title: Health care for the homeless in a national health program.
abstract: To assess the impact of adoption of a national health program on homeless care in the United States, care for this group in Britain's National Health Service (NHS) was evaluated. Although hospital and medication charges are eliminated, primary care for the homeless lacks central government directive, suffers from overlap of statutory agencies and mechanistic biases, is disproportionately delivered in emergency rooms, and has relied on advocacy by the non-profit sector. Disadvantages of this void in NHS provision are marginalization of the homeless and continuation of a two-class care system. Removal of financial barriers to care by enactment of a national health program in the US would not solve all issues related to delivery of quality care for the homeless unless its structure addressed the special needs of disenfranchised groups.
authors.affiliation: Ambulatory Care Service, VA Medical Center, Portland, OR 97207.
authors.forename: J B
authors.initials: JB
authors.lastname: Reuler
mesh_terms: D005251:Fees, Medical; D006297:Health Services Accessibility / Q000191:economics; D006703:Ill-Housed Persons; D006801:Humans; D009313:National Health Programs / Q000458:organization & administration; D011320:Primary Health Care / Q000191:economics / Q000379:methods / Q000458:organization & administration; D006113:United Kingdom; D014481:United States; D014838:Volunteers