Improve health care, lower costs

World Health Day is celebrated every year on April 7. It is a unique opportunity to think about our individual health status. Do you know what one factor will predict your health status more than your age, income level, employment status, racial or ethnic group, or educational level?

It is literacy. That’s right, health care literacy. This year on World Health Day we want to bring to your attention this important issue because it transcends all of the usual predictors of health status. According to the Partnership for Clear Health Communication, a coalition of national organizations, including America’s Health Insurance Plans (AHIP) of which Anthem Blue Cross and Blue Shield is a member, the ability to read, understand and act on health information is directly related to an individual’s overall health.

Let’s face it, most of us need help understanding health care information, regardless of our education or reading levels. Think how difficult it must be for people without strong reading skills. One in five Americans reads at a fifth-grade level. The average American reads at the eighth- to ninth-grade level. Yet most health care materials are written for people with much higher levels of literacy.

As you might imagine, the problem is even more acute among our vulnerable populations such as minority groups, immigrants and the elderly. As our parents age and begin to rely more on the health care system, this dilemma will become increasingly important.

Aside from the often tragic personal consequences of low health care literacy, the impact on health care costs is enormous. According to a report by the Institute of Medicine, low health care literacy affects 90 million people in the United States and costs the health care system more than $58 billion every year.

Annual health care costs for people with low health care literacy levels are four times higher than those with higher literacy skills. Only about 50 percent of all patients take their medications as directed. People with low literacy and chronic diseases such as diabetes, asthma or high blood pressure are less able to properly manage their diseases. And people with low literacy skills face a 50 percent increased risk of hospitalization.

These statistics indicate that a unique opportunity is available to us that will help solve the problem. One of the Partnership’s first initiatives is “Ask Me 3,” a quick and effective tool to improve communication and understanding between patients and their doctors. “Ask Me 3” is based on three simple questions that every patient should ask the doctor, nurse or pharmacist every time they see each other:

1. What is my main problem?

2. What do I need to do?

3. Why is it important for me to do this?

These three simple questions can have a major impact on the quality and cost of health care in this country. Think about that. We’re not talking about expensive new technology or pharmaceuticals. We’re not talking about expensive new buildings. We’re not talking about a new government program or mandated benefit. Just three simple questions and some straightforward conversation between patients and their doctor, nurse or pharmacist.

In addition to the three questions, patients can take other simple steps to ensure clear communication with their medical team, such as bringing a friend or family member to help with their doctor visits, making a list of all their health concerns so they won’t forget anything when they talk to the doctor, bringing a list of all the medications they are taking, and always asking the pharmacist when they have questions about medications.

Doctor visits and hospital stays can be stressful. Learning that you have an illness can be frightening. Taking a new medication can be confusing. We all have shared these emotions when it comes to health care, but the only way our doctors can help us is if we clearly understand what we need to do to stay well or get better. “Ask Me 3” provides another level of assurance that we hear it right – and get it right – the first time.

Making high-quality health care more affordable and accessible is one of the biggest challenges of our time. The issues are complex and all of us – providers, insurers, consumers and policy-makers – are working to find the solutions that will fulfill the promise of our health care system for all citizens. World Health Day 2005 is a unique opportunity to start to work on improving our health literacy.

It is something that we can all do right now to hold down costs and improve the quality of care we receive.

Erin Hoeflinger is president of Anthem Blue Cross and Blue Shield in Maine.