"Doctors on the Streets" is a completely volunteer-based program in Cleveland, Ohio (7) where doctors go out on Friday nights to see people sleeping in public areas and in shelters. Kenneth Williams, a shelter patient, said it was like germ warfare going on in his chest and without the help he said he “would have been in big trouble.” (8)

Many doctors, nurses and other health care providers throughout the country volunteer in community clinics and on mobile health vans.  They are all living up to the credo that medical care is a helping profession. But the doctors on the streets know there’s more at stake in reaching those who are afraid or have had bad experiences in the past.

So why is it an exceptional experience for doctors to go to the homeless? And why does it have to be as a volunteer? The care they provide not only prevents suffering, but it saves enormous amounts of money.  How much? Well, Californian Angelo Solis racked up nearly $1 million in medical charges – paid for by taxpayers. (9)  Time after time police would take a passed out Solis to the ER where he could detox and get help for his diabetes and heart disease. But nothing changed.

One million dollars would pay for a lot of home visits by doctors to alleys, parks and emergency shelters. It seems like a no brainer. The practice of short term thinking leads policy makers to question who will pay for it.

In reality there are multiple agencies that could invest in this kind of outreach. All would save money and all would reduce their workloads.

If any organizations should see the long-term benefits it would be hospitals, insurers and Medicaid/Medicare. Even paying a premium to health care providers who work on the streets would save along the whole continuum of care – vaccinations to improved heart health.

Law enforcement systems can dedicate their finite resources to improving community relations and crime fighting. As a matter of public safety and public service police are often the ones who find the homeless person in crisis and transport him/her to the ER.

Mental health substance abuse organizations might be the biggest winners of all if they contributed to the cost of street-based medical care. People with psychoses may easily be afraid of health care workers they don’t know, but Drs. Withers and McConnell both have succeeded in building trust with those they help.

There’s a huge added bonus for mental health care providers. While health care providers are addressing infections and high blood pressure they can discreetly screen for human trafficking, drug use and domestic violence.

Then there’s the cost of unintended pregnancies and lack of pre-natal care. Street care offers a chance to discuss and disperse contraception. Better pre-natal care reduces the incidence of infant mortality and premature births; it could reduce the incidence of babies born addicted to drugs or severely disabled.

If all of these service providers decided to collaborate on managing and paying for street based care we can at least reduce the suffering of our homeless citizens. And all of that money that we save on medical care could pay for housing. Then one day we would not need street-based health care.  The truth is: housing is health care.