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Securing appropriate healthcare hinges on having the necessary skills to read and fill out medical and health insurance forms, communicate with healthcare providers, and follow basic instructions and medical advice. At virtually every point along the healthcare services spectrum, the healthcare system behaves in a way that requires patients to read and understand important healthcare information. This information is dense, technical, and has jargon-filled language. Examples include completing health insurance applications, reading signs in hospitals and clinics about where to go and where to sign in, and following written and oral instructions in brochures and pamphlets, as well as prescription medication directions. The healthcare system itself can pose a serious barrier to appropriate care. Fear, embarrassment, and a non-user-friendly health care system are likely to inhibit many people from seeking clarification regarding what is meant by treatment instructions or medical advice. Cultural and language barriers, as well as low general literacy levels, can further exacerbate the problem of effective communication between patients and the health care system. Not having dependable health insurance is a significant deterrent to literacy in its own right, because uninsured persons are significantly less likely to use healthcare and, thus, may be that much more inexperienced in navigating the system.

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