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    1. Koh et al. (11) detailed a cycle of crisis care elaborating the nature of high medical costs, possibly resulting from fear and denial. First, an individual is in need of medical help, so he or she goes to a physician's office where the staff asks the individual to fill out a complex and confusing form. The physician examines the patient and explains the condition and treatment options using medical jargon. Numerous prescriptions, laboratory tests, and referrals are given without confirmation of the patient's comprehension. The staff sends the patient home with complicated instructions. Inevitably, the patient may consume medication incorrectly or miss follow-up appointments, and his or her condition worsens. Eventually, the patient presents to the emergency department, and the hospital staff develops a new treatment plan. Again, no one confirms the patient's understanding. When the patient is discharged, he or she is likely to get sick again and repeat the cycle (11)