The Dark Side of Health Care Co-production. Health literacy as a requisite for the co-production of care

“Patient involvement” and “patient engagement” are two buzzwords in the field of health care provision, whose statement is recurring in most of the current international health care reforms. Both of them suggest a reconceptualization of health care: from a provider-led service, it turns to be a coproduced service. Consistently, the patient is understood as the subject rather than the object of care, being engaged in any phase of the provision. Nevertheless, most of the patients are not able or they are unwilling to be involved in the provision of care. Information asymmetry, psychological weaknesses, and poor health literacy hinder the activation of the patient. Lacking a process of patient enablement, co-production of care is doomed at remaining beautiful words. This article depicts the results of a descriptive literature review aimed at discussing the relation between health literacy and patient involvement. Although health literacy is widely understood as a key determinant of patient activation, it is infrequently addressed within the initiatives proposed at the empowerment of the patients.