Paula Hein


Private physicians struggle to provide translators for patients, especially in rural areas like the one in which Dr. Kerr practices. Translators cost anywhere from thirty dollars to four hundred dollars depending on such factors as the time needed to translate, whether or not the translator is trained as a medical translator, and the language that is being translated. Telephone language lines, which provide translation over the phone through a dial up service, costs providers an average of two dollars and fifty cents ($2.50) per minute. There is also the price of the extra personnel time that is required to develop, conduct training, and administer the physician's LEP (Limited English Proficiency) program. Additional costs would include the following: researching the needs of limited English proficient patients in an area; translating medical literature; evaluating the plan; and reassessing the needs of the community to ensure the program's success. Advocates of patients with LEP argue that there is a need for greater enforcement of existing guidelines, including adding a private right to sue. However, this will not assist LEP patients in rural areas where physicians simply cannot afford to follow these guidelines. More money needs to be spent on programs that already have been proven to be successful in these areas without placing additional burdens on physicians. Part II of this article looks at the difficulties that patients who are limited in their English proficiency face in health care systems. Part III examines the history of Title VI and its use to end discriminatory practices in the health care system. Part IV analyzes the most recent and controversial Supreme Court decision regarding a disparate impact case brought under Title VI. Part V examines the limits of a private right to sue for assisting LEP patients, and Part VI presents some better solutions to this difficult problem.