... where there is a power imbalance, educationalimbalance, and where they are fearful of appearing stupid and fearful of rejection or abandonme nt. As a result, they arehesitant to admit that they ... managed care organization in the United States, that 23% of the English-speaking and 34% of the Spanish-speaking respondents could not adequately read and comprehend medical information in their ... literacy amongmedicare enrollees in a managed care organization. JAMA 1999;281:545–51.[10] International Reading Association, Special Interest group on reading and readability. Newark, Delaware,...