Marcel Slockers

132 Summary Netherlands, has observed a growing number of homeless patients who do not have health insurance resulting in their access to healthcare services and medication being limited. In this article we raise the alarm about the epidemic of uninsured Dutch homeless. We explain and comment on the reasons why people are no longer insured and elaborate on the regulations and obligations related to homelessness and the characteristics of consumers and providers of social and medical services. We describe how difficult it is for homeless people to become re-insured as in order to follow a complex set of requirements, commitment and patience are necessary. For most homeless patients, the re-insurance process requires the personal guidance and support of a motivated case manager. Consequently, we suggest that policy makers and service providers should have a better understanding of factors contributing to being uninsured and more compassion for those who are. In chapter 7, after having described the barriers in chapter 6, we try to contribute to the implementation of a tool to deal with the problem of the uninsured. We therefore suggest that organisations use the protocol ‘Health care for the uninsured homeless patient’. We investigated by asking health care workers and experts by experience why uninsured people are denied medical care. Overall, the investigation shows that the scheme works insuffi- ciently in practice, with unnecessary health damage of the uninsured homeless people as a result. The presented protocol provides care professionals with a tool in clear steps on how to proceed, and thus aims to provide clarity about the subsidy scheme and about what a care organisation should do to obtain reimbursement. In this way, a care professional will be compensated for the provided care and the homeless people will receive adequate care and guidance. In chapter 8 we describe the findings of this study. With this study on mortality, health problems, accessibility to care, we show again that homeless people belong to an extremely vulnerable group. We observe a variety of serious diseases and disorders among homeless people in a shorter life. Homeless people do not die from homelessness but from preventable and/or treatable causes and health problems. In terms of accessibility of care, a constant fight against deterioration was needed. New regulations in 2015 -homeless people have since lost their health care insurance if they no longer have an address- has complicated the accessibility of care.