Choosing a health insurance plan was an exciting moment in my life—a rite of passage into adulthood—and an equally exciting moment for my mom, who no longer would be paying my health care bills. However, as I started reviewing my options, I had more questions than answers. Do I want a high-deductible plan that comes with lower copays? Or a low-deductible plan with higher copays? What is coinsurance? How much will my prescriptions be? Can adulthood wait a few more years?
My mom was a medical biller at an emergency department, so I felt pretty confident that I was going to be able to navigate this process with ease. Finding that wasn’t the case, even though I grew up hearing about the terminology and concepts, reminded me of the many ways that our health care system is difficult to navigate and understand, even for the most health care literate among us.
Health literacy is defined as the ability to access, read, understand, and use health information in order to care for yourself and your family. Can we adhere to an immunization schedule or follow directions on a prescription drug label? Do we understand what our insurance covers or what’s on a nutrition label? The National Assessment of Adult Literacy found that only 12 percent of adults had proficient health literacy. A startling 65 percent of Hispanic adults had only basic or below basic health literacy level.
Colorado adults who lack a high school degree are nearly two times less likely to feel confident in basic health insurance terms (PDF) than high school graduates or adults with an associate’s degree. The same is true for income—as income goes up, understanding of health insurance terminology improves, too. In addition, nearly one in four Coloradans say they are not likely to check if a doctor is in-network before getting care and nearly one in three Coloradans aren’t likely to review what their plan covers before getting services.
Across the globe, there are efforts underway to improve health literacy. Engage for Health in Pennsylvania works to boost patient engagement through education. The program includes helping people prepare for their doctors’ visits and support for libraries becoming community centers of information in health literacy. A trial in Uganda is teaching children how to detect the difference between true and false health claims. In Colorado, the 2nd Annual Colorado Health Literacy Conference will take place on October 21, and will provide practical strategies on integrating health literacy into our organizations. The Colorado Consumer Health Initiative has also launched CoveredU, a website that teaches health insurance literacy.
We believe patients have a right to receive health information in a way they can understand; so does the Joint Commission, the group that accredits and certifies health care organizations and programs in the United States. While it’s important that patients do their part, the primary responsibility for improving health literacy is with the system itself—public health, health care, health insurers, and other systems players.
Though I eventually did choose a health insurance plan, it continues to be a learning process to navigate the system without my mom to hold my hand. I’m glad to see so many efforts to help patients like me increase their health literacy, and hope we’ll continue to make it a priority; it’s an important step to ensuring better health outcomes.