Language a Barrier to Health Care

Randy Nieves provided by Terra

My main reluctance to getting health care in this country is the English language, and I suspect thousands of Latinos—especially those who aren’t fully bilingual—might feel the same. The idea of navigating the health-care system stirs the simple fear that hidden within the arcane language of insurance policies are some unpleasant surprises.

I first got a taste of this when a close relative of mine tried to arrange a medical appointment. She’s Latina and was transferred here by an international company that didn’t require her to speak English. When the moment of truth came, she asked, “How do I do this? Are there any doctors that speak Spanish? How is it that these doctors do not take ‘new patients’? Is it going to cost me? How do I explain to them what I’m feeling?” She eventually got up the nerve to call a doctor, although many people don’t even get that far. But making an appointment is only the first obstacle to overcome.

My health-insurance company has a nice Spanish-language Web site full of information about diet, exercise, and healthy living, but the terms of the policy are in English—and it’s this fine print that scares me.

I am Latino and fully bilingual, but my native language is Spanish, and in life or death situations—either at the doctor’s office or in court—I would rather hear the diagnosis or the sentence in Spanish.

Along with half the 47 million Latinos in the United States whose mother tongue is Spanish, I wonder, “Will I understand what the doctor said, or when I should take the medication?” These are not minor questions when your health is involved.

“I do not believe in a doctor that cannot speak English” were the words spoken by Hyman Roth, a gangster in The Godfather: Part II, when he experienced health problems in la Habana and called on his doctor to come to him from Miami. Maybe he was scared of being treated by a Cuban doctor, a foreign physician in a Third World country, but I like to think he was scared of not understanding what he was going to experience.

While bilingual health-care professionals exist, they simply cannot keep up with the demand. A couple of months ago I went to an emergency room to pick up a friend who was involved in an accident and does not speak English. The Spanish-speaking nurse was busy down the hall, so the other nurse on duty did her best to speak slowly and clearly. Still, when my friend was bombarded with all kinds of questions and instructions, she pretended to understand, even though I knew she was not able to.

Some may say, “Well, people need to learn English if they live in the United States.” They might be right. But reality is often different from aspirations, and in life-or-death situations that can arise among those who are ill, there is no time for this debate. Fear of being mistreated due to the inability to communicate contributes to people’s willingness (or lack thereof) to seek health care, even though that fear may not be justified.

Of course, language is far from the only issue. When we talk about Hispanics’ health care, we cannot disregard the fact that many people, especially those who are undocumented, simply do not have time to get sick because of their illegal status, their tenuous job security, or the high cost of health care.

From farms employing Hispanic labor in the Coachella Valley in California, to those in Immokalee, Fla., or workers waiting tables or doing construction, we hear the same response: a sick day means losing a day of work, in addition to incurring expenses the worker cannot afford.

A farm worker from Immokalee with a limp once told me that he would take painkillers to deal with a leg fracture. He risked becoming permanently disabled for not getting care. “I can’t afford to stop working,” he said.

In that sense, Hispanic immigrants have gone over the language barrier and have assimilated the American dream in a language that everyone, from patients to doctors and insurance companies, fully understands. They have adopted the saying “el tiempo es dinero” (“time is money”) as truth.

Ruiz is news editor for, a global digital media company and bilingual content producer with a presence in 18 countries, including the United States, where it serves the growing Hispanic community.

Read the Spanish version of this story here.

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