House The Homeless, Inc.

P.O. Box 2312

Austin, Tx

78768-2312

(512) 796-4366

info@housethehomeless.org

 
 
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 miniscule 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)
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 previous Texas legislative sessions, we fashioned bills 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
NOTE on DOMESTIC VIOLENCE: House the Homeless believes that if
alcohol is the bomb then economics is the fuse.
www.UniversalLivingWage.org
 
 
To Read More On Alcohol Issues/Hearings Click On Image Below!
 
 

 
 
 

 
The following is temporarily under construction!