Inmates of the House of Correction were also surveyed, and seven public forums were held across the Cape, at which the responses from more than 300 people closely paralleled the survey's results. Language barriers are also a problem. Smith said that eight percent of the people surveyed didn't have anyone in their household who could speak, read, write, or understand English. In response to the lack of interpreters, Cape Cod Hospital did recently hire one who speaks Spanish and Portuguese. But there is also a growing Haitian population locally, and most local health care providers don't have any available interpreting services.
Patients often have to rely on a friend or family member to communicate with doctors and others.
One of the biggest barriers a lot of people face, however, is the combination of increasingly high health care costs and a lack of affordable health insurance. To make matters worse, only eight of the 179 dentists on the Cape accept MassHealth. A big reason for this is that MassHealth reimburses dentists for less than their normal charges. Conversely, doctors are reimbursed a little more than normal fees, although still less than physicians off-Cape. And although 95 percent of Cape doctors accept MassHealth, only one third of them are accepting new patients currently.