Did Obamacare Just Flunk Its Spanish Test?
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Did Obamacare Just Flunk Its Spanish Test?

Did Obamacare Just Flunk Its Spanish Test?

CuidadoDeSaludIn another embarrassing development for the Obama Administration, U.S. Hispanic and Latin American advocates have charged officials with failing to properly translate the Spanish-language version of Healthcare.gov. The result, they say, is a travesty of justice for the nation’s 53 million Spanish-speaking health care consumers.

CuidadoDeSalud.gov, the Spanish-language version of Healthcare.gov, has been beleaguered by problems from the start. Will the language issue be a nail in the Affordable Care Act coffin or just another stumble along the path to affordable health care for all?

Political Football

One part of its struggles, naturally, has been the current tenor of U.S. politics regarding the nation’s Hispanic population. Although they represent some 17 percent of the entire U.S. population and continue to be its fastest growing minority group, Hispanics and Latin Americans in the U.S. have found their health care needs used as fodder in the political war.

Democrats understand the value of their participation — although they are less than 20 percent of the entire population they make up a third of the nation’s non-elderly uninsured, according to health policy researchers. Those are the very kind of enrollees that reduce insurance-based costs.

“Disproportionately we are being counted on to sustain this program,” said Daniel Garza, executive director of the Libre Initiative, a nonpartisan, nonprofit grassroots Hispanic advocacy organization, in an interview with CNN.

Republicans, seen increasingly driven by its conservative Tea Party brethren, counter that it’s the impact of a high number of undocumented immigrants that has over-burdened the health care system in the first place.

The second challenge to CuidadoDeSalud.gov was the roll out of the main English-language site. Although scheduled to launch in October, CuidadoDeSalud.gov was not actually completed until December due to technical problems with the English-language site. The delayed launch of the main site was a source of considerable controversy on its own. This was so much so the case that journalists in high profile newspapers began quoting political analysts and major Democratic players, including former President Bill Clinton, who were calling the entire health care initiative into question.

The specifics of the Spanish-language problem, while less reaching in scope, also undermine the goals of the entire initiative, assert Hispanic and Latin American activists.

“To put up a website that is only cosmetic it’s disrespectful of this administration,” Garza said to CNN. “If you’re going to have a website, have it work, for the love of God.”

Misunderstanding Spanish

Examples given, of course, point to a lack of understanding about how translators for the U.S. Spanish market should have been qualified. As translation and localization industry experts understand, there is no one Spanish language. U.S. Spanish is not the Spanish of Spain nor the Spanish of Argentina nor the Spanish of Peru, regardless of a shared heritage. U.S. Spanish has a vocabulary that is a mix of a diverse ethnically Hispanic community in the U.S. and the influence of American English. Moreover, there are terms distinct to the U.S. health care and pharmaceutical sectors. Place atop that, too, the need for professional translation services that understand the differences and have training and experience in life sciences translation.

Little has been done to recognize that, apparently. As the CNN investigation showed, “some words and phrases are literal translations from English to Spanish, which health advocates in the Hispanic community say makes the site difficult to understand.”

The Need for Health Care Translation Standards

We wrote about that specific problem just recently in our coverage of an Australian initiative on standards in health care translation. In getting away from the literal to get to meaning, Australian health care professionals asserted that some procedures were critical in health care translation to meeting the needs of a underrepresented health care consumers. Their new ten-point standard calls on health care professionals to:

  1. Develop the English text and/or test the translation with members of the target language-other-than-English (LOTE-) speaking community.
  2. Undertake a cultural and linguistic assessment of the English text in preparation for its translation.
  3. Undertake a subject matter expert assessment of the English text as appropriate.
  4. Organize for the English text to be translated by an accredited translator.
  5. Undertake a cultural and linguistic assessment of the translation.
  6. Organize for the translation to be proofread by an accredited translator.
  7. Include the title of the text in English on the translation.
  8. Include the name of the target language in English, on both the English text and the translation.
  9. Distribute the translation in bilingual format-English and LOTE.
  10. Date, monitor, evaluate and update the English text and the translation as part of an ongoing review program.

(Click here to read more about the Australian health care standard in translation.)

According to representatives of the U.S. Department of Health and Human Services, efforts are already underway to resolve these matters so that CuidadoDeSalud.gov is back on track for U.S. Hispanic and Latin American health care consumers. Let’s look forward to that. No doubt, we all benefit from health care systems that work, no matter where we live and what language we speak.