One of the mostly ignored costs of our current large-scale migration is that of interpreters, or more precisely the costs of migration from non-English-speaking nations, which predominates.
The costs are distributed through various units of government at local, state, and federal levels, and are thus almost impossible to measure; they are particularly important in healthcare, where there has to be an interpreter if the doctor or nurse does not speak the patient’s language, and the patient does not speak ours.
I was reminded of that the other day when I received in the mail a six-page document telling me, in my case, that I might owe a medical provider $4.92. It was from the Department of Health and Human Services, and I got it because I am a (happy) user of Medicare. It is a “Medicare Summary Notice for Part B (Medical Insurance)” dated September 23, 2021, and tens of millions of these six-page summaries must be mailed out each quarter. It is not something that is available online.
Why does it take six pages to tell me I might owe someone less than $5? Over and above poor document design (and no concern for the tree-killing involved), two of the pages are devoted to telling the recipient in English and 15 other languages that they can get attention in their own language by calling an 1-800 number.
I started looking at the languages offered and noticed that there was an enormous gap between the current flows of immigrants and the languages listed. For example, there was no offering of Mandarin or anything else spoken in China, and there was a similar total gap for the languages of the subcontinent (India, Bangladesh, Pakistan, Sri Lanka). It was as if DHHS and DHS never communicated, and DHHS was using the immigration data of 50 years ago. (The Medicare listing — but not the Blue Cross one — also included the language of a small European nation that was not recognized as such in those days, more on that later.)
I looked a little further and found a reference to the languages mentioned in the 128-page annual publication “Medicare and You, 2022"; its list, on p. 125, is the same as the one I got in the mail with the exception that this document included Chinese dialects. Maybe DHHS ought to stir in a proofreader with all those interpreters.
My next step was to create a table, shown below, with Census data on the number of foreign-language speakers in the U.S., in descending order; then the Medicare list of recognized languages from the mailer I received; and then the quite similar list of languages provided by the Blue Cross program, I use. The latter includes Chinese dialects, but otherwise was quite similar to the Medicare list.
Both lists exclude Yiddish, but include Japanese and Farsi, which have smaller numbers of speakers than Yiddish. Another oddity was the presence in the Medicare listing, but not in the Blue Cross one, of Armenian, even though there are at least nine languages used more commonly that did not make either of the Medicare lists.
Languages Recognized by Medicare and Federal Employees Blue Cross, 2021
and U.S. Speakers
Notice, September, 2021
|Spanish: 41 million||Yes||Yes|
|Chinese, Various Dialects: 3.5 million||No||Yes|
|Tagalog: 1.7 million||Yes||Yes|
|Vietnamese: 1.5 million||Yes||Yes|
|Arabic: 1.2 million||Yes||Yes|
|French: 1.2 million||Yes||Yes|
|Korean: 1.1 million||Yes||Yes|
|Russian: .9 million||Yes||Yes|
|German: .9 million||Yes||Yes|
|Haitian Creole: .9 million||Yes||Yes|
|Hindi: .9 million||No||No|
|Portuguese: .8 million||Yes||Yes|
|Italian: .6 million||Yes||Yes|
|Polish: .5 million||Yes||Yes|
|Yiddish: .5 million||No||No|
|Japanese: .5 million||Yes||Yes|
|Persian (incl. Farsi): .4 million||Yes||Yes|
|Gujarati (India): .4 million||No||No|
|Telegu (India): .4 million||No||No|
|Bengali (India): .3 million||No||No|
|Thai and Lao: .3 million||No||No|
|Urdu: .3 million||No||No|
|Greek: .3 million||No||No|
|Punjabi (India): .3 million||No||No|
|Tamil (India and Sri Lanka): .3 million||No||No|
|Armenian: .2 million||Yes||No|
Why is Armenian recognized by Medicare (and the U.S. Department of Health and Human Services) when it is out of numerical sequence?
One possibility is that longtime Sen. Bob Dole (R-Kan.), a one-time candidate for vice president, and for president, must have done it. Dole was very badly wounded in the Battle of the Bulge, in the last stages of World War II, and was famously grateful to the Armenian physician who helped his recovery. Dole pushed for many Armenian causes, such as a statement from our government blaming Turkey for the Armenian genocide of World War I. Dole, at 98, is still with us.