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It's not that simple. It's not always clear who is who. Some frequent flyers are coming back because they don't want to go to the shelter. Some are coming back because the ED keeps not treating them because they think the problem is mental illness and they never did a basic work up...
It may be helpful to model this similarly to however you feel about the legal system, letting guilty go free and so on.
The legal system doesn't involve people coming into my house, stealing tens of thousands of dollars, and then the next time they are at the front door I am supposed to let them back in. In fact, most of the more sane jurisdictions allow for pretrial detention of something as serious as a burglary or theft by deception.
The problem is the state blatantly violating freedom of contract by forcing these victims to treat these menaces, and then trying to fudge away the actual cost of the insane policy by smuggling it through various re-distributive schemes as opposed to a budgetary line item.
$100 billion for ER visits from meth heads and heroin addicts is less defensible then "we can't have people dying in the streets (ignore this massive cost we've hidden with subterfuge)"
The problem isn't necessarily your idea (although I'm sure some would take issue with it), the issue is the implementation. How do you decide? Some people with chronic medical illness look like a mental health patient, some mental health patients try repeatedly to get medical care and get ignored... when the issue is "live or die" you have to get things absolutely right.
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