The United States numbers more than 610,000 people in its borders who do not have a home (Manness & Khan, 2014). These men, women, and children represent complicated medical and mental illness challenges to the healthcare system of the country in combination with social and economic issues. A unified healthcare team comprised of multiple disciplines is required to work with state and local agencies in order to guarantee quality of care and promote self-sufficiency. The United States National Healthcare for the Homeless Council (HCH) is one of those agencies. Over 10,000 physicians, nurses, advocates, social workers, and patients form a network striving for a goal of eradicating homelessness ("National Healthcare for the Homeless", 2016).
Summary of the Organization
The non-profit U.S. National Healthcare for the Homeless Council was formed in 1985 funded by the Pew Memorial Trust and the Robert Wood Johnson Foundation for nineteen projects with the intent of determining if the health of homeless persons would be improved through delivering services through a specialized model ("National Healthcare for the Homeless", 2016). More projects were funded in 1987 by the federal Stewart B. McKinney Homeless Assistance Act. When the projects were consolidated and teamed with other primary care projects and community health centers in 1996, the HCH projects became eligible to receive 8.7 percent of funds appropriated for health centers; donations are also accepted. To date, there are 208 HCH projects operating in every state in the country, including Puerto Rico and the District of Columbia for the purpose of obtaining secure housing and all-inclusive health care for America’s homeless population. The main office for operations is in Nashville, Tennessee.
The organizational structure of the HCH includes a governing membership with organizational members, a board of directors, steering committees, and standing committees (see graph 1). The HCH is also associated with the Respite Care Provider’s Network, the National Consumer Advisory Board, and the Clinician’s Network. The President of the HCH is Doreen Fades, who is also the Executive Director for Community Benefit and Health at Mercy Medical Center in Longmeadow, Massacheusetts ("Doreen Fadus ", 2016). Mrs. Fadus has worked with the homeless for 27 years by assisting in the provision of healthcare, education, and jobs. She holds an Associates in Liberal Arts, a Bachelor of Arts in Sociology and Anthropology, and a Masters in Guidance and Psychological Services. Considering the demands of her position at
National Healthcare for the Homeless Council Governance Structure ("National Healthcare for the Homeless", 2016)
Mercy Hospital, there is a question how she can adequately fulfill the functions of her position with the HCH. The organization works to support over 200 community health centers and, while the qualifications of Ms. Fadus are admirable, perhaps a full-time administrator would be advantageous.
In the past, the HCH created materials directed toward the special needs of funding sources and the population served. They focused primarily on policy brief and informational materials that assisted in the interpretation of health reform legislation such as the Health and Education Reconciliation Act of 2010 and the Patient Protection and Affordable Care Act of 2010. Current focus in on promoting a national health care system that is financed publicly but administered privately. The organization feels that using a “single payer” (Medicare for every American) financing system is the best method for providing optimum universal health care in the United States. Delivery systems such as physicians and facilities would remain private while patients are given a choice of providers. While the HCH supports the proposals of the Affordable Care Act, it believes the law leaves many gaps in the health care system, especially concerning for-profit insurance companies.
Consequently, the HCH supports the Improved Medicare for All Act in combination with efforts on the state level to created single payer health care systems. In conjunction with its mission, the homeless would be best served by this type of national universal coverage. Presidential hopeful Senator Bernie Sanders recently introduced his plan of “Medicare for All: Leaving No One Behind” (Sanders, 2016). Under a single payer system, the 47 million American who are uninsured and an additional 50 million without adequate insurance despite making payments on premiums would receive the same quality of health care currently available to patients who have the ability to afford full insurance payments (Conyers, 2016). Based on statistical analyses, businesses will pay less for employee coverage, individuals and families will have lower premiums, and the cost to the national budget will remain approximately the same while at the same time covering every American citizen.
The HCH supports the single payer type of universal health care system despite opposition by critics stating that middle-class taxpayers would experience a significant increase in taxation, there would be no protection for people with pre-existing conditions, doctors and hospitals would receive decreased income, state politicians would be in charge of health care administration, and the transformation would be chaotic (Hellander, 2016). The response by the organization Physicians for a National Health Program is that the single payer system will save over $400 billion a year on administrative costs associated with private insurance providers that could be channeled into direct health care payments. Strategies such as the creation of comprehensive budgets for medical facilities, physician fee negotiation, and buying medications and medical devices from companies directly are methods to decrease costs by cancelling the market-driven costs of for-profit health care.
Under a single payer system, physicians and facilities would not face decreased incomes, but rather expensive administrative costs would be largely eliminated. State governors and other politicians who may be influenced by contributors would not be in control of the system, but rather the federal government as with Medicare. Finally, while there would be some adjustments needed to transition from the current health care system to a single payer system, the process would be easier than to any other health reform options, especially in light of the fact that each American would only need to register once in a lifetime, rather than consistently over periods of time mandated by age, employment status, and health issues as with private insurance companies.
The advocates and employees of the United States National Health Care for the Homeless Council face the challenges of working within the current health care system while actively campaigning for a single payer system that would be most advantageous for the homeless and economically disadvantaged the organization serves. An individual interested in making an impact on the future of health care in America may consider a career with the HCH or a similar corporation while looking to make a strong change for the universal good of the public and the economy of the United States.
References
Conyers, J. (2016). Expanded & Improved Medicare for All Act, H.R. 676. Healthcare-now.org.
Retrieved 15 March 2016, from https://www.healthcare-now.org/legislation/hr-676/
Doreen Fadus . (2016). Cjaonline.net. Retrieved 15 March 2016, from
http://www.cjaonline.net/doreen-fadus/
Manness, D., & Khan, M. (2014). Care of the Homeless: An Overview. American Family
Physician, 89(8), 634-640. Retrieved from http://www.aafp.org/afp/2014/0415/p634.html
National Healthcare for the Homeless. (2016). National Healthcare for the Homeless. Retrieved
15 March 2016, from https://www.nhchc.org/
Sanders, B. (2016). Medicare for All: Leaving No One Behind - Bernie Sanders. Bernie Sanders.
Retrieved 16 March 2016, from https://berniesanders.com/issues/medicare-for-all/
