Crowdfunding Is a Symptom Of America’s Sick Health Care System

“I nearly went to the hospital for the 22nd time in 7 months. As you can imagine this has depleted all of my money,” writes Tara. She continues: “My family has done so much and will help me once I’m there, but I need to move on my own…So look, I’m a responsible girl, I’ve been holding it down for 16 years while feeling like I could be taken at any time.”

Tara is running a campaign  on the popular crowdfunding site GoFundMe. She has fibromyalgia and a host of complications, and needs to relocate to access health care. She started fundraising in March 2017, and a year and a half later, she’s raised less than a quarter of what she needs. She’s not alone. Medical expenses are already the leading crowdfunding cause and donations can’t keep up with demand; a 2017 study showed that 90 percent of medical crowdfunding campaigns failed to reach their goals.

The use of crowdfunding to pay not just for medical care but adjacent costs, such as lost work associated with being ill, caregiving costs for ill family members, utilities, travel and lodging costs to access care, and other externalities, is growing common. For low-income people who are under and uninsured, these cost burdens can be particularly high.

Faced with urgent financial needs, some may turn to payday lenders and other high-interest, high-risk “alternative financial services.” An increasing number are looking to crowdfunding, but Lauren S. Berliner and Nora Kenworthy at the University of Washington Bothell, authors of the 2017 study finding that these campaigns often fall short, discovered success can hinge on things like socioeconomic networks, media literacy, and the ability to translate needs into a compelling and understandable narrative. Campaign success can also be contingent on the nature of the ask; asking for help with ongoing caregiving costs, for example, is less straightforward than requesting assistance with the costs of a specific medical procedure.

Perusing crowdfunding sites reveals ample glossy, well-prepared pleas for help that are netting healthy proceeds, like “Join Oscar’s Village,” featuring a baby with acute flaccid myelitis, a brief, emotive story, and pictures of a happy family. Other campaigns have few to no donations and haven’t been optimized for an audience, like Tara’s: rambling, poorly-punctuated pleas for help, lengthy and apologetic stories, and blurry photos that don’t catch the eye of visitors. It’s a brave new world of health care financing in which those with socioeconomic privilege are better positioned for success than others.

Berliner and Kenworthy fear crowdfunding may be exacerbating socioeconomic inequalities. “Crowdfunding normalizes a means of health care financing that runs counter to a more rights-based system of values,” says Berliner. “

It normalizes the idea that individuals should make decisions about who does and doesn’t deserve care.

” Their work finds that crowdfunding promotes “hyper-individualized accounts of suffering” — the kind of tearjerker personal stories that get picked up in the media, like the widow of a shooting victim who needed help with his lung disease or the woman who saved her husband’s life with CPR while 39 weeks pregnant — that depend on individual ability to leverage media platforms. Crowdfunding sites themselves are also pulled into this debate as they become “an arbiter for public problems,” they say, developing the algorithms that can determine success or failure, verifying high-profile campaigns, and making decisions about what gets highlighted.

With crowdfunding occupying a growing role in the health care landscape, it should be noted that campaigners may also not be aware of the financial implications of participation, including tax liabilities or jeopardizing eligibility for need-based programs like Medicaid. Those most in need of advice on these issues may be least able to access it, lacking attorneys and accountants in their friend networks and unaware that they may need to consult a professional for advice.

The rise of medical crowdfunding demonstrates that insured and uninsured alike are struggling with health care expenses, especially among low-income people. In states without Medicaid expansion, medical debt is particularly high. Medical debt may be ubiquitous, but the amount of debt is often surprisingly small. A 2018 Health Affairs study discovered over half of medical bills sent to collections were under $600. Still, that’s much more than most Americans can pay. In 2017, the Federal Reserve found that 40 percent of people would struggle with an unexpected expense of $400 or more.

Far from being a grassroots solution to disparities in health care access, crowdfunding may just be making the problem worse by foregrounding personal responsibility over institutional accountability. It’s an extension of the argument we saw during the Affordable Care Act fight, put succinctly by Republican Representative Steve King when he said “I think a national health care act substitutes for a lack of personal responsibility.” The belief that the ACA was a handout rather than a hand up is ubiquitous among Congressional Republicans, who enjoy a comprehensive and very affordable health care plan as part of their jobs.

But more and more, we’re seeing voters disagree. Health care affordability was certainly on the minds of voters last week as they turned out to vote for Medicaid expansion in three states, Democratic governors who can drive Medicaid expansion like Laura Kelly in Kansas, and members of Congress who made health care part of their platform.

Stabilizing the Affordable Care Act and moving to protect Medicaid and Medicare may help bring some direct health care costs under control for currently vulnerable groups. This includes those in states currently without Medicaid expansions and moderate-income people who don’t qualify for subsidies or have high-deductible employer-sponsored insurance.

In the meantime, those facing high health care costs and associated expenses will have to keep turning to the internet for help. “I’m white knuckling it to California in a thyroid storm and was just told I need a biopsy now! It may be a long journey, if I have a surge it’s a hospital or hotel! Please pray and god bless you all!,” says Tara in her last update, featuring a photo of her in a hospital bed. It was posted 18 months ago.


First Person

Poverty Isn’t Neglect, But the State Took My Children Anyway

As I write this, I’m sitting in a small, humid room in Plantation, Florida. I’m from Seattle, and I know almost nobody in this area, but I can’t leave. That’s because my three- and four-year-old daughters were taken from me by the state last April. Until that case is overturned, or my parental rights are restored, this is where I’ll stay.

When most people hear “the state took my kids,” their minds jump to the worst conclusions. These cases are quiet and the courtrooms are closed, so I don’t blame you for assuming I was beating them up, or looking the other way while they were abused, or some other such nightmare scenario you see on the Lifetime channel. Those kinds of cases happen, but far more common are the ones where parents do their very best but still come up short on money for the heat, or the rent, or a licensed babysitter. My case is one of those, in which a little more cash and sympathy would have kept my daughters with me.

Three-quarters of substantiated child maltreatment cases are related to neglect, and the kind of neglect that triggers a CPS case is almost always the result of poverty. Although each state gets to set its own specific definitions for neglect, they typically center around deprivation of things like food, shelter, clothing, or medical treatment, which are problems almost totally exclusive to poor people.

The accusation that brought child services into my family was related to drug use. My mother-in-law, with whom I’ve never really gotten along, called the child abuse hotline and told them she suspected I was out using heroin while she watched the kids.  After a series of urine and hair panels tested negative, child protective services broadened their investigation. They raised concerns about the fact that I was living with my in-laws, and that I had been unable to attend trauma therapy for a month while I waited for my new state insurance to go into effect.

The investigation lead to a dependency trial, where the investigator made it clear that my daughters showed no signs of abuse or neglect. I lost anyway. There are no juries involved in child welfare cases, and the burden of proof is lighter than in criminal cases: It only requires a “preponderance of the evidence,” which means the judge’s ruling depends on their personal opinion. In this case, the judge didn’t think I was a credible witness, so she ruled against me.

This means that my daughters now live with my in-laws, and I am legally barred from being in their home after 8 p.m. I get two supervised visits per week while I navigate a web of random drug tests, mental health evaluations, parenting classes, and trauma-based therapy — the details of which get reported back to my case worker, the state attorney, my daughters’ guardian ad litem, and the trial judge — in an effort to win back custody.

If I had been in a different city, or a different state, things might have turned out a lot differently. Child protective services is an umbrella term used to describe individual local agencies. They are governed by standards set at the federal level but operate independently in each state, and city-level jurisdictions set their own policies to manage reports of neglect or abuse. This means that location plays an enormous role in CPS response. Families who live in an area experiencing an economic boom are more likely to receive support, like help turning the water back on if it was shut off for nonpayment, while families in more depressed areas are less likely to have resources available to them. Because of the subjectivity of these cases, it’s likely the politics of the judges and caseworkers play a large role as well.

I’ve experienced this difference first hand. This time last year, I was living in Seattle. When I overdosed during a brief relapse in 2016, the King County child protective agency inquired about my family’s financial difficulties. After learning that the relapse had been prompted by legal difficulties with my abuser — for which I could not afford representation — they referred me to an agency that was ultimately able to provide me with an attorney pro bono. When I disclosed that I was having difficulty accessing trauma therapy because I could not afford child care, they helped secure placement for both of my daughters in a free, comprehensive daycare. And when I told them our utilities were pending shut-off, CPS paid the portion required to keep them running. My daughters did not spend a single day out of our home, and our lives began to improve.

But Seattle is a very wealthy area, with a high cost of living. When my husband had a mental health crisis that prevented him from working, we had to move somewhere more affordable and closer to his family. That somewhere ended up being Broward County, Florida. The economic differences are stark: Seattle’s median household income is almost 50 percent higher than Broward’s, and its minimum wage is nearly twice as high. Although it can be hard to catch your breath in Seattle if you’re poor, there are more avenues for help available than in Broward, and the CPS response between the two areas reflects that. In Seattle, we were given a chance to recover. In Broward, it was assumed we wouldn’t be able to.

The investigator made it clear that my daughters showed no signs of abuse or neglect. I lost anyway.

Josh Michtom, a Connecticut public defender who represents child-welfare involved parents and children, says that poor families have the most difficulty when they come under CPS scrutiny. “Starting from the beginning…poor people as a general rule live a little closer to the edge. Scrambling to and from daycare, hurrying from job to job or job to home, living in more precarious housing or housing that isn’t as well kept-up…it’s not to say all poor people are neglectful or abusive, but run the simulation a hundred times and it’s going to come out with more things that raise an eyebrow for a teacher or daycare worker or hospital worker [who are mandated to report suspected abuse or neglect to CPS].”

According to Megan Martin, vice president of public policy at the Center for the Study of Social Policy, the “vast majority” of child welfare cases are poverty related. Martin also points out that the numbers may not even fully capture the extent of the relationship between poverty and child welfare involvement. She says that the official figure, which links 47 percent of cases to poverty, measures families who are financially unable to meet their basic needs. (For example, a parent who does not have the means to heat their home in the winter.) But that doesn’t include other issues related to poverty. She uses the example of inadequate supervision, a common factor in child removals that has gained some past media attention.

“If you can’t afford child care and don’t have other resources like family to watch your kids, you might end up with a nine year old watching a two year old,” says Martin. “When kids are removed for inadequate supervision, that’s not necessarily included in that 47 percent.”

In his practice, Michtom also struggles with the huge cultural divide that often exists between mandatory reporters and many parents living in poverty. He describes how something such as a parent deviating from the typical upper- or middle-class vernacular may lead a teacher or pediatrician to subconsciously distrust the parent and therefore ascribe malicious intent to something like a bruised knee or unkempt clothing.

Even using that vernacular can count against parents who don’t look the part. At the end of my trial, the judge cited my “skill with language” as her reason for disbelieving my testimony, adding that I could “sell ice to an Eskimo.” My advanced education and ability to communicate clearly should have benefited my case, but coupled with my poverty and substance use disorder diagnosis, it led her to read me as a con artist instead.

“Middle- and upper-middle-class people have a language and way of talking to professionals that seems ‘good and responsible,’” Michtom observes. “When a kid has a completely not abuse related injury and the school nurse calls the parent and says ‘can you explain this?’ and the parent maybe doesn’t speak English as well or just seems less trustworthy to this middle-class nurse in a way maybe the nurse can’t quantify, then the nurse says ‘I have a duty to report this.’”

Once an investigation is opened, the family’s life is picked apart. Even if the original allegation turns out to be unfounded, a myriad of other factors — issues that may not have been enough to prompt a call on their own — can be used against the parent. In my case, the state obsessed over the fact that I didn’t have my own housing, despite the fact that more than one-third of adults were living with their parents in 2015.

I remember the shame and anxiety I felt doing something as simple as going to the playground.

Michtom believes that cultural differences between investigators, judges, and other people involved in the substantiation process directly affect how even small deviations are perceived. “If you don’t know what it’s like to be poor and you don’t know what it’s like to make the compromises poor people have to make,” explains Michtom, “the wrong social worker calls them deplorable or filthy even if it was just messy or cluttered, and that increases the likelihood that it leads to a court petition [for the child’s removal].”

As he says this, I remember the shame and anxiety I felt doing something as simple as going to the playground, where my daughter’s coats, though surely warm enough, looked dingy and stained next to the kids running around in clothes so absurdly bright they looked like something out of a cartoon. My anxiety wasn’t just based on embarrassment; it was also couched in the visceral fear that people would assume I was a bad mom because of something as simple as clothing my daughters in used coats.

Parenting in poverty creates a cycle of factors that compound each other. For my family, an inability to pay for child care or legal aid in 2016 created a snowball of stressors that ultimately led to a relapse and almost killed me. This year, when we were managing to get by, a sudden unexpected health emergency sent us spiraling right back into the system.

As I continue to fight for the return of my daughters, I can’t help but wonder what it would look like to have a uniform child welfare system that recognizes these types of complexities. Maybe my daughters would be with me now. Maybe my husband would be on a road to wellness instead of struggling alongside me to find permanent housing. Maybe the other 3 million families involved with CPS would flourish and thrive. Maybe parenting in poverty would stop being so hard.



California Already Has a Housing Crisis. The Fires Just Made It Worse.

California is on fire. Again. The state’s 2018 wildfire season has been devastating, and it’s not over yet. The dramatic Woolsey and Hill fires scorching the hills around Los Angeles are still being brought under control, and first responders are battling the Camp Fire in Butte County, which has killed at least 56 people and torn through 140,000 acres and more than 10,000 structures.

Recovery from wildfires can take years, and for affected communities, one aspect is especially pressing: Housing. California’s housing prices are infamously high, and in Butte County, this problem is particularly bad. With 19.5 percent of the county living below the poverty line, explains Ed Mayer, Executive Director of the Housing Authority of the County of Butte, many households are heavily rent-burdened.

Five of his 36 staffers from around Butte County lost their homes in the blaze and many others are housing friends and family left houseless by the fire. The Camp Fire was most devastating in Paradise, where 95 percent of the city’s residential and commercial buildings are gone, says Mayer. The county as a whole lost a staggering 10 percent of its housing stock in the Camp Fire.

“Prior to the crisis, we had a vacancy rate of maybe 1.5 percent to 2.5 percent,” he says, estimating that Butte had approximately 1,000 units available around the county before the fire. That’s far short of the 6,000 households, including some receiving housing assistance, that will be looking for new homes after theirs were destroyed. Evacuees from Paradise are predominantly low-income elders and disabled people who settled there for a unique combination of affordable housing (by California standards) and access to medical services, he explains, a situation they may struggle to find elsewhere in the state.

He fears low-income residents may leave the state altogether, while others may be left doubling up with friends and family or moving in and out of shelters and the street. Mayer even raised the prospect of “tent cities” akin to those seen during the Dust Bowl to accommodate desperate residents, some of whom are already camping due to the lack of sheltering options. The local alternatives, like neighboring Oroville, are unlikely to meet the needs of evacuees — 60 percent of Oroville renters are already paying more than 50 percent of their income in rent and utilities every month. Oroville was also in the headlines in 2017 for its crumbling dam, which itself may be threatened by the fire.

Rents tend to spike after disasters

“This is not the first time this has happened,” Mayer says, noting that Butte County reached out to officials in Santa Rosa, where last year’s Tubbs Fire destroyed nearly 6,000 structures, including in low-income neighborhoods, to learn more about how they handled losing five percent of their housing stock to a fast-moving wildfire. The lessons from Santa Rosa and surrounding Sonoma County may prove to be instructive for other communities in the state facing similar catastrophes.

In the weeks and months after the Santa Rosa fires, rents began soaring, and so did property values, though Governor Jerry Brown instituted temporary price gouging protections that led to at least one successful prosecution. Construction costs also began to rise, further crunching homeowners attempting to rebuild and complicated by a proliferation of unlicensed and unqualified contractors flocking to the area to take advantage of property owners eager to start rebuilding.

In Santa Rosa, the Santa Rosa Press Democrat estimated the housing crunch caused by the Tubbs fire drove some 7,000 people to leave the city of 175,000, and over 1,000 fled the county altogether — some, tragically, for Butte County. Renters particularly struggled, with working-class people and undocumented immigrants heavily represented amongst those scrambling for housing.  According to the industry-supported Insurance Information Institute, only 37 percent of renters carried renters’ insurance for their homes, which left many renters with limited resources to replace belongings, let alone find new homes. Long, uncertain waits while property owners determined whether and how to rebuild were compounded by housing scarcity and rising prices, making it hard to stay in the area in the aftermath of the fire. Sonoma County was ultimately forced to declare a homelessness crisis to access funds for people experiencing homelessness, with rates climbing six percent in the aftermath of the fire.

Yet, even with an obvious crisis, Santa Rosa voters just rejected a $124 million bond measure designated for affordable housing.

According to CoreLogic, rents tend to spike after disasters, as illustrated in the aftermaths of Hurricanes Irma and Harvey as well as the Tubbs fire. Delinquencies also increase as impacted residents fall behind on their mortgage payments, and something else happens too: Property tax revenues drop, at the precise moment counties and municipalities need that money most. Another Santa Rosa ballot measure, which passed, approved a temporary sales tax increase to provide funding for emergency services, offsetting some of these tax losses. But sales taxes are regressive: they place the highest burden on the people who are most likely to need the support.

These trends are highly predictable, yet communities are still unprepared for them.

Devastating wildfires are no longer shocking exceptions

The Camp Fire is the deadliest in California history, but devastating wildfires are no longer shocking exceptions. They are the status quo for the Golden State, which has hit the frontlines of climate change just like hurricane-wracked communities across the country in the South. Another CoreLogic study estimates over 48,000 homes are at risk from wildfires in California, many in communities that have already burned before, sometimes multiple times. California’s own Climate Change Assessment, released in August of this year, found that the number of acres burned by fire throughout the state will increase by 77 percent by 2100 as a result of impacts from climate change.

Decreasing rainfall is desiccating already fire-prone environments right as the wind kicks up in the summer and fall, and all it takes is a spark from a flat tire, poorly maintained electrical line, or bad hot tub wiring to ignite a fire. Embattled utility company Pacific Gas and Electric has already taken the unprecedented step of temporary power cuts during periods of high fire risk in an attempt to avoid sparking another conflagration, and a group of Camp Fire survivors just filed suit against the utility, claiming it played a role in the fire that took their homes, though the cause remains under investigation.

“I don’t know,” says Mayer, pausing for a moment to gather his thoughts. “There’s major decisions facing the community.” It’s a sentiment echoed across fire-prone California, from Santa Rosa officials agonizing over whether and where to approve new developments to the fire evacuees roaming the aisles of drugstores far from home in search of replacement toothbrushes.



First Person

My Criminal Record Kept Me Poor For 30 Years. A New Law Will Finally Let Me Move On.

I love getting credit card offers in the mail. I know most people throw them straight in the trash, but they’re my favorite. I’ll turn them over in my hands, read the promises written on the envelopes and remember that my name is worth something to someone.

I am 54 years old, but this is a new feeling. Going to the laundromat and the grocery store in the same week, living without roommates, and sorting through this pile of junk mail all feel like proof that I’m a whole person now. It’s all evidence that I might finally be allowed to move on from mistakes I made last century.

I have a criminal record. I was convicted of two nonviolent misdemeanors decades ago, and they have haunted me, and my daughter, ever since. For her entire life, I struggled to make ends meet. That’s not the kind of thing you can explain to a child: she hated skipping school field trips and wearing homemade Halloween costumes. And even though I tried to explain, again and again, why I had to leave during dinner to make the late shift at the bar, I could never find the right words to make her understand why things had to be this hard for us. I didn’t know the answer myself.

I’ve worked jobs wherever I could — minimum wage at the supermarket, part-time at a clothing store, cleaning gigs that only paid under the table. At the same time, I went back to school and got a degree that taught me how to do the clerical work that keeps a doctor’s office running. I always wanted to help people, and even though I graduated on the honor roll, I couldn’t find a person who’d give me the chance. When they looked at me, all they saw was my record.

So I tried to get that record cleared. I went to expungement clinics, and I applied for a pardon. Nothing worked. I didn’t know what to do. All I could do was what I had been doing for years already: piecing together part-time jobs, raising a child on an income meant for a teenager, and searching for a way to change our lives.

Eventually, I found a lawyer. She taught me my rights, and gave me the confidence I needed to apply for jobs and insist that I be given a fair chance. After thirty years of struggling, my life has finally started to get better. Still, this is only a partial solution — it depends on me sticking up for myself.

New legislation in my home state of Pennsylvania, passed by the Republican-controlled legislature and signed into law by the Democratic Governor Tom Wolf, would help people like me rebuild our lives. The Clean Slate law automatically seals certain misdemeanor convictions after the individual is crime-free for 10 years. No jumping through hoops, no trying to work the system, no hoping you get lucky enough to find a good lawyer. It would have reset my life more than a decade ago.

In the past year that I have learned to advocate for myself, I’ve finally been able to  put my education to work. I work as a home health aide, cleaning and feeding folks who need support, and  caring for them with a gentle touch.

I’m the first to take an extra shift at work, and because I do, I can afford to help my daughter for the first time in her life. I can’t buy her a house, but I can help pay her rent when she needs it. We don’t have to stay on the couch at a friend’s place, or making a temporary home in a basement. I get to be a mother I always wanted to be, and a Nanna to my grandkids.

This is the only version of me that they know. When I open the door to their home, they shout  “Nanna, do you have something for me?”

For the first time in my life, I get to say “yes.” I always do. Isn’t that what Nannas are for?

Editor’s Note: The Center for American Progress, where TalkPoverty is housed, is a partner in the Clean Slate campaign. Find out more at CleanSlateCampaign.org.



The Frenzy Over Amazon’s HQ2 Should Be a National Embarrassment

Amazon’s HQ2 auction is finally over.

On Tuesday, the internet retailer announced that its search for a second headquarters has ended, with Long Island City in Queens and “National Landing,” Virginia, a conglomeration of Washington, D.C. suburbs, selected as sites for its big expansion. The company is promising to bring tens of thousands of jobs to the two areas, along with billions of dollars from direct investments and a broadened tax base from its new, highly-paid workforce. The company also announced a smaller expansion in Nashville, Tennessee.

However, there’s a catch: Both Virginia and New York offered Amazon monetary incentives in an attempt to win HQ2, as it’s known. Until now, the public — and even some lawmakers in those states— had no idea what those incentives were. And it’s ultimately low-income residents in both places who will pay the biggest price.

Amazon’s announcement included the news that it will receive $1.5 billion in tax breaks from New York, and another half a billion from Virginia, along with promises from both states to make significant infrastructure improvements. As a result, each new job that Amazon brings will cost these cities tens of thousands of dollars.

Depending on which analysis you look at, cities and states in America spend up $90 billion annually on corporate tax incentives. That category of spending has more than tripled since 1990. The theory at work is that incentives are an investment in corporations creating jobs and boosting local economies.

Corporate tax breaks have little to no effect on job creation or economic growth

The evidence backing up that theory, though, is thin. In fact, most studies have found that corporate tax breaks have little to no effect on job creation or economic growth, because they mostly encourage shifting jobs from one locale to another without creating any new economic activity. (Think, for instance, of a worker who leaves her current job to take one at Amazon, or moves from Amazon’s Seattle headquarters to Long Island.) What these tax breaks really stimulate is politicians’ efforts to get re-elected, as doling them out is correlated with rising vote shares.

The secrecy surrounding the effort to woo Amazon adds insult to that injury. 238 cities responded to the corporation’s initial request for proposals. Only a few of them made what they offered Amazon public. Reporters and activists in several cities took their local governments to court in an effort to ascertain what they promised Amazon.

The secrecy even extended to local elected officials.“My understanding is the public subsidies that are being discussed are massive in scale,” a New York state senator who represents Long Island City said to CNN before Amazon’s announcement.

New York’s incentive package was overseen by the state’s development office, with Democratic Gov. Andrew Cuomo promising to go to great lengths, including naming both a polluted creek and himself after Amazon, in order to secure HQ2. Already, New York spends more on corporate tax breaks than any other state, including $8.25 billion in 2015.

That officials promised a private corporation unknown amounts of taxpayer money is troubling on its face, and prevented activists and elected officials from organizing against specific proposals. But it’s also problematic because every dollar that winds up going to Amazon is taken from programs that are designed to help the area’s residents more directly.

Since most states have balanced budget requirements, the money spent on Amazon can’t be spent on education, health care, infrastructure, affordable housing, or the host of other responsibilities of local governments. (For instance, the entire annual budget of the Virginia Department of Housing and Community Development is about $150 million — less than one-third of what the state offered to Amazon.) And other corporations have said they want the same deal Amazon received, which would strain budgets even more as states promise ever-bigger sums to major corporations.

The New York and D.C. areas are already among the most economically unequal in the country.

Plus, the influx of money and people that Amazon brings will exacerbate inequality in the New York and D.C. areas, which are already some of the most economically unequal in the country. According to the Urban Institute, D.C.-area rents have risen by about 10 percent since 2011, and the median house price is now north of half a million dollars. Per that analysis, “the challenges of rising affordability pressures and lengthening commutes will intensify, and more households will experience hardship” with the influx of Amazon money and workers.

Even before Amazon made its announcement, D.C. was facing a housing deficit of tens of thousands of units, while Arlington County, Virginia, has seen its affordable housing stock plummet by 90 percent over the last two decades. New York is facing similar concerns. Though the effect will be more muted than it would have been in some smaller cities, it will still be significant.

Already, other cities have experienced the downside of being home to big tech corporations that stress local housing markets, including Seattle, Amazon’s main home. An effort to tax big corporations there in order to raise funds to address the lack of affordable housing was defeated thanks to opposition from Amazon.

In many ways, the Amazon HQ2 process has been a charade. After gathering data on hundreds of cities, Amazon wound up going with the home of Wall Street and the home of America’s government, two advantages no amount of money could buy.

Meanwhile, struggling cities across the country were led to believe that an economic renaissance could be headed their way, and spent time and money trying to win something they possibly never had a chance at to begin with, instead of expending those resources on the people they are supposed to serve. The whole thing should be a national embarrassment.