Next Great Immigration Hurdle -- The Right to a Medical Interpreter

SAN FRANCISCO--The two out of five Los Angeles residents who speak Spanish at home would find it easier to buy a can of paint at Lowe's than explain to a public hospital emergency room doctor where it hurts.

The home improvement store offers foreign language interpreting in less than a minute over a special telephone line at the customer service desk. But there is only one fulltime, trained, Spanish-speaking medical interpreter in L.A.'s five public hospitals and clinics; and the health department is investigating why a desk clerk at the USC Medical Center emergency room recently failed to know the access code to its Spanish language line.

Thousands of miles away, the regional trauma center in Savannah, Ga., boasts of having improved its medical interpreting for a burgeoning limited-English-speaking community. But that was only after a young, Spanish-speaking woman, whose boyfriend acted as her interpreter, died during her second visit to its emergency room.

Across urban and rural America, policymakers are grappling with the reality that more than 20 million U.S. residents -- 1 in 12 -- speak one or more of hundreds of languages, but may not speak English well or at all. By law, they are entitled to free interpreting when they seek medical attention.

The issue of medical interpreting for immigrants is poised as the next challenge to every polarized bone in America's body politic. Buried in the text of the Senate immigration bill -- to be considered by the congressional conference committee during the summer -- is an amendment by Sen. Jim Inhofe (R-Okla.) that could kill the federal law protecting interpreting as a right by making English the language of the land. To counter it, Sen. Ken Salazar (D-Colo.), included in the same bill an amendment that supports language access. The conference committee will have to choose one or the other, or delete both.

The senatorial mixed message comes just when the issue of medical interpreting is showing up on the national radar. Debate begins with the lack of consensus over what a medical interpreter is, how many are working in the country and what constitutes professional training. It dead-ends at how much professional medical interpreting costs and who should pay for it. Language access researchers, lawyers, policy specialists and advocates estimate it will take at least five more years to agree on solutions. Even with current law on their side, many health care experts wonder if they can beat a brewing health crisis within a health care system they consider dysfunctional.

The issue is fraught with danger. The total number of patients dying annually in the United States due to medical error is roughly equivalent to a full 747 jetliner crashing and killing all passengers every other day. According to the Institute of Medicine, which recently studied medical error, language plays a part in many preventable deaths.

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