How many times have you heard, “Once they start talking about health care, after a few sentences, my eyes glaze over”? That is one kind of illiteracy in health care. That one is largely voluntary, in that the issues surrounding health policy can be complicated and difficult to understand. And sometimes health policy people are not as clear as they should be.
However, for 90 million Americans – just about half of all adults – who cannot understand the simplest health-related problem, their “health illiteracy” could actually kill or disable them for life. A new study by the prestigious Institute of Medicine (IOM) has determined that such illiteracy is no joke.
Doctor-patient relationship
The IOM cited the case of a woman who misread the instructions for an oral antibiotic. She tried to insert the liquid into her kid’s ear, rather than have her kid swallow it. A male patient thought that he was being diagnosed as being “hyper, can’t sit still,” when he was actually being diagnosed as having hypertension. Sounds a little crazy, but it isn’t. In cases involving children, these mistakes are too often blamed on the mother. The IOM isn’t doing that.
The report cites many studies that show that patients with limited literacy are more likely to be hospitalized, have poor health habits and are less likely to use preventive services.
Patient-insurance carrier relationship
The IOM did not report on the almost impossible task that everyone has in understanding his or her insurance policy. For people with limited literacy, the problem becomes even greater. When right-wing health ideologues talk about the importance of choices for patients to make, as if that was more democratic, what they are actually doing is introducing more impossible alternatives to choose from. It is truly a phony use of the term “democracy” that only serves the profit goals of insurance carriers and drug companies.
Unfortunately, even some liberal politicians fall into this trap. For example, the Federal Employee Health Benefits Program, which is heralded as a truly democratic insurance program, is so complicated that anyone can be confused by the options, let alone people who are suffering from this kind of illiteracy.
National health policy
Promoters of even progressive national health legislative proposals are also confronted with “the glazed eyes syndrome.” Practically every person, regardless of their political stripe, uses the terms “universal” and “high quality” to describe their ideas. Striking back against health illiteracy is a good place to start.
IOM recommendations
The IOM report recommends four steps to address such problems:
• The federal government must pay for research on ways to improve health literacy. As simple as that sounds, this kind of education program would strike at the greedy hearts of corporate executives now making billions off of the illiteracy rampant in our country.
• Organizations that accredit medical, public heath and health related schools must require those schools to follow national health education standards, from elementary schools through college. This is a very important recommendation and would reestablish the federal government as the leading political body on health care.
• Health organizations and medical-public health schools should teach health literacy and how to communicate with patients. If this is taken seriously, then teaching methods must be developed with those who will be receiving the education, e.g., community and labor groups.
• Federal Medicare, Medicaid, and other health groups should develop creative ways to communicate clear health information. It would be totally naïve to think that those who profit and benefit from the illiteracy in the health system, that is, the insurance carriers and drug companies, would honestly conduct this kind of program. The federal government must promulgate and directly fund community based and labor programs that will be able to fight against being ripped off by these interests.
The author can be reached at pww@pww.org.
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