New York City had 250,000 people who were homeless at some point in the last five years, but only 2,500 were chronically homeless. And it's these 2,500 who cost the most--New York City spends $62 million per year on these 2,500 chronically homeless. The health bills alone are staggering:

The University of California, San Diego Medical Center followed fifteen chronically homeless inebriates and found that over eighteen months those fifteen people were treated at the hospital’s emergency room 417 times, and ran up bills that averaged $100,000 each.

It's so hard because the standard answers of soup kitchens and shelters don't make much difference to the chronically homeless. We treat the symptom but we're not curing the problem. We're managing homelessness, but not solving it.

Sometimes causes require radical new thinking if we want to do more than put a band aid on a mortal wound. And sometimes radical new thinking isn't fair or deserved. It might be a solution that doesn't make us feel as good as ladeling bowls of soup. But the solution is what matters. The cause is king. Not our feelings or the status quo or the tidy answer. It's not always what you think.