Homeless spikes are an individual versus communal issue. Homelessness is a societal problem, but once society has failed and there are homeless people about, individual landlords don't want them sleeping around their buildings so they install spikes.

The bathroom situation in some parts of Europe does seem like something that could be addressed. When I'm wandering around a European city and find myself with a full bladder, I'm always relieved to find an outpost of American corporate imperialism such as a Starbucks or a McDonald's because---regardless of anything else they bring---at least they bring clean well-maintained public bathrooms.