HEALTH-INSURANCE AND THE HOMELESS

There is very little known about health care utilization among the hom eless or about the role of health insurance on utilization patterns. M any health care reform proposals advocate expanding health insurance c overage for various segments of society, including the homeless. Altho ugh homeless people who lack health insurance face strong financial ba rriers to health services, providing them with health insurance may no t appreciably increase their demand for health care if they also face important non-financial barriers. We investigate the relationship betw een insurance and utilization for this group based on estimates from a n empirical model of medical care use and insurance coverage. Using ou r estimates, we simulate potential effects of policy changes on variou s types of utilization, including use of mental health services and tr eatment for alcohol or other drug abuse. (C) 1997 by John Wiley & Sons , Ltd.