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Two primary issues are addressed in this article: the economic status of the older adult and the economic implications of health care. The relationship of elder homelessness is integrated into this discussion as relevant from the literature on the socioeconomic and psychosocial aspects of aging. The emergence of older adults as a substantial subgroup within the United States population has been identified as signaling a crisis for the health care system. This article places recent changes in health care financing for older adults in the context of biomedical, demographic, and social factors that lead to homelessness in an older adult population. These factors, in turn, are related to the larger economic and political structures that have shaped our national health care policies and social programs. Current policies and programs are inadequate in meeting the needs of the growing number of older adults because they provide only a limited array of services. This article examines how the needs of older adults have been portrayed to support age-based entitlements to limited health care coverage, irrespective of need across age strata. All health care practitioners can use their understanding of the genesis of particular public policies to assist in developing a health care system that is responsive to the needs of all members of society.