DLI Alumni & Friends Community

[BauerMN]

I know that this is old news, but I just learned about it:


In August 2000, President Clinton issued an executive order mandating that all physicians, clinics, hospitals and other medical care providers who receive Medicare and Medicaid reimbursement for treating patients with limited English proficiency, or LEP, provide to those patients full interpreter and translator services in their own languages.

Just to understand the scope of the mandate, consider that the United States Commission on Civil Rights reports there are as many as 500 different languages and dialects spoken by persons residing in the U.S.

In addition, the mandate forces these medical care professionals to ensure the competency of the medical translation and interpreter services they provide. And even though federal Medicare and Medicaid reimbursements rarely cover the actual costs of the medical services rendered, the full financial burden of providing the mandated language assistance services to LEP patients is placed solely on the medical care providers themselves; the federal government does not contribute anything to this huge financial and administrative cost.

Yet, under this edict, an LEP patient's complaint to federal authorities that the medical professional failed to provide competent language services in his native tongue automatically triggers a federal investigation, following which the doctor or hospital can lose federal reimbursement and right to future participation in the Medicare and Medicaid programs. Worst yet, the LEP patient's complaint can lead to a federal charge of intentional "national origin" discrimination under the Civil Rights Act of 1964, which pro-immigrant activist groups will seize upon to publicly accuse the doctor or hospital of racism.

Some may be wondering how this monumental change in law and public policy could have occurred – whereby a bureaucracy-bloated federal agency (U.S. Department of Health and Human Services) directly interferes with the age-old doctor-patient relationship by dictating how they must communicate. There was no act of Congress. The federal government didn't even give the nation's doctors, hospitals and other directly affected health-care providers and associations the opportunity to point out why this idea was an oppressive solution to a nonexistent problem. The edict took effect immediately upon issuance.



This is rather disturbing. I have nothing against Clinton. (I supported him in 1992 until I realized it was a two-for-one co-presidency deal.)

But the law basically states that if a foreigner from the Phillipines walks into a hospital emergency room in Sioux City, Iowa, the hospital not only has to provide an interpreter that speaks fluent Tagalog but the hospital is responsible for the accuracy of the medical translation. What is wrong with this picture?

[Johnway]

What is wrong with this picture is that neither the doctor, nor the patient can make an informed decision unless they can understand one another. I cant say I agree with the procedure and potential ramifications to individuals, but Medical necessity requires understanding of all symptoms, and informed consent for surgery requires the same.

I would not like to walk into a hospital in Uganda with a stomache ache and have them remove my appendix if it is not the problem.