Tuesday, September 29, 2015

The difference between health care and housing policy, and why I'm inflexible on the latter

This was written in response to a friend's comment on facebook.  Published here because I hate reading long comments on facebook.

I think there are two big differences between our discourse on housing policy and that with health care.

First, the external context for the latter was much more objectively defined.  Health care had been the topic of extended national debate.  There was tremendous literature on health care reform, from academics to journalists and everyone in between.  Many of those people were self-consciously working to inform public debate, people like Aaron Carroll and Uwe Reinhardt put a lot of work into translating research results and policy discussion into layman's terms.  You and I could draw on that, it wasn't just "I think…".  Finally, when we began discussions the ACA was law, we never dealt with mutually exclusive choices where doing one thing necessarily implied not doing something else.  We also never confronted value choices like universal coverage vs. affordable care for the very sick, the ACA set the table.

None of that is the case with housing policy.  I find the literature sparse and of limited scope, and the only people promoting it in public discourse are advocates of one policy or another.  There's nothing objective to connect with.  And with that material we confront a vaster problem, the gulf between "what is" and "what should be" is bigger with housing.  For example, even before health care reform we had  backstops, anyone could walk into an ER and receive life sustaining care.  We didn't have bodies in the street.  That's clearly not the case with housing.  A bigger problem means bigger solutions, and more variability in preferred courses of action.

The second difference is that with health care, I thought both the state and the country were going in the right direction.  Political debate was focused on how best to expand access to care, there was no voice of significance arguing that we needed less access to care, or that some people should get care and others should not.  I'd liken health care discourse to a river that, while it had rocks and other hidden dangers that could turn over the unwary, would sooner or later get everyone to the right place.  In contrast, I think the housing discourse in Portland is headed to a terrible place. 

Two groups have dominated that discourse in recent years.  One is a large chunk of people interested in nothing other than preserving the economic exclusivity of their neighborhoods.  The other is a smaller chunk of people who think the problem isn't that there's not enough housing, but that the wrong people get it.  They want to take housing away from some people and give it to others.  Those two groups define political discourse in Portland, every code or policy proposal related to housing since Sam Adams left office served one group or the other.  Needless to say, I think both groups are wrong.  To go with the flow, to not contest the bogus assumptions (less housing means lower prices!  people can't live without cars!) and questionable values (I should be able to dictate the economic class of my neighbors!) they rely on, is to accept a more racially and economically exclusive Portland.  I don't want that.

At the bottom, I suspect we have fundamentally different ideas on what a community should do to define itself. I'd call one way a negative approach, to exclude those who don't conform.  How do you maintain a neighborhood of Amish people?  You refuse to allow residency to anyone who isn't Amish.  That negative approach is conservative and reactive, at best it preserves what is.  It relies on authority rather than consent.  It is sterile, incapable of building anew.

As you might guess, I think the negative approach is intensely undesirable, I'd go so far as to say it's a recipe for community self-destruction.  Such a community lasts only so long as it attracts sufficient members, and as soon as its authority or self-definition is violated it becomes meaningless.  White city neighborhoods that spilled blood resisting integration only to crumble away into suburban flight are an example.

The alternative is a positive approach, to promote public community institutions and traditions that are open to all.  Things like parks, schools, and community groups can include residents regardless of demographics.  They can demonstrate to residents what they can do, and why they should care.  That approach creates a two-way conversation, it continually challenges groups to show their relevancy and adapt as necessary.  It doesn't just maintain but increases the public good by bringing an interest to people who wouldn't otherwise be exposed to it, and in turn by being exposed to new ideas and challenges that exclusion wouldn't allow.

I think the positive approach, building more good, is what Portland desperately needs.  I think that's how Portland should respond to growth.  Not by putting up walls, but by embracing people and showing them who we are.

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