El Diario-La Prensa, New york

Health Reform Proposal will help non-English speakers

One of the most important aspects in taking care of patients is obtaining a detailed medical history. The plan of care and treatment also need to be carefully explained in a way that is understandable by the patient. Yet some conservative groups have argued that for patients who do not speak English these important principles of medical care do not apply.  They propose that persons who do not speak English get lower quality health care so that they are forced to learn English.   However, discrimination of patients because they do not speak English is illegal in this country.  In addition, many accrediting organizations require hospitals and large health plans to make efforts to provide language services to non-English speakers.  As a result, many large health systems have taken important steps to accommodate such patients.  This includes the right to translation services as part of a hospital’s “Bill of Rights”. The rules are very flexible and only apply to health care practices where a significant proportion of patients speak another language.  One way to provide these services is through professional interpreters.   But, there other options. For example, if over half the patients speak Spanish we think having providers who speak Spanish is a better alternative.    In practices where many different languages are spoken access to low cost telephone interpretation may be a better alternative. 

Now as part of health reform, the government is proposing a study to find the best approaches to providing cultural and linguistically appropriate health care services for elderly Non-English speakers.   This study is a critically important component of health reform which will help us understand the most cost-efficient methods to deliver such quality health care among diverse populations in diverse settings.   Another component of the health reform are imposing fines on large health plans fail to provide language services to limited English proficient Medicare beneficiaries as required under law.  The problem is that current laws do not fine health providers from violating these anti-discrimination laws.  Thus, some hospitals and health insurance plans still do not comply with the law.  We believe that fines for health plans that act illegally maybe a way to get them to adhere to existing laws.  Therefore, such fines are also another important component of health reform. 

Most of the non-English speakers in this country are hard working people who make positive contributions to our society and economy.   Some groups have argued that allowing patients to get inferior health care, suffer or even die because they do not speak English is in our national interests.  We believe they are dead wrong.   

Olveen Carrasquillo, MD, MPH

Vice President, Latinos for National Health Insurance & Chief, Division of General Internal Medicine

Ana Palacio, MD, MPH

Assistant Professor of Medicine

University of Miami, Miller School of Medicine