Nearly one million more Americans were without health insurance in 2010, compared with the year before. That’s according to new Census numbers released Tuesday, which also show the Midwest has one of the lowest rates of uninsured in the nation. But even for people who have health insurance, understanding a doctor’s orders can be an obstacle to getting good care.
In an exam room some 35 years ago, Toni Cordell’s doctor assured her the procedure would be an “easy repair.”
“I asked absolutely no questions, except ‘when,’” she said. It wasn’t until after the surgery that a nurse happened to mention the name of the procedure. “I did not learn until my six week check-up that I had had a hysterectomy and part of my body was gone.”
Cordell said she didn’t ask questions out of respect. “Physicians were very god-like,” she said. “If they said something, we did not question it. Because if I asked a question of a doctor, I was afraid it would come off as me disrespecting their expertise.”
The incident helped turn Cordell into a health literacy activist. These days, of course, patients have much more access to information. But making sense of it remains a problem: According to a 2003 report by the National Assessment of Adult Literacy, only 12 percent of Americans are at a “proficient” level when it comes to understanding health-related information.
“It’s a huge problem, particularly in rural areas, where basic education level is not as great as it is in urban areas,” said Steve Pu, a general surgeon based in the bootheel of Missouri. He’s also the chairman of the board for Health Literacy Missouri, which hosted a summit on the topic in Columbia on Tuesday.
Pu said pressure on doctors to work quickly means less time to explain things clearly to patients. “You know, physicians are more driven by volume, being able to see more patients, more patients, and you spend less time with patients, less time with patients, and that obviously impacts the communication, the doctor-patient relationship.”
Also at the summit was Howard Koh, assistant secretary for health at the US Department of Health and Human Services. He said the health care reform law has several measures aimed at helping people understand health issues. One, unveiled last week, will require insurers to use simpler, standardized language to explain coverage options.
“We need to make this information, which is already complex, as easy as possible for people to understand. Define our terms, so people can use this information to make the best decisions about their own health.”
Those new requirements will go into effect next year.