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House
The Homeless, Inc.
P.O.
Box 2312
Austin,
Tx
78768-2312
(512)
796-4366
 Series Three HEALTH CARE/SUBSTANCE ABUSE
This
is the third installment of a four part series dealing with
homelessness in North America. In the first installment, we looked at
the national trend to criminalize homelessness in the 1990's and the
need to create a Protected Class and the need to pass a Protected
Class Resolution which would safeguard homeless citizens. In the
second installment, we examined an economic response and the need to
pass a Universal Living Wage as a means to enable people to work
themselves off the streets of America and access at least the
cheapest form of independent housing.
In
this installment, we explore another major aspect of
homelessness....Health Care. Until recently, our nation housed our
homeless mentally ill in large institutions that were cold to the
human touch. With the advent of psychotropic drugs such as Lithium
and Prozac, many felt that an appropriate response to
institutionalization and the retraction of mental health social
service dollars across the country was to close these
"monster" institutions and treat these citizens on an
out-patient basis. Unfortunately, the result has been no less than
disastrous. Almost a 1/4 of todays' national homeless population is
comprised of persons with serious mental health problems.
In
the past few years, there have been only minuscale model outreach
programs in a few select cities such as Fort Worth and Austin, Texas
whereby concerned, dedicated mental health professionals have
literally ventured out to the parks, bridges and byways in an effort
to reconnect with this population. The success of their model
projects has only pointed to the need to further these efforts and
expand their capacity. Unfortunately, the federal financial
involvement in these programs has ended this year, leaving this work
to the individual states to complete. Thus far, individual states are
overwhelmed with the prospect of mustering any kind of effective
response. This is coupled with the urban shift in the late 1990's to
criminalize homelessness and use our criminal justice system as a way
to respond to this population by housing these citizens in our local jails.
Physical
Health
In
the late 1990's, as our country experiences boom times, we have
again begun to retract dollars from our health clinics in the name of
"fiscal responsibility." The fiscal reality of this
adjustment is anything but cost effective. We continue to use and
abuse hospital emergency rooms to serve our homeless medical needs,
but even then it is only after their physical problems have
deteriorated to the point of very serious and costly need for medical
attention. In 1997, it was reported in Austin, Texas that the
Brackenridge Emergency Room was abused in this fashion to the tune of
4 million dollars. One would think that this alone would be a winning
argument for more clinics and more preventative health care. In fact,
a 1997 Rand Corporation study relating to health care surrounding
substance abuse treatment, reported that money spent on treatment was
ten times more effective than law enforcement and twenty-three times
more effective than suppression programs. And yet, the hospitals have
found it convenient to write this expenditure off as the "cost
of doing business."
This
strategy is neither good long term health care nor is it good
business practice. The process is not only extremely costly, but it
is also abusive to its patrons--the homeless and the citizens
comprising the poor communities of America. So the issue becomes how
we can fund good long term substance abuse preventative and treatment
programs that are both cost effective and beneficial to those we serve?
Our
Proposal Is Simple: We believe that the alcohol businesses
themselves can and should provide the solution to this piece of our
nations national health care problem.
The
alcohol business is a multi-billion dollar industry recognized to be
legitimate. In fact, we are a nation of imbibers. We drink and
"toast" to one another as we come into this world and we
drink to salute those that leave. We drink to our successes and drown
our sorrows when we lose. We drink to celebrate and we drink to
commiserate. Alcohol is part of the very fabric of our lives....of
our nation....the world. However, neither when we enter that bar nor
when we leave that liquor store are we asked to succumb to a blood
alcohol test that will indicate that we are one of those few
individuals who will have a very strong negative reaction to alcohol
consumption and as a result, should not consume the product. And yet,
there will be those of us who are either allergic or incapable of
consuming alcohol without it tearing apart the very fabric of our
lives. We believe that the alcohol industry is welcome to its
profits. However, it should take responsibility for those persons who
have a serious negative reaction to their products.
To
this end, House The Homeless, Inc. has devised enabling local
legislation that will provide these protections. We can create an
entire medical health care system by adding what amounts to putting a
couple of extra pennies on each alcoholic drink for those of us that
suffer from the ill effects of alcohol. The legislation would enable
municipalities to set aside a percentage of all alcohol sales for the
specific purpose of creating substance abuse treatment programs. The
idea is to place this nominal fee at each point that alcohol changes
hands and someone profits from its sale. This spreads this minucule
burden throughout the industry thus drastically lessening any impact
on either the manufactures or distributors of these products. Local
city/county health departments would present their "Findings of
Need" to their local government during budget cycle. Example:
The health department might report that in a particular metropolitan
area that they have 3,000 citizens who have serious substance abuse
problems. Then based on the local industries gross receipts--
example: ($200,000 million) it will take .00135% increase
approximately less than a penny per product to fund 3,000
comprehensive substance abuse treatment slots based on the cost of
providing that service @ $9,000 per recovery event.
In
this very specific fashion, the industry does not pay one penny more
than is actually required to cover the preventative health care costs
necessary to help all persons (both housed and unhoused) who have a
negative reaction to their product!
Cost
Savings--Litigation
Consider
the cost savings to the alcohol industry. The alcohol businesses are
not unlike the tobacco businesses; except here, people are suffering
and dying from end organ diseases like pancreatic and kidney failure.
Thus far, the courts have allowed unbridled lawsuits against the
tobacco industry. Just in the past few weeks, a woman was awarded
$80,000,000 for the tobacco related death of her husband. While that
individual family surely suffered desperately, how does such an award
benefit society or even avoid the next lawsuit? Individual states are
suing for billions of dollars in an effort to recover the
astronomical medical expenses based on the treatment of these end
organ diseases. Similarly, President Clinton announced in the State
of the Union Address that he thinks the Federal Government should
line up in the suing frenzy of the tobacco companies. (The national
lawsuit has since been initiated and was filed on 9/20/99.)
Alternatively,
what if, for what amounts to, a couple of pennies on a beer, we
could create a specific health care program for those suffering
alcoholism and simultaneously avoid the lawsuits? Can you imagine the
courts response when a potential alcohol litigant asks to sue because
he/she is now dying from the disease of alcoholism? The court will
first want to know that has he/she availed themselves of the health
care programs. How sympathetic will the courts/juries be if someone's
response is that they failed to seek this free preemptive health care?
Futhermore,
while the tobacco industry is perceived as "public enemy
#1" and is receiving the nation's ire, by using this approach,
would not the alcohol industry become the "poster child" of
industry and heralded as a community partner? Would not the cost
savings to the industry be in the billions of dollars; while at the
same time, the savings in lives, families and work place hours
recovered be of equal or even greater value to our society? With so
many of the homeless persons suffering from some form of substance
abuse, wouldn't this permanent revenue stream also help us to make a
quantum leap forward in our efforts to deal with their medical needs?
The
Health Care concerns of our nations homeless citizens are varied and
extensive. However, we believe that they must and can be addressed as
outlined. The question remains, do we have the political will to work
for comprehensive solutions?
In
Unity There Is Strength,
Richard
R. Troxell
Board
of Directors Member, National Coalition for the Homeless
President-
House The Homeless, Inc.
Alcohol Personal Responsibility Bill (HB#3611) RECENT UPDATES
April 3, 2000
Tom Collamore
Vice President of Public Affairs
Phillip Morris Companies Inc.
120 Park Ave.
New York, NY 10017
Dear Sir:
Your efforts to support the National
Domestic Abuse Hotline are to be commended. We share your concerns
about abuse. It is well documented that alcohol is often the main
contributing factor in domestic violence. Alcohol and fine alcohol
products such as produced by your company, Miller Brewing Co., have
been enjoyed through the ages the world over. However, some people
have very negative medical responses to it. No one knows who will
experience these adverse reactions. Nonetheless, each year, the
results include DWIs, deaths, and a countless number of devastated
families. What if by placing one designated penny at each point of
sale per item we could create an entire medical health care system
for those citizens that suffer from the ill effects of alcohol? This
might be worth looking at.
Consider the cost savings to the alcohol
industry. The alcohol businesses are not unlike the tobacco
businesses where people are suffering and dying from end organ
diseases like cirrhosis of the liver and kidney failure. Thus far,
the courts have allowed unbridled lawsuits against the tobacco
industry. In April of 1999, a woman was awarded $80,000,000 for the
tobacco related death of her husband. While that individual family
surely suffered desperately, how does such an award benefit society
or even avoid the next such lawsuit? Individual states are suing for
billions of dollars in an effort to recover astronomical medical
expenses. Similarly, President Clinton announced in a State of the
Union Address that he thinks the Federal Government should line up in
the suing frenzy of the tobacco companies.
Alternatively, what if, for what amounts to,
a penny on a beer or mixed drink, we could create a specific health
care program for those suffering alcoholism and simultaneously avoid
the lawsuits? Can you imagine the courts response when a potential
alcohol litigant asks to sue because he/she is now dying from the
disease of alcoholism?
The court will first want to know if he/she
availed themselves of the health care programs. How sympathetic will
the courts/juries be if someone's response is that they failed to
seek this free, preemptive health care?
During the last Texas legislative session
your lobbyists spent over $6000,000 to advance your products. How
much was spent to help those that were hurt by them?
Furthermore, while the tobacco industry is
perceived as "public enemy #1" and is receiving the
nation's ire; by using this approach, would not your company become
the 'poster child' of industry and heralded as a community partner in
the same fashion that Smith and Wesson is now being praised? Would
not the cost savings to the industry be in the billions of dollars;
while at the same time, the savings in lives, families and work place
hours recovered be of equal or even greater value to our society?
In the last Texas legislative session, we
fashioned a bill that would:
"Enable
Texas municipalities to set aside a percentage of all
alcohol sales for the creation of
substance abuse treatment
programs for all Texans based on the
number of afflicted as
identified by local health departments."
The political climate is ripe for such an
initiative. A little over a year from now, the legislature
will meet again. The bill will be enhanced and receive more and more
support until it becomes a national mandate.
We invite Phillip Morris to initiate the
industry dialogue on this subject and to set the tone and course
suggesting the most appropriate outcome.
Sincerely,
Richard R. Troxell
President-House The Homeless Inc.Board Member- National Coalition for the Homeless To Read More On Alcohol Issues/Hearings Click On Image Below!
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