Nan Roman, president of the National Alliance to End Homelessness, reminds us that homelessness is also a health care issue.

...a 1996 nationwide study of homelessness found that only 25 percent of homeless single adults were enrolled in Medicaid.

It's not always easy to see, but homelessness and health care have a clear -- and cyclical -- relationship: poor health can lead to homelessness, and homelessness can aggravate poor health. And both can be a burden on our health care system.

Many people become homeless due to a lack of health care. Untreated illnesses can lead to disability and job loss -- and unemployment remains one of the leading causes of homelessness. It's worth noting here that the leading cause of bankruptcy in the United States is medical expenses, insured or not. So people's incomes are clearly tied up with their ability to get or pay for health care; and the lower incomes lead to higher risk of homelessness.

The other side of the coin is that homelessness aggravates poor health. The lack of access to water, food, and clean, safe and stable housing only puts further pressures on a person's body.

With few resources and little access to any alternatives, homeless people will wait until the last possible moment to seek treatment, and then likely resort to costly emergency room (ER). Once they're in the hospital, then tend to stay longer. After discharge, pushed back into homelessness, their symptoms often return and worsen, until they're right back in the ER.

The cost of this inefficient, ineffective cycle is something we all pay for -- through higher medical costs, insurances rates, and local and state taxes. In fact, many cost studies of this social problem suggest that it may be more financially prudent to ensure that homeless people receive preventive and primary care before minor conditions become chronic ones.