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To: Knighty Tin who wrote (283504)4/8/2004 2:21:38 PM
From: Pogeu Mahone  Read Replies (1) | Respond to of 436258
 
Reuters
Health information too complex for many in US-report
Thursday April 8, 1:57 pm ET
By Susan Heavey

WASHINGTON, April 8 (Reuters) - Drug labels, consent forms and other health information are often in language that is too complex for many Americans to understand, a panel of experts said on Thursday.
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As patients continue to manage more of their own care, the inability to grasp medical jargon can lead to worsening health and higher costs, according to an Institute of Medicine report.

"Many people who deal effectively with other aspects of their lives may find health information difficult to obtain, understand or use," the independent group, which advises the federal government on health matters, said in its report.

Medical experts reviewed more than 300 studies and found language used by doctors, insurance companies and researchers is often above a high-school level. Information meant only for the public also includes highly technical terms, they said.

About half of all Americans adults, or about 90 million, read below a high school level, and half of those have trouble finding information on charts, forms and labels, according to the report.

Older adults, non-English speakers and those with less education have the most trouble, but the experts found native-born English speakers and those with more education also struggled.

Less-literate patients with chronic conditions requiring constant management are particularly vulnerable and can have trouble making decisions about their care, the Institute said.

NAVIGATING THE SYSTEM

Difficulties navigating the health care system are made worse by the flood of information from the government, food and drug companies, and the media, especially Web sites.

"People are frequently and repeatedly exposed to quick, often contradictory bits of information," the report reads.

The report also found such confusion can raise health care costs.

Less literate adults are less likely to follow healthy lifestyles or take advantage of preventive care, it found. They are also more likely to be hospitalized and use emergency services, which can increase health care costs $29 billion to $69 billion a year, studies said.

The experts reported their findings in a 331-page report that included seven chapters, four appendixes and nearly 30 tables and charts.

Some recommendations to make health information less complex included:

"... a national consensus conference to initiate the development of operational measures of health literacy which would include contextual measures."

"... the development of conceptual frameworks on the intersection of culture and health literacy to direct in-depth theoretical explorations and formulate the conceptual underpinnings that guide intervention."

Health care companies, federal health agencies and other groups should adopt simpler language to make documents more readable, the Institute said.

The report was paid for by Pfizer Inc. (NYSE:PFE - News) , MetLife Foundation, the National Cancer Institute, and the American Academy of Family Physicians Foundation, among others.

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To: Knighty Tin who wrote (283504)4/8/2004 2:24:20 PM
From: Pogeu Mahone  Read Replies (3) | Respond to of 436258
 
Point Proved?
Clarke Says Rice’s Testimony Bolstered His Claims
ABCNEWS.com
April 8— National Security Adviser Condoleezza Rice repeatedly told the 9/11 commission today that there was no "silver bullet" that could have averted the deadly Sept. 11 terror attacks on America.


But former counterterrorism czar Richard Clarke, who is also an ABCNEWS consultant, said he tried to warn the president of the imminent threat of al Qaeda. He testified during the Sept. 11 commission's public hearings that the Bush administration paid too much attention to Iraq and underestimated the threat from al Qaeda, before and after the Sept. 11 attacks.
After Rice's three-hour testimony concluded, ABCNEWS' Peter Jennings asked Clarke what he thought about Rice's testimony before the commission.

The following is an unedited, uncorrected transcript of Clarke's interview with ABCNEWS' Peter Jennings as it aired on Thursday, April 8, 2004:

Jennings: Now let's talk a little bit about Richard Clarke. Even if you heard only a little of the testimony today, much of the testimony centered on the testimony of Dr. Clarke. Dr. Rice, you heard comment on it. She certainly contradicted it in some cases.

Mr. Clarke is an adviser to ABCNEWS on the subject of terrorism and has been for many months. I don't think we necessarily expected that he was going to make the kind of news that he did when he appeared before this commission, but we — you will recall that when he testified before the commission, the Bush administration took ample opportunity to attack in a very public, very widespread way what he had said before the commission.

So in trying to understand some of the truth and the facts about this commission today, we've asked Dr. Clarke, who, as I said, has been a paid consultant to ABCNEWS over many months, to come back and try to answer a couple questions about what he has heard today and he is in Boston.

Mr. Clarke, can you hear me?

Clarke: Yes, Peter, I can.

Jennings: I just want to ask you, you heard people using your testimony in a variety of different ways. But I wondered if you would start first by reaffirming your statement that even with more aggressive action by the Bush administration, the events of 9/11 could not have been prevented and then explain then, if you would, why what you have said should matter to this commission.

Clarke: Well, Peter, I was asked by Senator Gorton if the adoption of the strategy in February, as opposed to September, would have stopped 9/11, and I said no. And Dr. Rice said no. I think we agree on that.

The adoption of the strategy would not have stopped 9/11. What I've said might have had some effect on 9/11 would have been if Dr. Rice and the president had acted personally, gotten involved, shaken the trees, gotten the Cabinet members involved when they had ample warning in June and July and August that something was about to happen.

And frankly, I think that Dr. Rice's testimony today, and she did a very good job, basically corroborates what I said. She said that the president received 40 warnings face to face from the director of central intelligence that a major al Qaeda attack was going to take place and she admitted that the president did not have a meeting on the subject, did not convene the Cabinet.
She admitted that she didn't convene the Cabinet. And as some of the commissioners pointed out, this was in marked contrast to the way the government operated in December of 1999, when it had similar information and it successfully thwarted attacks.

So I don't see that there are a lot of factual problems with what Dr. Rice said.

There are one or two other minor points here or there that I think are probably wrong, but overall I think she corroborated what I said. She said it was inefficient to bring the Cabinet members together to have them work to stop the attacks that they had been informed were coming.

Jennings: Do you agree with her, and she said it repeatedly this morning, that the structural deficiencies, most notably in the relationship between the FBI and the CIA prevented and would have prevented any administration from doing a better job?

Clarke: No, I don't. We had meetings that I chaired two and three times a week where FBI and the CIA shared information. My deputy had a daily meeting where that took place. The problem was that there was information buried in FBI and the CIA that wasn't shaken out.

And by having the Cabinet members come to the White House every day in crisis mode and then go back to their departments and look for anything that is anywhere in the departments in December 1999, we were able to get the kind of information we needed to stop the attacks. You know, there may be structural problems within those agencies, but the way you overcome them in a crisis mode is by having the leaders of the agencies get together in the White House as a team in crisis mode. And Dr. Rice admits she didn't do it. Dr. Rice admits she didn't do it.

Jennings: Dr. Rice and you also disagree about whether or not the White House generally regarded the whole thing as a crisis.
She says the memos which you wrote to the president had an historical nature to them rather than being actual plans of action which could be moved forward. She also says she didn't try very hard to see the president — you didn't try very hard to see the president when you felt as strongly as you did. Would you comment on both of those?

Clarke: First of all, the document I sent to her on Jan. 25, days after the administration started, the documents ought to be declassified and people can decide for themselves. That memorandum on Jan. 25 said I urgently need a meeting with the Cabinet to approve these plans, these strategies. we can get into semantical distinctions as to whether it was a plan or strategy or a series of decisions that had to be made, but on Jan. 25, I was saying we have a strategy, it needs these additional elements, the president has to make decisions about that so we can go forward.

And I think what you'll see if it's declassified and you compare it to where they came out on Sept. 4 is basically on Sept. 4, they adopted what I proposed on Jan. 25. And so the time in between was wasted.

Now, on the issue of whether or not I asked for a meeting with the president, I did. I asked for a meeting with the president several times beginning, in fact, before Dr. Rice even took office in the transition briefing. I said I have given this briefing to the vice president, I've given it to the secretary of state, I've given it now to you, I would like to give it to the president.

And what I was told was I could brief the president on terrorism after the policy development process had been completed.

Jennings: You moved at one point from terrorism to cyber security and you did have a meeting with the president at that time.
If you felt as passionately about your terrorism plans, why did you not tell the president about that when you had a chance to see him face to face?

Clarke: Because I had been told by Dr. Rice and her deputy that this was a briefing on countering the cyber threats and not on al Qaeda and that I would have my opportunity on al Qaeda if I just held on, eventually they would get to it, probably in September.

Jennings: Mr. Clarke, thank you very much for joining us today. And thank you for your help to us over the last many months.

Clarke: Thank you, Peter.