Focus on Health Literacy: A Path to More Affordable Health Care
By Michael J. Cohen, principal of MJC Health Solutions, LLC
As New Hampshire sees declining insurance enrollment, longer waits for care, and growing pressure on hospitals, clinics, and community providers, one challenge is becoming harder to ignore: our health care system is just too difficult for too many people to navigate.
Imagine losing coverage, facing a frightening diagnosis, choosing a new insurance plan, or trying to schedule care for your child while sorting through confusing medical terms, hidden costs, limited provider networks, and unclear instructions. For too many New Hampshire residents, this is not a rare experience—it is the reality of seeking care in an increasingly strained system.
This is not just a personal hardship or a business concern. It is a systemic failure that drives up costs, weakens health outcomes, and makes health care less affordable for everyone. More residents are enrolled in high-deductible or limited coverage plans, more employers are facing unsustainable benefit costs, and more families are struggling with unexpected medical bills. As a result, patients delay care, and medical debt grows. These are not isolated hardships—they are symptoms of a system that is difficult to navigate and increasingly expensive for everyone.
Why Health Literacy Matters
Health literacy is the ability to access, understand, and use health information to make informed decisions. It means knowing what questions to ask, how to compare treatment options, and how to anticipate costs.
When businesses, families, or individuals understand the care and coverage they have, they make better choices and avoid unnecessary expenses. When they don’t, they delay treatment, misunderstand bills, and often end up in emergency settings—costing more and suffering worse outcomes.
A recent survey of more than 1,300 New Hampshire adults highlights the challenge. While many respondents felt confident following a physician's instructions, far fewer understood insurance terminology or knew how to challenge an insurance decision. Fewer than half could define "coinsurance," even though it directly affects out-of-pocket costs. One-third received an unexpected medical bill during the past year, yet very few appealed it—often because they believed the process would be unsuccessful. This is not a failure of patients. It is a failure of the system.
Health Literacy as Cost Containment
Improving health literacy is not simply about patient education; it is a cost-containment strategy. When providers communicate clearly, care becomes safer and more efficient. When patients participate fully in shared decision-making, unnecessary procedures decline. When policymakers ensure transparency, public trust grows, and resources are used more wisely.
New Hampshire has made important progress on price transparency, but publishing prices alone is not enough. Information must be accurate, understandable, and actionable. Consumers also need protection from unexpected out-of-network charges when they make good-faith efforts to choose affordable care. As insurance products become more complex and provider networks change, many families select plans that appear inexpensive but later expose them to significant financial risk.
A Shared Responsibility
Strengthening health literacy requires collaboration among patients, policymakers, insurers, providers, employers, and community organizations. Several practical steps could make an immediate difference:
Use plain language. Hospitals and insurers should present insurance plans, bills, and notices in clear, culturally competent language that consumers can understand.
Restore patient enrollment and navigation assistance. A fully funded program offering one-on-one support to patients during insurance enrollment and when coverage denials and billing disputes arise would help residents make informed decisions and avoid costly mistakes.
Leverage technology wisely. User-friendly price transparency tools and digital educational resources—videos, interactive guides, and clear explanations of patient rights—can help residents navigate care more confidently.
Building a More Affordable Health System for New Hampshire
Health care affordability is about more than lowering prices. It is about giving people the knowledge and confidence to make informed decisions. Health literacy is one of the most practical—and most overlooked—tools for improving outcomes, reducing unnecessary spending, and restoring trust in the health care system.
If we want a health care system that works for everyone in New Hampshire, strengthening health literacy is one of the most practical and immediate steps we can take. The time to act is now.
Michael J. Cohen is a member of the New Hampshire Health Cost Initiative, Board of Contributors, principal of MJC Health Solutions, LLC, and a frequent opinion contributor on public health, mental health, and health policy.
