Longer looks: Health literacy's effect on costs

Mar 23 2012

Every week, reporter Jessica Marcy selects interesting reads from around the Web.

Huffington Post: Women's Health Care Is Stronger Thanks To The Health Care Law
In many families, women are the health care decision makers. When children go for their checkups, we are often the ones who make the appointment and sit in the room holding their hand. When elderly parents see a new specialist, we are the ones carrying the folder with all their health information. ... In the past, this also meant that many women would take care of their own health last. By the time they got around to it, women found a system stacked against them. But thanks to the health care law, that's changed (Kathleen Sebelius, 3/20).

The New Yorker: Holding Court
Late last year, a three-judge panel of the D.C. Circuit [Court of Appeals] voted, two to one, to uphold President Obama's health-care reform, known as the Affordable Care Act (ACA). [Brett M.] Kavanaugh dissented, primarily on the ground that the lawsuit was premature. ... "Under the Constitution," Kavanaugh wrote, "the President may decline to enforce a statute that regulates private individuals when the President deems the statute unconstitutional, even if a court has held or would hold the statute constitutional." … In other words, according to Kavanaugh, even if the Supreme Court upholds the law this spring, a President Santorum, say, could refuse to enforce ACA because he "deems" the law unconstitutional. That, to put the matter plainly, is not how it works (Jeffrey Toobin, 3/26).

Governing: What Will The Supreme Court Ask About Health Reform?
If the court decides to rule on the lawsuit, a decision is expected by the end of June before the conclusion of the court's current session. That decision has heavy implications for states. The ACA includes an extensive expansion of Medicaid (expected to add up to 20 million people to the program's rolls) and asks states to create a health insurance exchange where individuals and small businesses can compare and purchase insurance plans. Market reforms, such as rules for the medical loss ratios that insurance companies must maintain, would also require cooperation from state governments (Dylan Scott, 3/15).

The Atlantic: The Most Scientific Birth Is Often The Least Technological Birth
When I ask my medical students to describe their image of a woman who elects to birth with a midwife rather than with an obstetrician, they generally describe a woman who wears long cotton skirts, braids her hair, eats only organic vegan food, does yoga, and maybe drives a VW microbus. ... Many medical students, like most American patients, confuse science and technology. They think that what it means to be a scientific doctor is to bring to bear the maximum amount of technology on any given patient. And this makes them dangerous. In fact, if you look at scientific studies of birth, you find over and over again that many technological interventions increase risk to the mother and child rather than decreasing it (Alice Dreger, 3/20).

TIME: Inside America's Drug Shortage
Lynn Divers thought she had heard the worst of it when doctors told her that her daughter Alyssa had cancer. … Then came the truly heartbreaking news. In late February, when Divers called the hospital to confirm Alyssa's upcoming chemotherapy treatment, the nurse informed her that there was a drug shortage. The hospital couldn't be sure that there would be enough methotrexate -; the cornerstone of therapy for some childhood cancers, including leukemia and osteosarcoma -; to treat Alyssa, now 10. … How did this happen? How could hundreds, perhaps thousands of cancer patients suddenly find themselves without the drug treatments that could save their lives? (Alice Park, 3/19).

American Medical News: The ABCs Of Health Literacy
One in three patients has "basic" or "below basic" health literacy, meaning he or she struggles with tasks such as completing a health insurance application or understanding a short set of instructions about what liquids to avoid drinking before a medical test. This literacy gap has medical consequences. A wide body of research has found that patients with poor literacy skills have much worse health outcomes than patients who can read well. They make more medication or treatment errors, are less compliant and are 50% likelier to be hospitalized, says the National Patient Safety Foundation. Low-literacy patients with chronic diseases ... rack up four times more in annual medical costs than patients with higher reading ability (Kevin B. O'Reilly, 3/19).