Healthcare is a basic human right, just like education, shelter, and food and government has a responsibility to make sure every citizen has access to affordable healthcare. The government is in place to work for the people of the nation and not just for those who can afford to support the government in return. One of the ways to ensure access to affordable healthcare is healthcare insurance plans which cover a wide range of services such as medication, hospitalization, and other miscellaneous healthcare expenses.
But as can be expected, a significant proportion of homeless people are without healthcare insurance and the risk of being without healthcare insurance only increases the longer the individuals stay homeless . Humanity has a natural responsibility to help one another in terms of maintaining health through the basic needs of mankind. This means that, working for the people would include helping humanity fulfill that responsibility. The U.S. Government has a responsibility to ensure affordable healthcare for every citizen and even more so for those who are at the greatest risk of being without healthcare coverage such as homeless people.
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Homeless people could be defined as those individuals who, due to disadvantageous economic circumstances, are forced to be without permanent shelter and end up on places such as streets and crowded shelters. According to Alexander-Eitzman, Pollio, and North (2013) the inability to obtain or maintain permanent shelter makes it difficult for these individuals to keep up with health needs such as vaccinations and health monitoring physicals. The individuals are also more likely to fall victims to crimes which would put them in greater need for medical care (pg. 1).
Due to poor living circumstances, they are more susceptible to various illnesses and diseases and this should concern the government because this also increases the risk of spread of certain diseases among the general population. In addition, their limited economic means they will not either seek treatment or even if they do try to, they will simply be rejected by healthcare providers. Thus, the U.S. Government should provide healthcare insurance to homeless people because doing so will not only raise the healthcare standards among some of the most impoverished members of the society but will also reduce risk of exposure to certain healthcare diseases for the rest of the population.
Much of the reason that the homeless people do not maintain physicals and immunizations is that there is little or no access to primary physicians without health insurance or the ability to pay up front fees at the doctor’s office. According to Wise and Phillips (2013) the results of lacking a primary physician is that the homeless individuals use the emergency room as their only option for health care (pg. 359). As emergency room physicians are only required to stabilize an individual and then refer them to a primary care physician, they are not required to handle routine care such as vaccinations or physicals. Once the homeless person is stabilized to the best of the emergency care physician’s ability, they are sent back to the streets with a diagnosis, a prescription that they cannot afford to fill, and a referral to a physician that they cannot afford to pay.
Homeless people are at higher risk of many serious illnesses and diseases such as TB, respiratory illnesses, high blood pressure, diabetes, and asthma. The health issues are made worse by the fact that the treatments for many of these health issues are quite expensive. In fact, healthcare is so costly in the U.S., it is one of the primary contributors to personal bankruptcies. It is estimated that 62 percent of the one million personal bankruptcies in the year 2007 were due to medical debt. The high cost of the healthcare in the U.S. makes it less surprising that chronic health conditions among the homeless people frequently exceed the average population. For example, homeless people are at least three times more to have a liver condition as compared to the general population. Similarly, homeless people are almost twice as likely to suffer from mental illnesses as compared to the general population . The extremely high cost of healthcare in the U.S. means Government has even greater responsibility to take care of its most impoverished subjects including homeless people.
It is a common knowledge that one’s economic status influences treatment he gets from provider of goods and services which is why those with vast resources often get VIP treatment. Thus, it will not come as a surprise to many that homeless people are subjected to discrimination even by healthcare providers. This discrimination is not limited to refusal to provide healthcare services but is even apparent in the unwelcomeness displayed by healthcare providers. Many homeless individuals have reported experiencing intense emotional responses to such acts of discrimination which lowers their desire to seek healthcare treatment in the future . It is quite likely that discrimination by healthcare providers is also shaped by the fact that they do not expect homeless people to afford healthcare or possess a high risk of non-payment due to lack of insurance coverage. If the government starts providing healthcare insurance to homeless people, this will encourage homeless people to adopt more responsible attitudes towards their healthcare not just because they do not have to worry about financial aspects but also because healthcare providers may treat them with more respect.
The critics of the government provision of healthcare coverage for homeless people may contend that such a move will discourage individual responsibility because homeless people also become the way they are due to lack of personal responsibility. The critics may also content that funding for healthcare insurance for homeless people has to come from somewhere and this may involve higher taxes on responsible citizens which will be unjust. Why someone who is responsible, works hard, and has earned healthcare insurance fairly be responsible for funding healthcare for those who are irresponsible.
The critics sometimes engage in overgeneralization. While some might have become homeless due to personal irresponsibility, this cannot be said for everyone. Not everyone is fortunately to be born in ideal circumstances which explain why there are homeless children. In addition, even responsible people can become homeless due to factors outside their control such as loss of jobs. Once an individual becomes homeless due to circumstances beyond their own control, it is highly difficult for them to change their situation. Researchers note that “if the surrounding environment where homeless adults are concentrated has less available and affordable housing and more economic distress, this spatial segregation may be one of the many real barriers to obtaining stable housing in the future” (Alexander-Eitzman, Pollio, & North, 2013, pg. 1). This means that society does not support the homeless in a manner that would allow them to improve their situation. These people are cast aside as a burden to society and this isolation furthers their issues with poor health and limited health care.
Moreover, healthcare is a basic right, just like education. Education is free in America irrespective of one’s economic background and one can argue why those who can afford education be forced to fund education for those who cannot. This means that, although members of society may not feel the natural responsibility to fulfill this need for humanity, the government has placed requirements which ensure that the need is met. Societies progress when they take care of some of their most vulnerable members which is why we have food stamps and Medicare etc. This was recognized when the United Nations General assembly ratified the declaration on Rights of indigenous people to include the right to medical care in September 2007 (Burford, 2010, pg. 22). Although the Declaration of Independence and other primary documents in the United States do not address health care directly as a right, there is a distinct statement of equality. Therefore, if the nation states that indigenous people have the right to medical care, the same should then be true for the homeless and less fortunate within the nation.
The U.S. Government should provide healthcare insurance to homeless people because they are some of the most impoverished members of the society. Homeless people are at higher risk of certain health issues due to factors such as less-than-optimal working conditions as well as lack of treatment. In addition, they are also subjected to discrimination by healthcare providers. Government healthcare insurance will not only improve health standards among homeless people but will also benefit the rest of the society. The concerns of the citizens of the United States in regards to the cost of this healthcare could easily be explained away through the cost of a disease spreading or the increased costs at emergency rooms who are presently acting as the primary source of healthcare for the homeless. It would make much more sense to be proactive and address these costs upfront through establishing a healthcare program for the homeless rather than allowing them to suffer until they have no other recourse than to use the emergency room for mere stabilization.
- Alexander-Eitzman, B., Pollio, D. E., & North, C. S. (2013). The Neighborhood Context of Homelessness. American Journal Of Public Health, 103(4), 679-685. doi:10.2105/10AJPH.2012.301007
- Burford, G. (2010). Citizen’s choice of preferred system of healthcare as a fundamental human right. Journal Of Ayurveda & Integrative Medicine, 1(1), 22-25.
- Khandor, Erika, et al. Access to primary health care among homeless adults in Toronto, Canada: results from the Street Health survey. 24 May 2011. 5 August 2014
- National Healthcare for the Homeless Council. Homelessness and Health: What’s The Connection? June 2011. 5 August 2014
- Wen, Chuck K., Pamela L. Hudak and Stephen W. Hwang. Homeless People’s Perceptions of Welcomeness and Unwelcomeness in Healthcare Encounters. 6 April 2007. 5 August 2014
