What are hospitals for? I admit, that’s kind of a silly question. Hospitals are for healing the sick and keeping the healthy, well, healthy. Hospitals are there for moments of crisis and hospitals are filled with people who care about the sick or injured and who have dedicated their lives to the service of others. Hospitals are places of healing and hope.
Oh, and housing.
A recent Colorado Politics story examined how Denver Health and other hospitals are, against their will, being forced to become housing agencies for far too many patients. The article notes that by law and of course by morals, hospitals cannot discharge patients that do not have a safe place to go. Thus, the patient with dementia whose family refuses to take him back must remain “hospitalized” rather than turned out into the street. You can already guess the manifold impacts of such situations. A hospital bed is occupied that could be used (and likely is needed) for a truly ill or injured individual. The patient with mental illness is not likely to be paying anything for his or her care, while in the ER, patients in need of a bed wait for one to open up. The article noted that one person at Denver Health had occupied a bed for more than four years, for want of a place to go. This costs you and me more money, while also impacting our ability to get timely health care.
Hospitals are not the only type of agency to be impacted by caring for the mentally or physically ill. A 2006 Department of Justice study found that at that time, 64 percent of local jail inmates, 56 percent of state prison inmates, and 45 percent of federal prisoners had serious mental illness problems. I doubt things have improved much in the intervening years. Thus, many truly mentally ill individuals are unable to get the treatment they need, treatment that might make the rest of us safer upon the criminal’s release.
Whose fault is all of this? Well, no one in particular, but also all of us. I suspect most of these problems come down to money, in some way or another. Hospitals that cannot legally discharge a homeless patient must find a way to make ends meet, and thus healthcare costs continue to rise. Local governments find little support for building new jails, which include facilities to provide better care for sick inmates. As with so much, it often comes down to dollars and common sense.
I recall a few years ago, when I was the county chair for the El Paso County Democrats, I attended a debate between candidates for local office. I observed the Dem candidate detail an extensive plan to reform how our county was spending money. The Republican incumbent had only one point to make — I’ve kept your taxes low. Literally, he claimed only that one thing, that the voters paid less for local government than anywhere else, because he cut the services that the county government offered. Now, good people with good hearts can disagree on which approach is the best one, but the GOP tactic seems much more likely to increase the challenges noted above, instead of mitigating them.
Back when I worked for Colorado U.S. Sen. Michael Bennet, I remember being shocked (the first time at least) when a veteran, just released from county jail, came to see me in hopes of getting better mental health care for his PTSD, which had led, he claimed, to his criminal activity. He showed me his release paperwork from the county jail, and I was amazed to see that the form listed his “release address” as, I kid you not, “under the bridge at I-25 and Cimarron.” How could he apply for help, let alone a job, with such a “home address?”
As always, I have no solutions to offer. I’d suggest that we should stop thinking of lowering taxes as the only goal of government. I’m willing to be taxed to help reduce, say, veteran homelessness. In Denver, such a pitch may work with voters. In my hometown, Colorado Springs, not so much.
In the long run, I suspect having facilities to care for the hospital patient in need of a safe discharge destination and the inmate in need of mental health would be cheaper. But certainly, in the short term, there would be additional costs. As a veteran myself, I am often thanked for my service. I’d like to gently suggest that rather than thank vets, it would be far more meaningful to fund halfway houses and other such facilities for those in need.
I have no doubt that most people are good people. Perhaps it’s time for that basic goodness to win out and to say it’s ok to pay some additional taxes to help those in need? Perhaps a good place to start would be to support Prop CC? Alas, that last one must await a future column.
Hal Bidlack is a retired professor of political science and a retired Air Force lieutenant colonel who taught more than 17 years at the U.S. Air Force Academy in Colorado Springs.