Healthcare Reform Unlikely to Slow Medical Travel Growth, Experts Say

Healthcare Reform Unlikely to Slow Medical Travel Growth, Experts Say

Kiana Bright, vice president, Thailand Medical Travel and Tourism: More Americans will travel overseas for healthcare. Accessibility of care will be a long-term problem if more people are brought into the healthcare system. Canada has universal healthcare and is a perfect example of this. Many Canadians have to wait up to seven months or more to receive knee replacement surgery.

In addition, the healthcare cost will be increased for employers. This will drive them to find creative options to save money.  Medical tourism can be the answer for that.

Are there areas of medical tourism that will not be impacted by the Affordable Care Act?
Boucher: It should have no impact at all on dental coverage and therefore dental tourism. In fact, a lot of Americans are dropping their dental coverage. Even if you are covered, most dental premiums have a $1,500 or $2,000 a year maximum at best. So if you need $15,000 worth of dental work and you are only covered for $1,500, it still pays to travel for dental care.

Woodman: There is a vast landscape that will not change at all. Dentistry is not covered (under the Affordable Care Act), neither are cosmetic surgeries and some bariatric procedures.  Dentistry and cosmetic surgery comprise over half of all medical travel – and if you add in elective surgery, that’s about 75%.

What other factors beyond cost and insurance coverage are driving the future of medical tourism?
Boucher: With the increasing shift toward greater transparency and consumer awareness, there will be an increase in Americans traveling for healthcare as they learn more about the high quality care available overseas.

There’s so much more information out there on the safety, quality and service provided by medical institutions. More consumers are sharing their experiences. It’s no longer just what the medical facility wants to tell us. People will increasingly be able to make educated decisions.

Woodman: Global options for healthcare will be something that more people are comfortable with. People are growing savvier about these options already – there are people who are getting off a cruise ship and getting an MRI while in port.

We haven’t yet reached a critical mass on healthcare transparency but it is coming. More patients will be rating their experiences online. It will be like hotels on TripAdvisor.

Hospitals are offering packages and special deals, but not enough yet and they are not posted on their websites. The next phase is to pry all this information loose and aggregate it. It will be easier to shop and compare.

The global potential for medical travel is huge – and increased global activity will lead to improvements in healthcare. There’s a huge growth of the middle class in other countries, which means more people can travel for healthcare. Hospitals will be forced to compete.

 

See more:http://www.travelmarketreport.com/medical?articleID=7456&LP=1

Korea is looking to become a hot destination for medical tourism

South Korea hopes to multiply by three the number of travellers coming for medical purposes until 2018. Outbound markets from Russia and the UAE are seen as priority.

SEOUL- Korea has ambition to become a major destination for medical tourism within the next five years. The government has been supporting the globalization of Korean medical institutions under a brand campaign “Medical Korea”, in an effort to promote its medical sector abroad. So far, according to the Ministry of Health and Welfare, total number of foreign patients who visited Korea for medical treatment surpassed 110,000 last year, up from 81,789 in 2010. If everything goes according to Korea’s ambitious development plans in this niche market, the country could attract over 150,000 foreign patients this year and target 400,000 visitors for medical purposes by 2018. By comparison, in 2007, less than 8,000 foreign travellers came to Korea for medical tourism.

The government has been making efforts over the past few years to develop medical tourism as one of its new growth engines. An agreement has been for example signed with health authorities in Abu Dhabi to allow citizens from the UAE to get treatment in four contracted local facilities in four hospitals located in Seoul. According to Korea’s Health Ministry, the agreement could generate economic benefits of US$ 52 million per year. Various programs have also been introduced by the government and related state agencies to facilitate the arrival of tourists for medical purposes. Initiatives include the issuance of medical treatment visas, operation of an around-the-clock medical call centre as well as dedicated one-stop medical tourism service centres. Special visa issuance has already helped to welcome in 2011 some 8,259 for countries such as Russia, China PRC as well as Mongolia. Russia is seen as one of the market with the highest potential. An office to promote Medical Tourism has recently been opened in Vladivostok in Siberia.

Speaking with the Korean daily “The Korea Times”, Korea Tourism Organization (KTO)’s chief Lee Charm sees medical tourism as the next big thing for the nation’s tourism industry. “The prospect for medical tourism is fantastic. The area of medical service has unlimited growth potential.” Lee said. The high level of services, the blend of traditional Korean medicines with Western medical knowledge as well as a safe and reliable environment is considered as assets to further develop medical tourism. Korea medical services are also price competitive, especially when compared to Western European countries. “We are a bit more expensive than Thailand but our environment is much better and safer,” added Lee to the newspaper.

 

Read more: http://traveldailynews.asia/news/article/49911/korea-is-looking-to-become

AMA calls for pharmacies to offer interpreter services

Delegates also adopt policy seeking appropriate payment for physicians and others who provide such services.

By Pamela Lewis Dolan, amednews staff. 

 

Chicago American Medical Association policy encouraging the use of interpretive services at hospitals that treat a significant number of non-English speaking or hearing-impaired patients has been expanded to include pharmacies.

“The AMA already believes that offering these services is important, and it is clear that understanding medical instructions including, but not limited to, medical dosage and timing are all essential elements in providing health care services,” said Bethany Bush, a regional medical student delegate for the West Virginia State Medical Assn., speaking for the AMA Medical Student Section, which drafted the resolution approved at the organization’s Annual Meeting in June.

Urologist Paul Friedrichs, MD, an alternate delegate for the Air Force, supported the policy. He said that in the previous month, he had traveled around the world, “and I am very grateful that other countries have taken a proactive stance in providing translation services, both at pharmacies and hospitals, so that when Americans need medical services, they can speak to a trained translator who can assist them.”

“I hope that the United States will provide the same level of service that other countries are providing,” he said in reference committee testimony on June 17.

Many independent pharmacists, particularly those in cities, care for a diverse, underserved population and work to overcome language and other barriers every day, said Kevin Schweers, spokesman for the National Community Pharmacists Assn. But the decision of whether an interpreter is needed is “best made by state pharmacy boards and individual pharmacy owners with the most information and best perspective on their patients’ needs, obstacles to taking their medication and how to overcome those obstacles to achieve optimal health outcomes.”

The Civil Rights Act of 1964 already mandates that physicians and others who receive federal funds must make interpretive services available. Many comply with the law by using bilingual staff, family members or automated technology such as translation software or language lines. On June 18, delegates reaffirmed policy directing the AMA to seek legislation that provides for appropriate payment for interpretive services. Such legislation would eliminate the financial burden to physicians and hospitals for the cost of these services, the policy states.

The house also adopted policy that supports the publication of patient assessment tools in multiple languages. Tools such as the National Institutes of Health Stroke Scale and the Saint Louis University Mental Status Exam frequently are used by physicians to gain patient input while planning appropriate treatment. The majority of these tools are created for use only with English-speaking patients.

The policy calls on the AMA to encourage the publication of these tools in multiple languages and validation to ensure that the tools are translated properly so that patients understand the desired information.

 

Read more: http://www.ama-assn.org/amednews/2012/07/02/prsp0702.htm

Crime Beat: Interpreter standards and the court

A first-time court appearance can be frightening, but for someone who does not speak English as their first language it could be incomprehensible.

The terminology and the process can seem strange enough to someone who is not familiar with the legal field. Attorneys and judges go to great lengths to explain the process to all parties involved, but a language barrier presents a different problem.

The court is alerted when there appears to be a language barrier with a defendant or witness. They may speak English well enough to get by on Kaua‘i, but to better understand their rights and the proceedings, the judge appoints an interpreter to ensure equal access and a constitutional right to due process.

In recent 5th Circuit cases, attorneys have raised questions about interpreters. In one case, it was unclear if a question was raised about an immigrant Filipino defendant and whether he was asked his dialect. A Tagalog interpreter was appointed, a common second language in Hawai‘i. But the attorney said the regional dialect of the defendant was  Ilocano.

It turned out the defendant did speak Tagalog fluently. However, if had he not, then the judge may have been concerned that the proceedings would be over-simplified, allowing the defendant to respond, but not fully understanding his rights and consequences of options.

U.S. Census data says that just 73 percent of people in Hawai‘i speak only English. More than 26 percent speak at least one other language.

The 2010 Census reports that 13.7 percent of Kaua‘i residents are foreign-born, as are 17.7 percent of state residents.

Around 57 percent of Hawai‘i residents who speak another language say they also speak English very well. Around 26 percent say they speak English well, 15 percent not so well, and 2 percent not at all.

The Pacific Island languages lead all first-languages spoken in Hawai‘i at 7.9 percent. Tagalog, Japanese, Chinese, Spanish, Korean and Vietnamese round out the rest of the predominant languages.

Other measurable first-languages spoken in the state include Laotian, Thai, Portuguese, German and French.

Registered court interpreters recommend that a person unable to understand their interpreter raise their hand or make some sign that they don’t understand what is being said or happening. The same goes for people talking to a police officer during an arrest or while making a report at the scene of an accident.

Kaua‘i Police Department has access to local interpreters. They also use telephone interpreters when one is not available in person. The goal is to improve equal access for limited-English proficient, deaf and hard-of-hearing defendants and witnesses.

The State Supreme Court adopts the rules for certification of spoken and sign language interpreters. Eligibility is determined with written and oral examinations for English proficiency or sign language. There is also an ethics test and a criminal background check.

Once cleared, the applicant is issued a certificate of court interpreter tier status and placed on the court interpreter registry. They are selected by island courts as available when needed.

Tier 1 is a registered basic interpreting. Tier 2 and Tier 3 are more advanced but on a conditionally approved status.

Tier 4 and Tier 5 present strong simultaneous translating skills and are recognized with a national certification. Tier 6 is a certified master translator with advanced simultaneous and consecutive translation skills.

The State Judiciary conducts Court Interpreter Certification workshops to prepare applicants for a written English proficiency test and basic ethics exam. Applicant must be at least 18 years old, authorized to work in the United States, speak English and at least one other language, and pass a criminal background check.

On June 27 the Hawai‘i Supreme Court amended its rules for certification of interpreters. It now reads that when making an appointment, a court “should” (deleting “may”) give preference to court certified interpreters within that circuit.

This fell short of recommendations set by National Association of Judiciary Interpreters and Translators. The Seattle-based organization with 1,100 members and a Hawai‘i chapter recommended alternative language of “shall” give preference to the highest qualified and tier designation.

NAJIT Advocacy Committee Chairman John M. Estill stated in a letter to the court that the rule as stated allows “judicial whim” on interpreter decisions. He said the difficulties with finding qualified interpreters should not result in loosening standards.

The Hawai‘i Registry of interpreters shows that the majority of qualified interpreters live in the First Circuit. Estill said his concern is that courts prioritize on-island searches over looking for the highest qualified interpreter on any of the islands.

Hawai‘i Interpreter Action Network President Marcella Alohalani Boido, a certified court interpreter of Spanish and English, said the court is undermining its own initiatives with the certification program. She recommends a mandate for courts to select higher tier interpreters when possible.

She said the rule change conflicts with the guiding principles of the Supreme Court’s own polices set in 1995. It state’s court goals of equal access for deaf and limited English proficient immigrants.

Boido says the amended rule should provide for “evaluating the gravity of a court proceeding; the geographical location of the court; the rareness of a language; the jeopardy a party is placed in; the availability of the most qualified interpreters; and cost.”

The issue could be about travel costs. It could be that the court doesn’t see eye to eye with the interpreter organizations and doesn’t want to limit its options with selection.

If the bottom line is placing value on skilled interpreters, then interpreter advocates fear that individual courts setting standards of on-island availability. They present a decade of input from the legal and medical fields that have instituted professional interpreter standards.

For now the court will determine on a case-by-case basis that its interpreters meet the standards they set in the spirit of its comprehensive certification program.

Proposal for ‘English only’ city council meetings sparks debate in Walnut, Calif.

By Caroline Tan, NBCLosAngeles.com

WALNUT, Calif. — For Walnut residents who do not speak English, participating in City Council meetings and addressing local officials may soon become more difficult.

Council members voted 5-0 this week to postpone a decision on a proposal that would ask non-English speakers to provide their own interpreters for all Council proceedings, which would be conducted only in English.

But the prospect of English-only public meetings remains a distinct possibility. A vote may happen later this month, when the council is scheduled to meet again on July 25.

Though a formal decision has yet to be made, the proposed English-only policy has already raised concerns among some local residents, who fear the move would violate civil rights and unfairly disadvantage a portion of the population.

Nearly two-thirds of Walnut’s residents and three of the five council members are Asian.

The proposal comes at the helm of decades of similar policies targeting the growing immigrant population in nearby cities in the San Gabriel Valley, which has transitioned from a predominantly Caucasian collection of suburbs into a center of Asian culture in Southern California.

The English-only proposal was brought to the council by local resident Wendy Barend Toy, who said she could not understand several commenters who spoke Chinese when addressing the council.

On Wednesday, the council voted to seek federal review from the U.S. Department of Justice before making a decision on the proposal.

Daisy Duan, 27, a graduate student at the University of Southern California who speaks limited English, said in Chinese that the proposal would “definitely” affect her ability to participate in local politics.

“I feel like English is still very difficult,” Duan said. “I know many first-generation immigrants who, when they came to America, could not speak even a single word … It’s not fair.”

Duan added that she thinks the proposal is particularly problematic in California, which has a higher proportion of immigrants than any other state.

According to the 2010 U.S. Census, Asians represented nearly 64 percent of Walnut’s population. Whites accounted for about 24 percent, and blacks for nearly 3 percent, with the remaining residents from other races. Hispanics or Latinos of any race represented about 19 percent of the population.

Walnut Councilman Tom King said Friday that the city simply can not afford to hire an interpreter for every meeting. He supports the idea of English-only meetings but has reservations about specifics in the proposal.

King said it is uncommon for residents to address the council in a language other than English, so the demand for an interpreter does not justify the costs.

“It would be a financial restriction and waste of money,” King said.

He added that the last time a resident spoke to the council in a language other than English was when a Mandarin-speaking resident came to the podium in April.

Still, King said the council hopes to represent all voices and has considered alternative solutions.

“Nobody wants to disenfranchise anybody,” King said. “It’s just that our meetings are held in English, and we have someone record the meetings in English, and if they speak [a different language], their remarks are not understood.”

King said he has suggested that the Council create a “standby volunteer interpreter list” to provide language support.

But Sissy Trinh, an active member of local advocacy group Southeast Asian Community Alliance, said she has noticed that similar initiatives in other cities ended up as “abysmal” failures. Translation is a mentally exhausting activity and volunteer help can be unreliable, she added.

“You have to assume that people can take that time off and that they’re willing to,” Trinh said. “You don’t know what the quality [of translation] is, and I’ve heard of cases where people are brought in to translate and end up speaking the wrong dialect.”

Trinh added that she considered the proposal a “civil rights violation” that “definitely doesn’t build trust with government officials.”

But King said he was not worried about volunteer recruitment. There are many bilingual students in the region who are eager to give back to their community, he said.

Austin Yuan, 25, a first generation immigrant who is fluent in English, said he could understand the motives behind the proposal.

“As a citizen, you have to understand that perhaps it’s not just the responsibility of the government to just serve you,” Yuan said. “They have to look at everyone.

Still, Yuan said he sympathized with citizens who do not speak English and feel they are being “cheated out of their tax money.”

The legal debate will likely come down to an “access issue” for those who do not speak English, according to Los Angeles-based civil rights attorney Lisa Maki.

She said it’s a complicated issue, but added that developing a volunteer interpreter datase will likely help the city of Walnut avoid legal problems.

The Council is expected to vote on the matter later this month, pending input from the U.S. Department of Justice on any civil rights or legal issues associated with the proposal.

Apple, Samsung file first joint set of disputed jury instructions

In a 361-page joint filing late Friday Apple and Samsung laid out their respective objections to the opposing party’s preliminary jury instructions for the upcoming district court patent trial scheduled for the end of July.

The disputed proposed jury instructions cover a host of procedural necessities regarding juror handling and includes operating minutiae down to when an instruction can be given and how said instruction is phrased. Many objections are based on unnecessary verbiage or when an instruction should be given, though some call race into contention and illustrate the implications of trying an international patent case in the U.S.

Samsung is worried about how a jury may perceive a supporting witness’s ethnicity as seen in the South Korean company’s juror questionnaire and has extended that concern to jury instructions.

For example, Samsung disputes Apple’s proposed reading of the following when the first foreign speaker testifies:

Languages other than English may be used during this trial. One such language will be Korean.

The evidence to be considered by you is only that provided through the official court translators. Although some of you may know Korean, it is important that all jurors consider the same evidence. Therefore, you must accept the English translation. You must disregard any different meaning.

In objection, the Galaxy maker claims that the “proposal will disrupt the trial and unnecessarily call attention to the witness’ ethnicity.” The company is looking to remove any relation of ethnicity and expert testimony during the trial and wants to keep the issue of race out of the proceedings completely.

Samsung’s proposed instruction reads almost identically to Apple’s, though “Korean” has been removed from the leading sentence:

Languages other than English may be used during this trial.

    Witnesses who do not speak English or are more proficient in another language testify through an official court interpreter. Although some of you may know, for example, Korean, it is important that all jurors consider the same evidence. Therefore, you must accept the interpreter’s translation of the witness’s testimony. You must disregard any different meaning.

At issue is the interpretation of testimony given by Korean-speaking experts by a Korean-speaking juror who may form a different translation than the one given by a court interpreter.

While most of the parties’ objections are par for the course, some call into question the interpretation of certain trade and patent laws which are instrumental in trying a case regarding such issues. An example is Samsung’s proposed design patent summary which states “[a] ‘design patent’ protects the way an article looks, but not the way it functions.” Apple takes issue with this statement, asserting that the “instruction is misleading because design patents protect articles of manufacture that have or serve a function, so long as the overall design of the article is not “dictated by function.” Similar objections are seen throughout the document.

Presiding Judge Lucy Koh will take the proposed instructions into consideration and may request an updated pared-down set this week. Another option would be to hold judgment until the pretrial conference scheduled in which case the parties would have to make dynamic adjustments during the trial.

The Apple v. Samsung jury trial is slated to begin with juror selection on July 30.

Korean Air lost in translation

Nairobi, Kenya – When Korean Air announced its non-stop flights from Korea to Kenya on Monday, it posted a notice on its website describing Kenyans as indigenous people full of “primitive energy”, sparking a flurry of angry Tweets and Facebook postings.

Head of Public Relations for Korean Air in Kenya, Muthui Kariuki said that the notice had been removed from the website and that the word “primitive” was a result of a mistake in translation from Korean to English. Kariuki said the airline, which is supposed to launch the thrice-weekly flights on Thursday, will post an apology.

According to reports on Huffington Post, Kenyans expressed their anger on social media.

“An insult to a nation. Kenya doesn’t have primitive people,” posted a Twitter user who identified himself as George Njoro.

Others questioned whether the mistake was an intentional marketing gimmick.

“Now everybody knows Korea Air is coming to Kenya. Nice marketing strategy,” tweeted another person using the Twitter handle of Komboste.

Kenya is a regional hub where passengers can connect to flights to other countries in the region and in Africa.

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