No one chooses to be homeless. It’s a hard life, especially during a winter like this one. You wait in line for food, wait in line to use the bathroom, wait in line for a place to sleep.

Homeless people get sick more often than the rest of the population, according to the U.S. Centers for Disease Control. They are also more likely to be the victims of violence. Homeless people don’t live as long as even the poorest people who have housing, and they die at a rate four to nine times that of the general population.

No one chooses to be homeless, but homelessness is a choice – or more accurately, it is caused by a series of policy choices that go back decades. Until we look at it that way, it won’t go away.

That, however, is not the frame for the current battle between the LePage administration and the city of Portland over housing the homeless. The governor argues that the state has given Portland a “blank check” to spend as much as it wants on its shelter, leading the city to be overly generous.

He wants to create an incentive for the city to spend less by cutting the state reimbursement rate after reaching a target amount. The city says it’s following the rules as they have been worked out over the year. Portland’s spending, city officials say, is driven by need, not the resources available.

But whether the state pays to keep the homeless shelter open or the city does, people are still going to be lining up to sleep there, and that won’t change until we address real causes.

HOUSING

It sounds obvious, but homelessness is a housing problem.

The people who end up in shelters often have other problems, such as mental illness, addiction, a disability or a lack of job skills. But they all have one thing in common – no place to live.

Homelessness exploded in the 1980s, both in Maine and nationally, after the federal government radically cut its support for public housing.

The Department of Housing and Urban Development budget crashed from more than $80 billion a year in 1979 to less than $20 billion in 1984, according to the Western Regional Advocacy Program. Those cuts have resulted in a loss of new affordable housing that is compounded every year.

The HUD cuts coincided with the loss of other kinds of low-income housing. Skid Row flophouses, boarding houses and rented rooms used to be a source of low-cost housing that could be rented by the night or week to people with very little money. They have all but disappeared. Getting rid of them may have been a good idea, but not replacing them was a choice, and it affects us today.

MENTAL HEALTH

When hospitals like the Augusta Mental Health Institute were closed, they were supposed to be replaced with a network of treatment and prevention centers for people with mental illness. That system is still under construction, and funding for mental health and substance abuse services have been cut.

Not all homeless people are mentally ill, but the people who spend years living in shelters almost always are.

Last week, the state made much of a list that showed that 13 of the 30 heaviest users of the Oxford Street Shelter in Portland had bank accounts.

What the state didn’t say was that all 30 of them – 30 out of 30 – had a major mental illness, according to Jon Bradley of the social services agency Preble Street.

These are also the people who use a disproportionate amount of services. In 2012, Portland’s Homelessness Prevention Task Force calculated that 17 percent of shelter clients represented 82 percent of the nights spent inside.

CHANGING ECONOMY

The business story of the last three decades has been Portland’s emergence from its industrial past.

The city is becoming a destination for tourists who want to eat in restaurants and look at the working waterfront. But the docks don’t provide nearly as many jobs as they once did, and most of the small industrial workshops that were once scattered around town are gone. The change in the nature of our economy can be seen as progress, but it has left some behind, and they are among the people likely to end up living on the street.

Gov. LePage may think that he can change people’s behavior by withdrawing support from Portland, but that would just shift the responsibility for dealing with these long-term trends to another layer of government.

A “welfare reform” strategy that doesn’t address shortages in housing, mental health services and jobs for people at the bottom of the economy would be a bad choice that we would all have to live with for a long time.