今天的《词汇大师》讨论的是美国日益困难的医疗保险行业。由于越来越多的人移民美国，而其中很多的移民是没有医疗保险的。而语言上的差异也使得美国的医疗卫生情况越来越复杂……

Broadcast on "Coast to Coast": June 27, 2002
Re-broadcast on VOA News Now: June 30, 2002

AA: I'm Avi Arditti with Rosanne Skirble, and this week on Wordmaster: a special report about the linguistic challenges that health care workers face in the United States as a result of the nation's growing immigrant population.

RS: A recent study found that hospitals could lower medical risk and enhance their treatment of immigrant patients by providing interpreters to translate a diagnosis or procedure. The study involved a survey of patients who did not have medical insurance.

AA: The study was conducted by the Access Project, a resource center in Boston, Massachusetts, for community health initiatives. The center is affiliated with Brandeis University.

VOA correspondent Laurie Kassman sums up the findings.

TEXT: Access Project Executive Director Mark Rukavina says the study highlights the advantages language interpreters provide for the patient and the hospital — and the dangers when they do not.

RUKAVINA: "One of the more troubling findings from our report was that people who needed but did not get interpretation were much more likely to leave the encounter with the clinicians without a clear understanding of the medication or the instructions or how to pay for the care that they received."

TEXT: The Access Project surveyed four-thousand patients at 23 hospitals in 16 U-S cities, including many who did not speak English well. One in five of those who responded that they did not have an interpreter said they did not understand how to take the medicine they received. Only two percent of those who needed and got a proper interpreter cited this as a problem. Often, immigrant families who speak little English depend on their child or relative who does. But Washington attorney Mara Youdelman of the National Health Law Program says that can create added family tensions and more problems:

YOUDELMAN: "First and foremost, many children do not have the competency in English or medical terminology to accurately translate. Secondly, many children are brought in at inappropriate circumstances. For example, a ten-year-old child was asked to translate and explain to his mother that she had just been diagnosed with cancer."

TEXT: Access Project director Mark Rukavina says many hospitals may agree on the need for the service but see the added cost as an obstacle. Ironically, he says, only five U-S states currently take advantage of federal health insurance programs that will subsidize interpreter services for their public hospitals.

Ms. Youdelman says the federal government reminded state health services two years ago of the availability of federal funding.

YOUDELMAN: "We still believe there is an educational effort that needs to be undertaken so that states are aware of the federal reimbursement and make them understand that providing interpretation up front can reduce health care costs in the long term."

TEXT: Ms. Youdelman's law center recently studied 14 community health programs that use interpreters to see how handle the problem.

Mr. Rukavina says many urban hospitals and clinics that service large immigrant communities already have come up with a variety of programs to meet their needs and their budgets from pooling interpreter services or using telephone language hot-lines, to training bilingual, non-medical staff in medical terminology.

RUKAVINA: "There is an emerging field of study on how to effectively and efficiently provide these interpreter services and there is more attention being paid in the medical community as well."

TEXT: Immigration activists say it is not just the medical community that needs to take action.

Last month, hundreds of immigrants in New York City marched to show their support for legislation that would require the city's health, welfare and employment agencies to use interpreters, too.

AA: VOA's Laurie Kassman reporting. And that's Wordmaster for this week.

RS: Our postal address is VOA Wordmaster, Washington DC 20237 USA. Our e-mail is word@voanews.com. And you can find our programs on the Web at voanews.com/wordmaster. With Avi Arditti, I'm Rosanne Skirble.