Homelessness is unhealthy. In the United States poverty, extreme or otherwise, is unhealthy. For many middle-class families, simply being underinsured in unhealthy. Health care is a wide-reaching issue but the cost of health care, with or without insurance, is frequently financially devastating and potentially deadly.

• Street Medicine Institute (SMI)

Doctors don’t work for free. If you can’t pay the bill and the insurance company (assuming you have one) won’t cover the expenses, then medical care and medication are cut off. That’s the way things work.

• American Medical Association (AMA) Journal of Ethics: Refusal of Emergency Care and Patient Dumping

For people trying to survive extreme poverty (homelessness), the conditions of day-to-day life exacerbate medical issues. The lack of health insurance all but eliminates health care. Trying to find work or other resources necessary to get off the streets is difficult under the best of circumstances, add an illness into that scenario and ‘extremely difficult’ becomes ‘near impossible.’

Universal Health Care

• World Health Organisation (WHO): Universal Health Coverage (UHC)
• Harvard Public Health Review (HPHR): Universal Health Care, The Affordable Dream
• National Center for Biotechnology Information (NCBI): Universal health coverage from multiple perspectives: a synthesis of conceptual literature and global debates
• National Center for Biotechnology Information (NCBI): California Universal Health Care: An economic stimulus and life-saving proposal

Universal health care would address the financial devastation that pushes middle-class families into extreme poverty (homelessness) when a loved one falls ill.

Universal health care would provide extremely poor people access to much-needed resources and services. Simply being able to address an illness or injury makes finding a job significantly more possible, which makes escaping homelessness possible – not easy or guaranteed but possible.

Universal healthcare would begin the long and arduous process of addressing the medical resource caste-system currently built around government-provided Medicaid and Medicare programs. People who receive health insurance through an employer have significantly more options and receive markedly better care. There are large numbers of doctors and medical care providers who refuse to accept patients reliant on government-provided benefits – unless they are government employees, in which case they receive the same care as people in the private sector. Since extremely poor people are overwhelmingly dependent upon these programs, this creates a prejudiced resource distribution wherein people at the bottom are treated very differently from people who have more social and financial ‘value.’

• National Center for Biotechnology Information (NCBI): Reports of Insurance-Based Discrimination in Health Care and Its Association With Access to Care
• National Center for Biotechnology Information (NCBI): The Role of Stigma in Access to Health Care for the Poor
• The Heritage Foundation: Studies Show: Medicaid Patients Have Worse Access and Outcomes than the Privately Insured

A true universal healthcare system would help to place all Americans on equal footing within the medical care system. It would place every person under the same medical payment system, giving all citizens access to the same medical resources without fear of financial devastation.

The social stigma surrounding extremely poor people will take significantly more time and resources to change. Medical professionals who harbor an aversion to interacting with extremely poor people (homeless or housed) will continue to shun these individuals, provide substandard care or participate in abusing vulnerable populations for the same reasons that racists treat the objects of their hate in the same manner.

• Medical Apartheid by Harriet A. Washington

The cascading effects of hatred towards extremely poor (homeless) people will have to be addressed in another way.