Health literacy. Who (or what) is to blame for our nation’s ongoing struggle with health care access, utilization and personal care management? Is the patient born equipped to navigate (or fail) the system? Should environmental forces shape (or stymie) each of us as a savvy health care consumer? Or are doctors failing miserably in an unspoken “not my job” syndrome of patient education.

Last night, @kdhoffman2 and @rv_rikard hosted a chat on #hchlitss regarding health literacy. We got into quite a rally regarding patient responsibility. Can a person whose environment, culture, and heritage predicate poor health and outcomes truly be expected to rise above and succeed? Or, should we as a society, stress personal responsibility and somehow mandate ownership of health issues and an individual’s path to literacy?

I appear to be using way too many question marks in this post, and that usually indicates a tough topic. Yes, there ARE two sides to this story, so many angles to consider. While playing a blame game may get us no where fast, we as a society cannot continue on a path of blatant disregard for medical science and expect group insurance — or worse, the emergency room — to handle our health care costs indefinitely.

Literacy is a challenging topic in any arena. Even fundamental literacy in our education system isn’t clear cut. In one of life’s uncanny coincidences, today I co-chaired our public elementary school’s Literacy Day (formerly RIF, before it was unfunded at the federal level this year). We chose the term “literacy” for a reason. I wanted the children to make the connection between reading and responsibility for their own learning, growth and future (a truly foreign concept to many).

Today they did choose a book — a free book, which is a thrill for any of us — but that book symbolizes more than just beating the system. It symbolizes a responsibility. I explained this to them. There were a few eyerolls, even looks of disbelief from the teachers. But yes, I gave 650+ children today the responsibility to take that book and somehow make use of it. To hone a skill and grow. And you know what I saw in their faces? “I can do it.”

Will some struggle? Yes. Will some fail? Yes. But will some who never thought they could, rise to the challenge and succeed? YES.

So after a long day, put me in the camp that sets expectations and measures responsibility for health literacy in our society. All stakeholders (e.g., patients, providers, education system, social services, insurance industry) need to up their games. Yet individuals are capable of far more than they are generally ever asked. I saw the light in those young eyes today. We can do it.