Assuring Access to Health Care for Homeless People Under National Health Care

Abstract

Health problems are found among homeless people at a higher rate than among adequately housed individuals, and these problems are both a cause and a consequence of homelessness. Proposals for national health care reform that rely on managed competition are, alone, insufficient to insure access to America's homeless because homeless people have multiple health problems, are undesirable patients for many private providers, and will be costly to treat. Managed care programs may exclude services important for homeless people, such as outreach, social services, mental health and substance abuse, and traditional public health functions. The strengthening of safety net providers including public hospitals, community health centers, clinics, and local health departments must be part of efforts at health care reform. The continuation of the National Health Care for the Homeless program, which is funded by the U.S. Public Health Service, and the linking of this and other health care programs to housing initiatives are recommended.