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Determined patients could break a robot, but it's just a robot. Better that than maiming or killing a human. As for the humans currently working in those environments, some are in places where they have a prudent fear of injury or death and I'm sure that informs their interactions with some patients. Simulacras won't fear anything, so their interactions won't be tinged by fear.
More than 90% of labor will be automated in our lifetime. Simulacra will improve, the human facsimile will become seamless and their fine articulation and strength will first match and then permanently exceed humans, or at least those non-cybernetically-augmented. They will be tremendously cost-superior as their minimum effort in work will be better than many humans giving their utmost. So while fears of institutions being black pits for the dregs is valid today, in 30 years a largely simulacra-staffed institution will have patients receiving a higher standard of care than what premium specialized multi-patient care facilities deliver right now.
Some homeless need the hard support of institutions right now. The problem I have with mass institutionalizing advocacy today is I don't trust such institutions to not become abyssal places bereft of human dignity. The government could probably run a non-terrible pilot, but it would be a handful of the homeless and so not solve anything, but run in mass, and especially if turned to privatization, they will become hellish. And some might say, these people are already making cities hellish; they might argue their lives are already hellish, a warm place to sleep, food, and the removal of narcotics would be better; or they might argue the institutions would be hellish because such people inhabit them. To all of these, yeah maybe. But if the perception is these places are worse than prison there will be powerful opposition from the lowest of the individual homeless who fights at being sent, up to well-funded, organized actors working against it.
With the mass automation of labor and comparable-in-impact breakthroughs in other industries, costs of many products will spiral downward. Inflation is a motherfucker but things will either stabilize by the end of the decade or the country will start burning. I choose to believe the former will happen. The robots will look like humans, they sound like humans, they will feel like humans. The reason it will work so well when it's implemented is because that obstacle of "this thing isn't human" will be brief; we can't help but humanize that which isn't human. Look at the affinity for animals. The simulacra will be capable, they will be pleasant, they will remember everything but not hold to particular memories in spite for later cruelty. They will just be better. Not in the transcendent, infinite worth of the human, but as the continued demonstration of the spirit of man in improving the human condition. They are the next great step. On a long enough timeline, a healthy capitalism will compete itself into being socialism. Costs will be so cheap, quality will be so high, so many industries will just cease to exist as some breakthrough renders them entirely obsolete. Food, healthcare and pharma, energy, housing and construction, clothing, entertainment, automation comes for it all. Eventually these institutions will be able to provide what the patients need at the highest quality for a pittance of what it once cost and this is why I know I will eventually support such measures.
I don't see dregs being shoved in capsules and fed bugs. I see the indigent being, yes forcefully, put in institutions where not their wants but their true needs are addressed. Where they eat good food, where they have good rooms, where they have access to education and entertainment, where they receive the medical care they need. Where they have interactions with simulacra that are in the meaningful sense absolutely real, real relationships with simulacra who might be programmed to care but do it so well the patients feel truly cared for, which they will be.
It's utopian, so it's naive and dumb. What future is the alternative? Throw them all in a pit? Might as well send vans around for them to be shot and taken to crematoriums. I know that's reductive, there's an adequate middle ground, but why stop at hoping for a solution that's only adequate? The technology for the best swiftly approaches, why not hope for it in everything? I don't ascribe an unreasonable negativity to you, the concerns you raise of terrible conditions are entirely valid, and if that were the proposal or what ended up actually happening after the ostensibly good proposal, I'd oppose them. But at a certain point in the endless march of technological progress it will take more effort to poorly deliver such a service, it will take actual malice rather than simple avarice, because the avaricious option will so fortunately be the best option for the patients.
...Do you remember the optimism of the early internet? The realization that what we had here was a truly transformative technology with the potential to penetrate into every aspect of our lives and our society, and that seemed to be very near to entirely positive in its effects? The internet was my go-to example to make the case for techno-optimism as late as 2014.
And look at it now. That's your answer: because humans will always, always, always human. You can see the bright future just over the horizon, and the sad part is it might not even be a mirage, but there's still something cheaper, nastier, easier and more available just around the next corner, and the people around you are going to go for that instead, because that's what humans do.
Hasn't it been? Online commerce has improved the lives of millions of citizens. I can call my family in different places around the world with full video capability. I can remotely attend weddings and funerals ,that I never would have been able to before. I can debate with people all around the world. And I can access hundreds of thousands of words written on just about any topic I want from best Dungeons and Dragons feats for a Rogue to how to cook an Olive Garden style deep fried lasagna to web novels spanning millions of words, or how to best fix a shelving unit or replace a bulb in my car. I can download 3d printing specs for gaming terrain or miniatures.
Any business can now scale customers with a cheap website and I can order trinkets from a shop in California that I would never have seen otherwise. I can watch and listen to pretty much any music I want to and then read about the background of the album. I can play video games with unparalleled speed and connectivity and help my nephew tame sheep in Minecraft while being able to see him giggle.
I can submit test results to my doctor without having to call them or go in to the office, then he can create and fill a prescription for me at a pharmacy of my choosing, who will then email or text me when it is ready. When I switch dentists they email copies of my charts to my new dentist who has them immediately. I can carry out many of the functions of the DMV online and I can do the same for many government agencies.
I can research people I am about to meet in a professional context and I can check out the boys my daughter wants to date. Right now I can have an AI write me code that has a good chance of working to do all kinds of random things. Or create images for my roleplay characters or backstories. I can stalk prices of plane tickets over time to buy at the best time rather having to call and check or go to a travel agent. I can check reviews of hundreds of restaurants and make and cancel reservations much more quickly than ever before. I can use web chats to deal with issues that would have required a phone call or a physical visit before.
The sheer amount of time that the internet saves me in routine tasks compared to the olden days is astonishing.
If you had offered all that to 80s computer geek me, I would have bitten both your hands off to have it! And I can do most of it from a tiny handheld computer!
Sure the internet has negatives as well, but I would say the positives outweigh them significantly. I would suggest for most people in the West the internet is much more positive than negative.
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