Critical Care: How Medical Interpreters Save Lives and Money

Californians are at a crossroads in the history of this state.  We are on track to be the greatest beneficiaries of health care reform, yet almost half the Californians who will newly gain access to health care in the coming years, may not be able to understand their doctors, nurses and other providers.  We are the most diverse state in the country with the strongest laws requiring interpretation in medical settings.  Yet we are standing at this crossroads with no plan for how Californians who are Limited English Proficient (LEP) will access the care they are entitled to.  We have the opportunity to put our state on a course to save lives and money.

The people of California need to be understood.

  • Approximately 1 in 5 Californians speak English less than “very well.”
  • Nearly half of Medi-Cal recipients speak a language other than English.
  • With national health care reform, millions of Californians will be newly eligible for health care; of those enrolling in Medi-Cal, about 3 million over five years will require language assistance.
  • Californians with limited English proficiency frequently report problems related to their experience of care. 
  • Enrollees of the state’s seven largest health plans were more likely than English proficient enrollees to report problems understanding their physician (11.2% vs. 2.6%).
  • They are also more likely to believe they would have received better care if they were of a different race/ethnicity (14% vs. 3.2%).

The human and financial costs of doing nothing are too great.

  • Lack of proper interpretation in a medical center has dire, even tragic consequences. 
  • In one survey, almost half the physicians were familiar with incidents in which quality of care was compromised by language barriers.
  • Limited English proficient patients in hospitals are at far greater risk of experiencing unintended harm that is not a result of their disease or condition, up to and including permanent brain damage, paralysis, and death.
  • Lack of language access in health care increases the use of more expensive emergency services, higher diagnostic and testing costs, and increased liability for providers.
  • Beginning no earlier than January 2012, organizations that fail to comply with the new standards may risk losing their Joint Commission on Accreditation of health care Organizations (JHACO) accreditation.

California Has the Opportunity: A Plan to Enable Doctors and Patients to Understand Each Other.

  • California has the ability to draw down significant federal funding for interpreter services through Medi-Cal.
  • California can bill the federal government for administrative expenses involved in providing interpreter services at a rate that would cover 75% of the costs of medical interpretation for children and pregnant women in Medi-Cal and CHIP and 50% of the costs for adults in Medi-Cal.
  • The program will create a new, statewide system for providing health care providers with funded, professional medical interpretation.
  • Over five years, approximately 10,785 new jobs will be created in the medical interpreter field. 

The decision is up to us.

We can either allow thousands of newly insured Californians to join the ranks of Medi-Cal participants who speak a language other than English, but who receive little access to interpretation when needed, or take full advantage of the federal funds available to create a program in Medi-Cal that will offer certified, professional interpreters to both providers and patients, so they may be understood.  California can achieve quality of care for those who speak English less than well.  To do less is to court human and financial disaster.  California has a choice.  With the support of the federal government, quality of care and critical support for health care delivery in our state can be a reality.

With the numbers of Californians newly eligible for healthcare with health care reform, California Medicaid will see an influx of millions of enrollees, of which approximately 3 million over five years will require language assistance.