The Point in Time homelessness count is the most important data that has been produced in Los Angeles this year. LA County saw a 12% increase from 2018, meaning that 58,936 of our neighbors are sleeping without permanent shelter on any given night. LA City was worse, seeing a 16% increase with 36,300 of our neighbors living without permanent shelter. These increases came despite gains in housing people. Our leaders are pushing sweeps as the solution, when what our neighbors need are services.
Our housing crisis is killing us.
The evidence is everywhere. On Skid Row in Los Angeles, 14,000 homeless persons were arrested in 2016, including for urinating in public and other “quality of life” offences, while overall arrests in the city were declining. For those wondering what the problem is, the answer is not hard to find. In 2016 there were only nine public toilets available for some 1,800 homeless individuals on Skid Row. The resulting ratio of one public toilet per 200 individuals would not even meet the minimum standards the UN sets for Syrian refugee camps. – Philip Alston, UN Special Rapporteur on extreme poverty and human rights
In 2018, Los Angeles was able to house more than 21,000 people. This is a big increase over 2017 when 17,000 people were able to transition into housing. But this isn’t enough to keep up with the number of people who are losing housing.
This crisis has a body count. 918 people died on the streets of LA last year. That’s 2.5 people per day. In the span of your work day one person will die, needlessly.
Living without shelter guarantees that you will have contact with the police. Overall crime and arrests have dropped in the last decades. Except for people without housing. Arrests of the unhoused increased 30% in 2018. Overall, LAPD made 14,000 arrests of unhoused Angelenos in 2018. To make matters worse, 30% of LAPD’s uses of force were against people who have no place to live.
The city of LA has a population of about 4 million. 36,300 (at the minimum) live without permanent shelter. That’s 0.9% of our population. And yet LAPD targets them for harassment, violence, and arrest more than anyone else.
Race plays an outsized role in this crisis. Black Angelenos are about 11% of the city’s population, but 38% of those without permanent shelter. This mirrors the racialized policing tactics that we see across the city. LAPD is far more likely to arrest or kill someone if they are black than any other demographic.
Instead of offering help, our politicians play the blame game.
Sensational headlines spanned the globe last year when a typhus outbreak was reported in downtown Los Angeles. Initial reporting linked the disease to large encampments around downtown, specifically the community of Skid Row. Despite the fact that this chain of events made no sense, politicians sprung into action to call for more sweeps, more harassment, and more arrests.
Once the initial shock wore off the real facts surfaced. Typhus infected fleas had infested city hall, carried by rats who took up residence because of LA’s poor maintenance of its own buildings. In fact LAPD was recently fined for failing to maintain a clean and safe office. At least one LAPD employee was sickened and one City Hall employee is suing the city because of her illness.
This “medieval” outbreak didn’t come from Skid Row, it came from City Hall’s negligence. But there is a public health crisis on the streets of LA. Tens of thousands of people are left without basic hygiene facilities. Showers, toilets, garbage pick up, food storage, basic first aid, clean clothes, laundry facilities; the list of needs goes on.
Philip Alston, the UN Special Rapporteur on extreme poverty and human rights, visited Los Angeles while studying homelessness in America. His report back to the UN is a scathing indictment of how LA is handling this crisis. Our lack of compassion is clearly visible in places that would not even meet the standards of refugee camps in war zones.
We demand services, not sweeps.
Los Angeles currently uses a complaint driven model that privileges people who own property over those who are unhoused. Using the city’s 311 system business owners, homeowners, and tenants can call to give the location of encampments and bulky trash. These calls trigger a multi-part process. First, the Bureau of Sanitation sends out a team to the location to confirm the report.
If they confirm an encampment, then the Los Angeles Homeless Services Authority (LAHSA) conducts outreach. This outreach is supposed to offer housing and health services, but result in very few placements in permanent or temporary shelter. A notice is posted in the area announcing that a sweep will happen sometime in the next 24 to 72 hours. Last, Bureau of Sanitation workers, accompanied by armed police officers, arrive to clean the area.
Reports from DSA-LA Streetwatch have shown that this model rarely matches reality. Sweeps can be unannounced. Often, the cleaning only serves to throw out people’s possessions, leaving the sidewalks unwashed. Private capital like scooters are left in place, despite blocking access and creating obstacles for ADA access.
When the targets of these sweeps complain they are threatened with arrest. If they have more possessions than can fit in a 60 gallon plastic bag, the police and sanitation workers will arbitrarily decide what they can keep. Tents are supposed to be left alone, but unattended tents will be thrown out. Sanitation workers will use discarded food as an excuse to declare a tent a health hazard, giving them cover to throw out someone’s only shelter.
Under an agreement with the federal courts in Jones v. Los Angeles, the city is supposed to make sure that they are not throwing out vital documents or medications. But we know that this happens all the time. Joe Reyes lived on the streets of Koreatown, where he worked odd jobs to earn money.
He was a longtime resident of the neighborhood before high rents forced him out of his apartment. While away from his tent, a sweep was conducted. Workers threw out his possessions, including medications that he needed for a heart condition. Two weeks later, Joe was dead from his heart issues.
This complaint driven model is inhumane and deadly. The City of Los Angeles, as well as every other city in the state, must adopt a service driven model.
But what does this model look like?
Showers, both permanent and temporary installed in areas with proven need.
Empty trash, much like you receive weekly trash pickup.
Restrooms, both permanent and temporary.
Vector control, to stop the spread of illness through rodents and insects.
Internet, access to communication and information are human rights.
Cleaning supplies, so that people can maintain their space and retain their dignity.
Electricity, to provide a basic standard of living.
Sharps containers, to keep individuals safe and provide basic medical access.
Until the city adopts a policy based on dignity and compassion people will die, every day. Police and sanitation workers are not qualified to offer assistance. Destroying possessions and making arrests further traumatizes people already under pressure. We know what will solve this crisis: housing and services.
At the state level, we see anemic solutions. Governor Brown pledged $300 million to homeless services, less than 15% of what LA County and LA City pledged under Measures H and HHH. Governor Newsom has empaneled a new commission that simply recreates work already being done. We need real solutions. There are simple steps that can be taken now to lessen the suffering.
Groups like Koreatown for All, Nolmypics LA, Shower of Hope, Invisible People, Los Angeles Community Action Network (LACAN), Ground Game Los Angeles, and too many others to name, are working on the ground now. They need the support of our government and they need our help to reclaim the narrative. Human dignity must come first.
Imagine universal healthcare in California.
What if you never had to pay to see a doctor? What if your medications were free at the point of sale? What if hospital bills were a thing of the past? That’s the promise of the Healthy California Act (SB 562), and that’s our promise too.
SB 562 is a groundbreaking idea. Everyone in California would be covered. Health conditions and immigration status would not be barriers to care. Families would save an average of $1,000 a month. Diabetics would no longer have to worry about getting insulin.
“Californians want a single payer system that puts patients’ health and wellbeing at the center not insurance industry profits.”
– Bonnie Castillo, National Nurses United
So what happened?
The Healthy California Act was introduced to the California Senate in February 2017 by Senators Ricardo Lara and Toni Atkins. California was not the first state to consider covering everyone under a state plan. Hawaii and Vermont both have laws that are effectively single payer healthcare. 17 other states are also considering single payer plans.
SB 562 would put an end to some of the most costly parts of our privatized system. It would end healthcare premiums, saving individuals and families thousands of dollars a year. It would end deductibles that force patients to chose between paying for care or paying the rent. It would guarantee access to medications that save lives.
Maternity and neonatal care would be available to every parent in the state, not just those wealthy enough to afford it. Patients would no longer need to wait for a crisis before seeking treatment. Preventative care and wellness would be guaranteed. Mental healthcare services would be open to everyone.
And by everyone we mean everyone: every person who lives in California would be covered regardless of health conditions or immigration status. Something that even the Affordable Care Act does not guarantee.
People were excited about the possibility of finally bringing relief to 40 million patients. Unions and advocacy groups immediately voiced their support for the idea. The California Nurses Association held rallies across the state and hit the road to spread the word that we would finally see a sane healthcare system. Politicians took to the airwaves to talk about how revolutionary this would be. Patients and caregivers hoped that they would no longer be burdened by high costs that ration care and shorten lives. It looked like we would witness history, as California would become the biggest state to take a stand against the insurance industry.
On June 1st, 2017 the California Senate voted 27 to 14 in favor of SB 562. This meant that the last hurdle the bill needed to clear was the Assembly.
“Which is to say that we will keep pressure on the coward Rendon until his office guarantees that 562 gets a real hearing next year, and barring that we will build the coalition necessary to get every Californian covered as soon as possible.” – KNOCK.LA
All that momentum was brought to a halt by Assembly Speaker Anthony Rendon. Rather than allowing our representatives to boldly voice their support for universal healthcare, he chose to shelve the bill. Rendon put the interests of insurance companies above the people of California. Insurance industry allies in Sacramento created excuse after excuse for this failure of leadership.
But that has not stopped the dream of universal healthcare. Doctors, nurses, and patients are still fighting for a system that puts people over profit, not just in California but across the country.
Right now hope is stalled in the state house. Nurses, patients, and caregivers are pushing for change, but our representatives aren’t hearing them. Twice California has failed to move the Healthy California Act towards a full vote, even though 70% of the country supports a single payer system.
Universal healthcare is in reach for California.
Nowhere else in the developed world does anyone pay so much for such poor results. Every day our neighbors suffer and die from curable and preventable illness simply because they cannot afford the exorbitant costs of treatment. We need a single-payer system, and we need it now.
“Anyone who has struggled with poverty knows how extremely expensive it is to be poor.” – James Baldwin
Healthcare should not be contingent on your income. Healthcare should not be contingent on your job. Healthcare should not be contingent on the whims of an insurance adjuster. Healthcare is a human right.
Healthcare must be free at the point of care. And healthcare must be universal.
The Affordable Care Act, or Obamacare, granted access to health insurance to millions of Americans. But the legislation was written by the medical insurance industry to protect themselves, not to help us.
Leaving health insurance in the domain of the “free market” is a deeply flawed solution. As long as the profit motive remains in healthcare, insurers will be motivated to skimp on care, deny coverage and drive up premiums and deductibles — hurting their patients at every stage. We must value people over profit. Always.
“…the uninsured rate in California dropped by nearly half, from 16% in 2013 to an all-time low of 9% in 2016. However, 2.9 million Californians remained uninsured.” – California Healthcare Foundation, 2018
The Affordable Care Act expanded coverage to millions of people, but it has done nothing to bring down prices. Year after year the state of California allows premiums to increase by double digits. In 2018 the average increase across the state was 12.5%, in 2019 it is estimated to be 9.7%.
Now, people are paying an average of $500 a month or $6,000 a year, just for coverage. Families are paying more than $1,000 a month. That doesn’t include deductibles or the cost of care. 10% of income is going into the pockets of health insurance bureaucracies.
“Over the past five years, the average annual deductible among all covered workers has increased 53%.” – Henry J Kaiser Family Foundation, 2018
High deductibles, co-pays, and the cost of treatment are also climbing, nearly doubling costs for anyone who has insurance.
This is impacting lives. If families are spending nearly $20,000 a year in premiums and deductibles, then they have no money left over to save for retirement or emergency expenses. Average workers are left with a dire choice: health or savings.
Many people are choosing to go without coverage altogether, leaving them with few options if they get sick. Instead of preventative care overseen by their primary doctor, they are forced to seek help in emergency rooms where bills easily reach thousands of dollars for one visit. Long term health suffers because people wait until they are in crisis. These costs continue to add up for patients and the state.
Meanwhile health insurance CEO’s are paid millions of dollars a year to oversee a system that is bankrupting families. And those profits are then used to protect their monopoly on our health by funding politicians to block a fair system. As long as our healthcare is privatized patients will suffer physically and financially.
“Four in 10 adults, if faced with an unexpected expense of $400, would either not be able to cover it or would cover it by selling something or borrowing money… Over one-fourth of adults skipped necessary medical care in 2017 due to being unable to afford the cost.” – US Federal Reserve, 2018
Many life saving drugs are also kept out of reach of patients, pharmaceutical companies hide behind patents to protect profits and insurance companies deny life saving medications because of the price.
The cost of insulin, a critical part of managing diabetes, nearly doubled between 2012 and 2016. There is absolutely no reason that any drug that has been in use since 1921 should ever double in cost, let alone doubling in just four years.
Image from the Health Care Cost Institute, 2019
We can choose to continue to tinker and tweak the system as it stands now, hoping for a future that is slightly better. Or we can choose the solution that has worked over and over in countries across the world: provide single-payer, universal healthcare for everyone.
With a single-payer system:
- We save an incredible amount of money
- Life-saving medication won’t be out of reach for those who need it
- Workers aren’t tied to jobs they don’t like by insurance they cannot afford to lose
- Families don’t go bankrupt because of serious illness — right now 42% of cancer patients exhaust their life savings within 2 years
- Small employers don’t have to worry about picking an insurance plan for their employees, or renegotiating those terms every couple of years
In truth, our country needs a federal Medicare For All plan like what Bernie has been championing for years. But we cannot afford to wait for Congress to solve this for us. California is the world’s fifth most powerful economy — we can afford to make the Healthy California Act a reality. We can show the rest of the country that a healthy future is possible.
Better and more preventative treatment reduces the risk of minor injuries turning into catastrophic woes. It’s time we joined the rest of the world in treating health as a public good, not a commodity to be traded for profit.
The costs of healthcare has a direct impact on issues like housing as Californians are squeezed by increasing costs on all sides.