Health Care Reform: Will It Empower or Perplex Consumers?

Are American consumers "health literate" enough to play a leading role in their health care and coverage decisions? That question will be put to the test in 2014, when more than 30 million uninsured adults begin shopping for health plans through state insurance exchanges a core element of the national health reform package signed into law by President Barack Obama in March. Stakeholders hope to avoid another debacle like the one that occurred nearly five years ago when Medicare launched its then-new prescription drug benefit, called Medicare Part D. "If you look back at Part D, we learned a lot about how multiple choices in plans and in drug-plan coverage overwhelms, confuses, undermines people's confidence that they can manage the system," said Christina Zarcadoolas, an associate professor in the department of preventive medicine at the Mount Sinai School of Medicine in New York City and a health literacy expert.

Health literacy the capacity to obtain, process and understand basic health information to make appropriate health decisions isn't a new concept. But as consumers are encouraged to play a more active role in choosing health insurance coverage, using preventive services and screening tests and managing chronic health conditions, it's becoming more critical. "Health literacy is needed to make health reform a reality," U.S. Health and Human Services Secretary Kathleen Sebelius said in a statement in May announcing the National Action Plan to Improve Health Literacy, a set of goals and strategies for creating a "health-literate society." "Without health information that makes sense to them, people can't access cost-effective, safe and high-quality health services," she said.

More than one-third of U.S. adults have only basic (22 percent) or below basic (14 percent) health literacy. Just 12 percent have "proficient" health literacy skills, while less educated and poorer individuals, in general, have lower health literacy, according to a U.S. Department of Education analysis. To improve health literacy, the Department of Health and Human Services (HHS) is encouraging health organizations and insurers to use plain language and pictures or graphs to communicate with consumers, among other enhancements. These strategies "have the potential to both reduce the complexity and demands of the health care delivery system and educate and empower Americans so they are able to fully benefit from the Affordable Care Act and take charge of their health," an HHS spokeswoman said in statement prepared for HealthDay.