Language Barriers to Health Care: An Overview

Health services should be provided such that patients fully understand the nature and purpose of the services they receive. However, achieving this goal frequently requires trade-offs involving access, cost, and quality of services, particularly when the patient's principal language is not English. This background paper provides context for the discussion of language issues in health care by reviewing federal and state laws and related initiatives; discussing the case history of language access in Seattle, Washington; and surveying the expansion of managed care. It also describes different models of language services and raises issues to be faced in the delivery, financing, and regulation of language services in a managed care environment.