health literacy


Health Affairs: Many Don’t Know They Can Get Preventive Care Free

Here’s my suggestion for holiday lights over the White House: Big neon letters that read: “You can now get lots of preventive care with no out-of-pocket costs!”

Under the federal health reform known as Obamacare, preventive care like check-ups and vaccines must now be largely free, and insurance companies may not charge co-pays for much of it. (Actually, it’s more nuanced than that, as my far more knowledgeable readers Amy Lischko and Dennis Byron explain below, and I altered my neon message above in response.)

In any case, a great many people do not know which preventive care is now free to them; a poll last year found that more than 40% of Americans did not know that Obamacare bans “cost-sharing” for preventive care. And the trouble is, if you don’t know preventive care will cost you nothing out of pocket, you may not get it, and thus fail to reap the benefits of staving off illness before it hits.

A new study just out in the journal Health Affairs finds a similar “people-don’t-know-what’s-free” problem with high-deductible health insurance called “consumer-directed” plans. The title says it all: “In Consumer-Directed Health Plans, A Majority Of Patients Were Unaware Of Free Or Low-Cost Preventive Care.” From the press release:

Patients in high deductible consumer-directed health plans avoid preventive care due to unnecessary fears over cost. Consumer-directed plans typically exempt recommended preventive visits and tests from the plan’s deductible, or require only a small copay. These plans have grown in popularity, increasing to 19 percent of all covered workers in 2012 from 8 percent just three years prior. Mary E. Reed, of the Kaiser Permanente Northern California Division of Research, and coauthors found that more than half of the 456 Northern California-based respondents surveyed did not understand their plan benefits for preventive office visits and approximately one in five delayed or avoided a preventive visit, test, or screening because of cost. Continue reading

Blogger: ‘Health Care Reform Gangnam Style’

Has any media phenomenon ever gone as global as Psy’s Gangnam Style rap video? (Besides the bible, I mean.) It was at an astronomical 878,054,797 views on YouTube when last I looked, leaving Michael Jackson’s “Thriller” far, far back in the ancient dust.

So of course I had to read a post called Health Care Reform Gangnam Style when I saw it on The Health Care Blog (thanks to Its very fun concept: A start-up called Rap Genius crowdsources translations of rap lyrics that most of us are not gangsterish enough to understand. But what we really need, blogger Lisa Suennen writes, is translations of impenetrable “healthcare speak:”

You may think Nelly’s lyrics are opaque, but have you ever seen an Explanation of Benefits from your insurance company? Makes the “30 down at the bottom, 30 more at the top” phrasing downright obvious compared to trying to make sense of what was billed vs. allowed vs. paid vs. subject to the deductible vs. amount left for the patient to pay.

It may be cool to understand rap lyrics, particularly if you are a 45 year old white dude with two kids, a golden retriever and a Honda Accord, but lets keep it real, yo (defined as: be realistic): we are living in a healthcare world that is rapidly turning into a retail market out of the emerging ashes of what was previously the domain solely of the healthcare wonkery. More than ever it is becoming downright essential for actual humans to understand the “rap” (crap?) that the healthcare world turns out. Continue reading