By NextBestFitKeep social programs separate
Fund housing and food programs directly, not through health care.
Draft decision:RejectedConfidence: low · not yet reviewed
Health-budget pilots chosen instead.
Review ledgerHow this path connects
This path
Keep social programs separate
Concrete changes if chosen
What would actually have to change in law, agencies, payment rules, or systems.
- Fund housing and food programs directly
Effects
Each effect has its own page: the evidence, the case that it is or isn't a real cost, and whom it affects.
What it fixes
- Housing, food, and transportation drive health, but health care isn't designed for them
Direct funding gives housing and food agencies clear responsibility for work they know. It avoids stretching health budgets with nonmedical spending.
What it creates or worsens
- Solves only part of the problem
Funding housing and food outside health care leaves the health system unable to act directly when a patient’s housing is making them sick.
- Adds paperwork, coordination, or complexity
Separate housing, food, and health programs depend on coordination across agencies, which is weak in the United States.
Who's affected
Who gains
- Low- and middle-income households
- Housing, food, and transportation drive health, but health care isn't designed for them: Health systems lack tools and funding to address social conditions shaping their health.
- People experiencing homelessness
- Housing, food, and transportation drive health, but health care isn't designed for them: Health systems lack tools and funding to address social conditions shaping their health.
- Taxpayers and public budgets
- Housing, food, and transportation drive health, but health care isn't designed for them: Direct funding gives housing and food agencies clear responsibility for work they know. It avoids stretching health budgets with nonmedical spending.
Who loses
- People experiencing homelessness
- Solves only part of the problem: Funding housing and food outside health care leaves the health system unable to act directly when a patient’s housing is making them sick.
Other ways to soften the losses
- Fund social workers in clinics to connect patients with outside programs
Where it has been tried
- Most European countries: Strong social programs outside health.