Misinterpreting an Urgent Medical Need

Poulinna Po had just walked into the Long Beach offices of Khmer Girls in Action when she got the news: Governor Jerry Brown had vetoed Assembly Bill 1263, which promised to expand the number of state medical translators. The measure had seemed to offer a straightforward solution to the dilemmas faced by California’s estimated three million Medi-Cal beneficiaries who speak little or no English when they talk to Anglophone doctors or medical staff.

One tragic example of this kind of patient-doctor miscommunication occurred in 2008 at Los Angeles County General hospital, when a pregnant Maria Guevara, who only spoke Spanish, was prescribed an abortion-inducing drug — which she then took, believing it to be part of her prenatal care. She lost her baby.

“That lack of communication between the doctor and me has changed my life forever, ” Guevara would later bitterly recount.

For the past year activists with other personal experiences successfully fought for passage of AB 1263 and were stunned to learn of the governor’s veto.

“I was like, ‘What? No way!’ I was left speechless,” said Po.

Po had learned the hard way how difficult it is to navigate a medical conversation between an English-speaking doctor and a patient who speaks little or no English. Two years ago, the then-15-year-old Po was drafted into service as a Cambodian translator for her diabetic father during his visits to the hospital.

“It’s super hard translating at a young age,” she recalls. “Kids don’t know the root words and can’t get the exact message across. I’m not fluent in Khmer – there are multiple ways of saying things and I was never sure I was using the correct word. The staff was patient but they would have to rush us all the time, because they had other patients who spoke English.”

AB 1263 would have addressed California’s acute shortage of medical translators by permitting the state to spend $200,000 to gain access to $270 million in Affordable Care Act funds to create about 7,000 interpreter jobs within 10 years. The only palpable opposition came from  the National Right to Work Committee, a radical conservative lobby that claimed the bill would “grant union bosses monopoly bargaining powers over virtually all [medical interpreters] operating under the program . . .”

Brown made no reference to unions in his veto remarks, writing, instead:

California has embarked on an unprecedented expansion to add more than a million people to our Medi-Cal program. Given the challenges and the many unknowns the state faces in this endeavor, I don’t believe it would be wise to introduce yet another complex element.

In response, the bill’s author, Assembly Speaker John A. Perez, issued this statement:

At a time when California—where more than 40 percent of our population speaks a language other than English at home—is expanding access to health care, it is shameful that the Governor isn’t doing what it takes to help ensure that even those who don’t speak the language have the ability to adequately communicate with their health care providers. This veto is a prescription for raising costs to the system because of misdiagnoses and delayed treatment.

Po remains hopeful that the medical interpreters bill will be reintroduced next year.

“We can start,” she says of any future campaign, “by reaching out to more community members to testify and show the governor that there are so many people affected by this. We would ask him to walk in our shoes for one day. He would see how impossible it is for non-English-speaking patients to communicate to their doctors without a translator.”