoz 7y ago
  The combination of homelessness, first name, age, insurer, rough location, and a laundry list of major diseases is absolutely PII. https://dataprivacylab.org/projects/identifiability/paper1.pdf https://dataprivacylab.org/projects/identifiability/paper1.p... > It was found that 87% (216 million of 248 million) of the population in the United States had reported characteristics that likely made them unique based only on {5-digit ZIP, gender, date of birth}. About half of the U.S. population (132 million of 248 million or 53%) are likely to be uniquely identified by only {place, gender, date of birth}, where place is basically the city, town, or municipality in which the person resides. And even at the county level, {county, gender, date of birth} are likely to uniquely identify 18% of the U.S. population. In general, few characteristics are needed to uniquely identify a person.
- matheusmoreira 7y ago
  How many 54-year-old Steves exist? How many of those have multiple sclerosis, cerebral palsy, heart disease, and diabetes at the same time? How many were homeless? I've seen people identify patients using far less information than that. It's a small world.
  - drewbug 7y ago
    Doesn't MS cause the rest of those?
deleted 7y ago

hpoe 7y ago

Wait why are so many people shitting on this idea. This seems to me to be exactly what people are always comparing about, "big companies only care about the bottom line they don't care at all about suffering." Right here there is a private company trying to help ease the homeless problem and everyone is just shitting on them for not doing the way they think they should or are getting angry at them for making a profit on it. If we constantly dump on every person and company who makes any attempt to help address a social problem simply because it doesn't solve the whole problem or because they don't do it in the way we want or think is effecient, people are going to stop trying to do anything. Sure maybe this program didn't solve homelessness in Phoenix and maybe it didn't help significantly reduce the percentage of people that are homeless but you know whose life it did significantly help? Steve and every other person who got a home, so sure maybe this didn't change homelessness in America radically but it did radically change homelessness for those people.

appleflaxen 7y ago
Right here there is a private company trying to help ease the homeless problem That's not true: they are making an investment in housing, based on economical considerations, that they expect to cover by reducing the health liabilities of the covered individuals. I don't think this means that they should be shit on, or that the situation is bad. On the contrary: it looks like health externalities (homelessness) have been appropriately internalized, and it is enabling correct match-up between resources and needs. But it just sounds silly when you say they are "trying to help ease the homeless problem"
- hpoe 7y ago
  Sure maybe their motive is economic rather than altruistic but to quote my mother "if it's stupid and it works it isn't that stupid" I mean Steve Jobs didn't care about anything but the profits when launching the iPhone but it was arguably a significant factor in getting us to the state where we are at today where pretty much everyone has an internet enabled smart phone. It just sometimes there is the group think on HN that all companies and big corporations are always evil and are some sort of malevolent force and so we can't give them credit for any good they do because they don't meet our moral standard. I mean that's like saying Lincoln's role in freeing the slaves was fundamentally evil because he didn't also extend everyone the same protections enshrined in the Civil Rights act. Ultimately in my years of software engineering I have become convinced that big huge grand programs are almost always bloated ineffective and full of bugs whereas most real value derives from incremental improvements.

arnonejoe 7y ago

UHC still made 12.68 billion net income in 2018. https://www.google.com/search?q=unitedhealth+net+income https://www.google.com/search?q=unitedhealth+net+income

mk_net_safer1 7y ago
A lot people become Homeless because of the high price of health insurance. That's ridiculous .

skizm 7y ago

I want all the insurance companies to get together and go a calculation and see if banding together and opening a nationwide series of no questions asked homeless shelters with meals would bring down their costs at all. They could each contribute an amount that was proportional to their market share or something similar. Off the top of my head I want to say it wouldn't be worth it, but if this article is accurate, and the costs for insurance companies are actually going down, then who knows.

ianai 7y ago
Conversely, if this helps one portion of the economy that greatly then it will surely benefit the entire economy even more - or at least equally. Precisely why I would say this should be a governmental system of bare essentials living and housing. Every dollar spent on people with nothing will be spent by those people and increase aggregate demand, economically, and health, at a societal level.

tehjoker 7y ago

This is the sort of thing Tim Faust talks about in the concept of health justice. If we move people into a single payer system that takes care of them long term, it will suddenly be obvious that we need to do more stuff like this as it's more expensive and stupid not to.

jawns 7y ago

Nitpick: Title should read "America's Largest Private Health Insurer." America's largest health insurer is the government, via Medicare, Medicaid, and similar programs. I'm interested in seeing how this corporate-funded/corporate-managed program compares to the many housing assistance programs that are funded by public funds or private donations. I'm sure there are plenty of businesses out there that already help fund such programs indirectly by donating to charities that run affordable-housing programs. But it will be interesting to see what happens when the businesses are running the programs directly, cutting out the nonprofits as a middleman. My somewhat pessimistic take is that any efficiencies that might be gained by applying more rigorous business methods will be offset by lack of domain knowledge and for-profit perspective -- seeing a homeless person as a problem to be solved rather than a person to be served. That said, I'm all for large corporations trying their best to address homelessness and housing insecurity, even if they do so imperfectly.

azernik 7y ago
To nitpick your nitpick - this "private" insurer is actually a government contractor, administering Medicaid for individual states. > The research and development lab for this experiment is a pair of apartment complexes in a down-at-the-heels corner of Phoenix called Maryvale. Here, Brenner is using UnitedHealth’s money to pay for housing and support services for roughly 60 formerly homeless recipients of Medicaid, the safety-net insurance program for low-income people. Most states outsource their Medicaid programs to private companies such as UnitedHealth, paying the insurer a per-head monthly fee—typically $500 to $1,000—to manage members’ care. The company’s 6 million Medicaid members produced $43 billion in 2018, almost 20% of total revenue. ... > To keep down costs and avoid the difficulty of running a health-care system, most states contract with UnitedHealth and its competitors to establish what are called Medicaid managed-care programs. In 2017, $264 billion, almost 50¢ of every Medicaid dollar, went toward care for the 54 million people on private Medicaid plans.

Animats 7y ago

"In 1986, Congress enacted a law to bar hospitals from turning away patients who are unable to pay. Any hospital with an emergency room that participates in federal health programs must evaluate and stabilize every patient who comes through the door, including those who are uninsured, indigent, addicted to drugs, or mentally ill." That's part of what pushed the price of health care up - huge numbers of people going to fully equipped emergency rooms for problems that could be handled by a GP or a nurse-practitioner. It's free health care for all, done all wrong.

shmerl 7y ago

Smart idea, that actually saves them money.

carapace 7y ago

Dr.: "Hello, Mr. Smith, here's your Rx: one home." If that's the reframe it takes, more power to ya. It's uneconomical to let the homeless remain homeless. Such a blindingly simple fact.

gok 7y ago

I could have guessed it was UnitedHealthcare before I clicked the link. Maybe instead of buying apartments they could spend a little money on their billing system, which has literally fucked up every single medical expense I've ever had.

solidsnack9000 7y ago

This actually makes a lot of sense. A large insurer is in a position to actually see the end-to-end costs and since they are regulated in such a way as to have to pay them, this turns out to be the best way to run their company.

EricE 7y ago

What a brilliant idea - focus on prevention and not just putting the fire out. It makes far too much sense to ever gain popularity - and whoops, I just looked at the majority of comments in this thread and am not disappointed :(