San Fransicko

1. The Progressive Paradox: Worsening Crises Despite High Spending

California has the highest income tax, highest gasoline tax, and highest sales tax in the United States, spends significantly more than other states on homelessness, and yet has worse outcomes.

High spending, poor results. Progressive West Coast cities like San Francisco, Los Angeles, and Seattle, along with California as a whole, spend exorbitant amounts on homelessness, mental illness, and drug addiction services. Despite this, these problems have dramatically worsened over the past two decades, contrasting sharply with declining homelessness rates in many other major U.S. cities. This paradox highlights a fundamental flaw in the progressive approach.

San Francisco's stark reality. San Francisco, for instance, spends $31,985 per homeless person annually on housing alone, compared to New York City's $11,662 and Los Angeles's $5,001. Yet, its unsheltered homeless population surged by 95% between 2005 and 2020, while New York's fell by 11%. The city also faces an overwhelming human waste problem, with complaints doubling from 2014 to 2018, and lampposts corroding from urine.

Beyond economic factors. While high housing costs and warm climates are often cited, they don't fully explain the crisis. Cities like Miami, Phoenix, and Houston, with similar climates and rising rents, have significantly lower per capita homelessness rates. The issue is not merely a lack of money or affordable housing, but rather how resources are allocated and the underlying policies governing social services and law enforcement.

2. The Failure of "Housing First" and the Neglect of Shelters

Housing First may even increase addiction and overdose deaths and make quitting drugs more difficult.

Unconditional housing's flaws. The "Housing First" model, which provides housing without requiring sobriety or mental health treatment, has been widely adopted by progressive cities and even federal policy. Proponents claim it's "enormously successful," but evidence suggests otherwise. A Santa Clara study found that while Housing First kept people housed, it did not reduce death rates among participants, leading to demoralization among staff.

Shelters are demonized. Advocates often oppose building more shelters, arguing that "unhoused people... are screaming for housing," not temporary shelter. This stance has led to a severe shortage of shelter beds in San Francisco, where only 43% of homeless individuals have access to shelter, compared to 95% in New York City. This deliberate choice leaves thousands unsheltered, exacerbating public health and safety issues.

Perverse outcomes. The lack of conditions in Housing First programs can enable continued substance abuse. Studies show no improvement in drug use among participants, and some research suggests that the privacy afforded by Housing First can even worsen addiction. In contrast, "contingency management," which links housing to sobriety and treatment compliance, has shown high rates of abstinence and better long-term outcomes.

3. The Harmful Illusion of Drug Decriminalization Without Mandatory Treatment

People are not dying from drug overdose deaths in San Francisco because they’re being arrested. They’re dying because they aren’t being arrested.

Decriminalization's deadly cost. Progressive drug policies, including decriminalization of hard drugs like meth and fentanyl (e.g., California's Proposition 47), have been implemented with the intention of treating addiction as a health issue, not a crime. However, without robust, mandatory treatment, these policies have inadvertently fueled a catastrophic overdose crisis. San Francisco's overdose death rate is 81 per 100,000 people, significantly higher than other major cities, and rose 61% in 2020.

Open-air drug markets. Decriminalization has led to the proliferation of open-air drug scenes in neighborhoods like the Tenderloin, where drugs are cheap and readily available. This environment, described by one addict's mother as "Pleasure Island," makes recovery nearly impossible. The city even funded billboards promoting "safe use" of fentanyl, further normalizing dangerous behavior.

Portugal's misunderstood model. While often cited by harm reduction advocates, Portugal's success with decriminalization is due to its "carrots and sticks" approach, which includes massive expansion of mandatory drug treatment and social pressure. In contrast, progressive U.S. cities offer harm reduction tools (like clean needles and crack pipes) without compelling treatment, leading to a "life support" system that keeps people alive but doesn't help them reclaim their lives.

4. The Crisis of Untreated Mental Illness: From Asylums to Jails

The tragic irony is that many of the people who had drawn attention to the poor conditions in mental hospitals had hoped to mobilize the public to increase funding for better care in them, not shut them down entirely.

Deinstitutionalization's unintended consequences. The closure of state mental hospitals, often attributed to Ronald Reagan but initiated earlier by Democrats and civil libertarians, was intended to provide more humane, community-based care. Instead, it led to "trans-institutionalization," with jails and prisons becoming the de facto mental health facilities. Los Angeles County Jail, for example, houses more mentally ill people than any hospital in the country.

Anti-psychiatry's legacy. Influential works like Michel Foucault's Madness and Civilization and Ken Kesey's One Flew Over the Cuckoo's Nest fueled an anti-psychiatry movement that demonized involuntary treatment. This ideology, embraced by civil liberties groups like the ACLU, has made it nearly impossible to compel seriously mentally ill individuals into care, even when they are a danger to themselves or others.

A system in crisis. California's Mental Health Services Act (Prop 63), funded by a tax on millionaires, raises over $2 billion annually for mental health, yet the state has a higher rate of mentally ill people in jails and on the streets than the national average. The severe shortage of psychiatric beds and the reluctance to use conservatorship or assisted outpatient treatment mean that many floridly psychotic individuals are left to suffer on the streets, often cycling between homelessness, emergency rooms, and incarceration.

5. Victimology's Perverse Incentives: Coddling Over Accountability

When society says, ‘Oh, these people who’ve had these bad things happen to them are victims, and we should feel sorry for them, and should do everything we can to help them,’ people come to learn that playing the role of the victim gets them favors.

The "victim" identity. Progressive discourse often frames homeless individuals, drug addicts, and the mentally ill primarily as "victims" of systemic issues like poverty, trauma, and racism. While these factors can contribute to hardship, this singular focus on victimhood can disempower individuals and create perverse incentives. Former addicts like Jabari Jackson and Vicki Westbrook emphasize personal responsibility and the dangers of being "spoiled."

Pathological altruism. This excessive compassion, termed "pathological altruism," can lead to policies that enable self-destructive behavior. By "centering" the voices of the "victims" and their advocates, progressive leaders often overlook the need for accountability and tough love. This dynamic is evident in the resistance to mandatory treatment and the acceptance of public disorder.

Shifting moral values. Moral Foundations Theory suggests that progressives prioritize "Caring" and "Fairness" (for victims) while often rejecting "Sanctity," "Authority," and "Loyalty" in traditional contexts. This selective application of values allows for the justification of behaviors incompatible with civic life, such as public drug use, while simultaneously shaming those who advocate for order and accountability.

6. Eroding Law and Order: The "Legalize Crime" Mentality

It makes no sense that the district attorney will tell you that he has more fear of a Honduran dealer’s family having challenges than a local family whose kid OD’d on fentanyl.

Decriminalizing disorder. Progressive district attorneys, like San Francisco's Chesa Boudin, have campaigned on platforms of not prosecuting "quality-of-life crimes" such as public camping, urination, and even drug dealing, labeling them "victimless crimes." This approach, driven by the belief that jails don't address root causes, has led to a dramatic increase in property crime and a sense of lawlessness.

Empowering criminals. The lack of consequences for petty crimes, and even more serious offenses, has emboldened criminals. Drug dealers operate openly, and repeat offenders are often released quickly, sometimes committing more violent crimes. One San Francisco judge even ruled that banning drug dealers from the Tenderloin would "violate the defendants’ constitutional rights," a decision applauded by the ACLU.

Undermining police legitimacy. The "defund the police" movement and constant criticism of law enforcement have demoralized police departments, leading to resignations and a retreat from proactive policing. This "Ferguson effect" creates a vacuum that criminals exploit, contributing to spikes in homicides and other violent crimes, disproportionately affecting the very communities progressives claim to protect.

7. The "Homeless Industrial Complex" and the Abdication of Leadership

I do not know of any community plan that actually details how to dismantle the existing homeless service system after homelessness has ended. Maybe, just maybe, we don’t really want to end homelessness.

A self-perpetuating system. Joel John Roberts, CEO of a major homelessness agency, critically observes that a large, financially motivated "homeless industrial complex" of service providers, developers, and advocates lobbies for increased funding, yet homelessness only worsens. This system, often characterized by unaccountable nonprofit service providers, lacks clear metrics for success and perpetuates the problem it claims to solve.

Political cowardice. Governor Gavin Newsom, despite acknowledging the crisis and its drivers (addiction, mental illness), has failed to implement meaningful reforms. His administration's fear of lawsuits from the ACLU and political blowback from powerful progressive interest groups prevents him from expanding mandatory treatment or challenging the "Housing First" dogma. This "leadership problem" leaves the state without a coherent strategy.

Fragmented and inefficient. California's approach is fragmented, with numerous county-level programs and nonprofit contracts, making it impossible to track spending or assess collective impact. Experts like Dr. Thomas Insel, Newsom's former mental health advisor, lament the lack of "state leadership" and the waste of billions of dollars on ineffective programs, suggesting that "money is not the problem."

8. Reclaiming Civilization: A Call for "Responsibility First" and Balanced Governance

Freedom is essential, but without order it can’t exist in cities. If we are not safe, if our cities are not walkable, then we don’t have a civilization.

Order for freedom. The progressive emphasis on individual liberty, particularly for those deemed victims, has led to a breakdown of public order in cities. True freedom in an urban environment requires a foundation of safety and order, which is eroded by unchecked public drug use, defecation, and encampments. A "Responsibility First" approach balances individual rights with civic duties.

Balanced moral vision. Drawing on Moral Foundations Theory, a new morality for cities must integrate values beyond just "Caring" and "Fairness." It must re-embrace "Sanctity" (for public spaces and the human body), "Authority" (of laws and institutions), and "Loyalty" (to the community). This balanced perspective allows for both compassion and the necessary enforcement of norms.

Tough love in action. Effective solutions, as seen in Amsterdam and in successful addiction recovery programs, combine "carrots and sticks." This means offering robust social services and treatment opportunities, but also imposing consequences for behaviors that harm individuals and the community. It's about helping people reclaim their lives, not just sustaining their addiction on the streets.

9. The Power of Social Norms and the Shame of Neglect

It was shameful to not pick up one’s dog’s poop before Milk made it shameful. It was shameful to be gay before he made it unshameful. It was shameful to inject hard drugs on sidewalks, and should be so again.

Shame as a social tool. Harvey Milk's "Scoop the Poop" law in San Francisco demonstrated the power of social norms and peer pressure in changing behavior. While shame can be misused, it is a vital mechanism for enforcing social norms and motivating individuals to maintain healthy relationships and civic order. Progressives have inadvertently normalized aberrant behavior by removing shame from actions incompatible with city life.

Re-stigmatizing harmful behaviors. The current progressive discourse, which seeks to destigmatize all drug use and public disorder, has had the opposite effect of dehumanizing individuals by allowing them to live in degrading conditions. Re-stigmatizing hard drug use and public defecation is not about shaming the person, but condemning the behavior that harms both the individual and the community.

Beyond victimhood. The "homeless" label itself is a political construct that conflates diverse individuals with different needs. A more accurate and humanizing approach requires recognizing the specific challenges of each person—whether it's severe mental illness, addiction, or temporary poverty—and tailoring interventions accordingly. This moves beyond a simplistic victim narrative to one that empowers individuals towards recovery and responsibility.

10. The Need for a New State-Level Authority: Cal-Psych

What California needs is a new, single, and powerful state agency. Let’s call it Cal-Psych.

Centralized, accountable care. To overcome the fragmented, inefficient, and unaccountable "homeless industrial complex," California needs a new, powerful state agency like "Cal-Psych." This entity would centralize mental health and addiction services, with a clear line of command and direct accountability to the governor, allowing for a coherent, statewide strategy.

Comprehensive, contingency-based model. Cal-Psych would:

• Expand psychiatric beds: Meet the California Hospital Association's standard of 50 beds per 100,000 people.
• Mandatory treatment: Utilize assisted outpatient treatment and conservatorship for the severely mentally ill and addicted, offering it as an alternative to jail.
• Immediate intervention: Offer drug treatment immediately to overdose victims revived by Narcan.
• Contingency housing: Provide a range of housing options (shelters, residential homes, converted hotels) on a contingency basis, where better housing is earned through sobriety and treatment compliance.
• Assertive casework: Employ caseworkers with a "whatever-it-takes" mandate, tracking clients and ensuring compliance with treatment plans.

Overcoming political obstacles. While some existing providers and civil liberties groups may resist, the overwhelming failure of the current system and strong public support for a balanced approach create an opportunity for this "perennial rebirth." Cal-Psych would represent a pragmatic, humane, and effective frontier for California, restoring dignity to its most vulnerable citizens and order to its cities.

Last updated: March 5, 2026