Đề tài A study on the equivalence between English and Vietnamese translation of insurance terms in US health insurance

DECLARATION This thesis contains no material which has been accepted for the award of any other degree or diploma in any university or tertiary institution, and to the best of my knowledge and belief, neither does it contain material previously published or written by another person, except where due acknowledgement is made in the text. Signature Vũ Thị Thanh Yến ACKNOWLEDGEMENTS On the completion of this thesis, I wish to express my deepest gratitude to my supervisor, Assoc. Prof. Dr. Lê Hùng Tiến who gave me benefit of his wisdom and his expert knowledge in translation as well as his constant encouragement from the beginning stage of working out the research proposal to the final stage of writing up the thesis. Without his critical comments and valuable suggestions, this study could not have been completed. I owe a special debt of gratitude to Mrs. Rosemary Nguyen who helped shape the idea for my thesis, giving me her practical guidance, assisting me with data collection and sharing with me her long and varied experience in the translation of health insurance terms in the US health plans. I take this opportunity to express my sincere thank to all lecturers in Postgraduate Department at College of Foreign Languages, Vietnam National University, Hanoi for their useful lectures during my M.A course. Finally, I would also like to thank my parents who have been a constant source of encouragement, support, love and care during the course of my writing. ABSTRACT The need for the translation of US health plans into Vietnamese is a matter-of-fact since there are already a number of American insurer carriers operating in Vietnam, and many more are expected to enter such a potential market of more than 80 million people. However, it is not an easy task at all due to sharp differences in the sub-culture of health insurance between the US and Vietnam. This thesis titled “A study on the equivalence between English and Vietnamese translation of insurance terms in US health insurance”, therefore, is an attempt to find out the differences and similarities between English HI terms and their Vietnamese equivalents, and to draw out the strategies/procedures/methods that are appropriate to the translation of HI terms in the US health plans into Vietnamese. Hopefully, the research may make a contribution to the translation of HI terms and will be of some help to insurance circle, especially translators with little experience of doing the translation in the field. To this end, the paper identifies the equivalence relationships and classifies terms according to their structural patterns. More importantly, the research paper focuses on working out strategies/procedures/methods that can be best applied to the translation of terms of equivalence and non-equivalence groups. Suggestions for translation strategies/procedures/methods are also made so that translators may have an idea of what strategies/procedures/methods can be used to deal with certain groups of terms. ABBREVIATIONS 1. BH: Bảo hiểm 2. BHYT: Bảo hiểm y tế 3. BHSK: Bảo hiểm sức khoẻ 4. HI: Health insurance 5. SL: Source language 6. TL: Target language TABLE OF CONTENTS PART A: INTRODUCTION 1 1. Rationale 1 2. Scope of the study 2 3. Aims of the study 2 4. Methods of the study 2 5. Design of the study 3 PART B: DEVELOPMENT 4 CHAPTER I: THEORETICAL BACKGROUND 4 I. 1.Terminology 4 I.1.1. Definition 4 I.1.2. General features of terminology 4 I.1.3. Term creation 6 I.2. English single words and compounds in comparison with the Vietnamese ones 7 I.3. Translation theory 7 I.3.1. Definition of translation 7 I.3.2. Translation equivalence 8 I.3.3. Translation methods, strategies and procedures 10 I.3.4. Technical translation 11 I.4. Translation of terminology 11 I.5. Chapter conclusion 13 CHAPTER II: THE TRANSLATION OF HEALTH INSURANCE TERMS OF EQUIVALENCE GROUP 14 II.1. An overview of equivalence relationships in the translation of health insurance terms 14 II.2. Classification of health insurance terms in the US health insurance plans according to their structural patterns 17 II.2.1. Single terms 17 II.2.2. Compound terms 19 II.3. The common strategies and procedures used in the translation of health insurance terms of non-equivalence group 19 II.3.1. The translation of single terms – Old words with new senses 23 II.3.2. The translation of compound terms by rank shift or transposition 24 II.3.3. The translation strategy which involves the deletion of “OF” 26 II.4. Concluding remark 26 CHAPTER III: THE TRANSLATION OF HEALTH INSURANCE TERMS OF NON-EQUIVALENCE GROUP 28 III.1. The source of non-equivalence problem in the translation of health insurance terms in the US health plans 28 III.2. The strategies, procedures and methods used in dealing with non-equivalence problem in the translation of health insurance terms in the US health plans 29 III.2.1. The translation of terms by transference procedure (the use of loan words) 30 III.2.2. The translation of terms by paraphrase 32 III.2.3. The translation of terms with communicative method 34 III.2.4. Literal translation 37 III.3. Concluding remarks 38 PART C: CONCLUSION 39 The terms of equivalence group 39 2. The terms of non-equivalence group 39 3. Suggestion for the methods, procedures and strategies 40 4. Suggestion for further studies 42 REFERENCES APPENDICES PART A: INTRODUCTION Rationale Since Viet Nam has successfully gained its accession to WTO, and the Bush administration has granted Vietnam with Permanent Normal Trading Status (PNTR), a wide range of actors, including US enterprises, is expected to be here. It is also envisaged that US HI providers will do business in our country, hence a demand for the translation work in the field will be inevitable. The problem lies in the fact that sharp differences in the US HI and the Vietnamese one result in several diffrent HI plans between the two countries. Undoubtedly, this will pose a great obstacle to translators due to their insufficient knowledge about the two different sub-cultures of health insurance. They may have to squeeze their brain to convey the true essence of each kind of health plans from English in Vietnamese. In the USA, quite a few Vietnamese-American are full time employees in American companies and factories, hence eligible to HI coverage offered by their employers. Annually, the companies and factories have the so-called enrollment for their employees to enroll for health benefits or to choose the health plan that best benefits them. To guarantee that their employees do not end up in wrong decisions, which goes in counter with their benefits due to the failure to understand HI plans written in English, they have them translated by Vietnamese and native American translators. In Vietnam, though translators do not have to translate such HI plans for clients, they still have to translate a number of presumably popular HI terms, including many in the US HI plans for at least insurance-majored students or for training courses held by some insurance carriers. Having studied and compared the original and the translated versions by different translators, I have come up with an idea of making an investigation into how HI terms in the US HI plans are currently dealt with. Hopefully, the study, titled “A study on the equivalence between English and Vietnamese translation of insurance terms in US HI plans”, may be of some use to those who have been and will do translation in the field. 2. Scope of the study Within limited time, resources, conditions, and the length of the thesis, the researcher focuses only on HI terms collected from HI plans. Disability income insurance which is also a sub-type of the US HI is excluded from the study. Such is the boundary set for my thesis so as to achieve a thorough investigation. Specifically, the study takes into consideration such major aspects as follows: classification of equivalence relationships structural patterns of HI terms in English their translations 3. Aims of the study To work out the similarities and differences between English terms and their Vietnamese equivalents To draw out the strategies/procedures/methods that may apply to the translation of HI terms, especially to the translation of non-equivalence terms in the US HI plans into Vietnamese 4. Methods of the study 4.1. Research questions a. What are the similarities and differences between English terms and their Vietnamese equivalents? b. What are strategies/procedures/methods that are appropriate to the translation of HI terms in the US insurance plans? 4.2. Research methods On the completion of the thesis, the researcher went through the following steps: Building up a theoretical background by reviewing translation and terminology Collecting and grouping English insurance terms in the US insurance plans and their Vietnamese equivalents for description, analysis and induction Drawing out strategies, procedures and methods in the translation of HI terms The main method is contrastive analysis. 4.3. Data collection The English HIterms studied are taken from the US insurance health plans and their equivalents are picked out from the translations by native American and Vietnamese-American translators living in the US and those in charge of translation work in Bảo Việt, Pjico, Prudential, and Aoncare which are big insurer carriers in Vietnam. 5. Design of the study The study consists of three main parts, references and appendices as follows: Part A: Introduction The rationale for the study, scope, aims, methods and design of the study are orderly presented in this part. Part B: Development There are three chapters in this part: Chapter I: Theoretical background The theory of translation and terminology will be dealt with in this chapter. Chapter II: The translation of HI terms of equivalence group This chapter features an investigation into the equivalence between English and Vietnamese translation of HI terms in the US health plans. Accordingly, how HI terms in the US health plans are currently translated and what strategies/procedures/methods are employed are the focus of the research. Chapter III: The translation of HI terms of non-equivalence group This chapter examines how non-equivalence problem in the translation of HI terms in the US health plans is solved by available translation strategies, procedures and methods. Part C: Conclusion The conclusion summaries the strategies, procedures and methods of translation as well as makes relevant suggestions. The appendixes give more examples of different groups of HI terms. PART B: DEVELOPMENT CHAPTER I: THEORETICAL BACKGROUND I. 1.Terminology I.1.1. Definition Terminology has been defined variously by many different linguists, either native or Vietnamese. Chau, D.H (1981) claims “Terms are specialists words used within a specific field, a profession or any technological field”. To identify technical term, he states “Scientific and technical terminology consists of lexical units used to denote phenomenal objects, activities …in industrial technologies and natural or social sciences”. Sharing some common features in content with the one by Chau, though put differently, the definition proposed by Giap, N.T (1998) seems to be more informative: “Terminology, understood as a special linguistic unit of language, consists of word and fixed phrase that provides precise definition and objectives that belong to particular scientific area.” Such definitions can serve as a foundation on which we can base our distinction between terms and words. In fact, Baker (1998:261) puts that “Terms differ from words in that they are endowed with a special forms of reference, namely that they refer to discrete conceptual entities, properties, activities or relations which constitute the knowledge space of a particular subject field”. Accordingly, further important differences between terms and words are as follows: 1. Terms have special reference within a particular discipline whereas words function in general reference over a variety of subject fields. 2. Terms keep their lives and meanings only for as long as they serve the system of knowledge they gave rise to them. In other words, terms together with words and proper names constitute the general class of lexical items. Names refer individually to objects and people; words refer arbitrary boundary between terms and words is not a clear-cut, i.e. many terms become ordinary words when they are used in specialized field. I.1.2. General features of terminology Since terminology is not allowed to carry the speaker’ attitude, figurative sense, compliment or criticism, it should possess the following qualities: accurateness, systematicism, internationalism, popularity and nationality as claimed by Giap, N.T (1998) and Lang, L.V (1977). They will be briefly presented in the next part. I.1.2.1. Accurateness A term needs to be accurate and clear because basically it reflects an exact concept of a science. If a term is of absolute accuracy, people never mistake one concept for another. Once a word has become a term, it no longer has connotational, emotional meaning; it also loses its polysemousness, synonymousness and antonymousness. In short, terminology necessarily works on the principle that “one concept has only one term for it, and one term indicates only one concept”. This relationship is called the one-to-one equivalent between a concept and a term. I.1.2.2. Systematicism Any field of sciences has its own limited system of concepts, which are named by a system of terms. Therefore, each item has its own position in the system of concepts and belongs to a terminological system. As a result, a term loses its value when isolated from system. In short, a term has to be a dependent member of its system. I.1.2.3. Internationalism Terms are used internationally because they are special words expressing common scientific concepts to people of different languages. Therefore, it is useful to agree on terms to be used among languages in order to push up the development of science. The international links in science result in a number of terms presented in many different languages. For example, video, radio, telephone…are found in French, German, English and Vietnamese…with little difference in form. I.1.2.4. Popularity Terms need to be popular in the sense that they should be close to the language of the masses, which is to say easy-to-remember, easy-to-understand and easy-to-remember, since they will help bring knowledge to and benefit men of all walks of life. I.1.2.5. Nationality Though belonging to a particular subject field, terms are still a part of a language system of a nation. They, therefore, possess all the characteristics and colors of a nation language. Put differently, they should be made from the materials of the national language in terms of lexicology, forms and grammar. I.1.3. Term creation Since terms are to name concepts, so whenever a concept appears, is made in a culture, or translated to a new culture, it involves the creation of a new term to name it. I.1.3.1 .Primary and secondary term creation Primary and secondary terms formation are governed by different influences: Primary term formation occurs when a newly created concept has to be named wile secondary term formation occurs as a result of either (1) the monolingual revision of given terminology, for example, the purpose of producing a standard document, or (2) a transfer of technology to an other linguistic community-a process which requires the creation of new term in the target language. Anther fundamental differences between the two formation methods lies in the fact that in primary term formation, there is no linguistic precedent although there are rules for forming appropriate terms. On the contrary, in secondary term formation, there is always the precedent of an already existing term in another language with its own motivation. Secondary term formation is more often subject to guidelines than primary term formation which are on the basis of patterns terms and words formation already prevalent in the subject field and natural language in question. (Baker, M: 1998) I.1.3.2 .Guidance on the creation of terms Terms should consistently reflect some key features of the concepts they are liked to in order to facilitate precise reference. At the same time, they should be as economical as possible without giving rise to homonymy. Terms should be lexically systematic and should conform to the phonological and morphological rules of the language. Terms must conform to the general rules of word-formation of the language or they should allow composition and derivation where appropriate. The meaning of the term should be recognizable independently of any specific context. Those are advices from International Organization for Standard (ISO 1995) (cited in Bac, N.T, 2003) I.2.English single words and compounds in comparison with the Vietnamese ones Single and compound words in Vietnamese have been defined by many established linguists. Châu, Đ.H (1981:40) defines single words as one-morpheme words. He also claims that the majority of Vietnamized single words are monosyllabic. The number of polysyllabic simple words such as bù nhìn (scarecrow), ếch ương (frog), mồ hôi (sweat) is relatively small. According to Cẩn, N.T. (1999: 51), a Vietnamese syllable, in most cases, corresponds to a word, whereas compounds are comprised of at least two words that normally can exist independently and seperately from each other. Nguyen Hiet Chi and Le Thuoc (1935) defined that ‘Compound words are words with at least two roots; namely, words in their structures, have at least two morphemes which are not affixationals but root morphemes’. Unlike a Vietnamese single word that is formed by only one morpheme in most normal cases, a single word in English contains at east one morpheme. In fact, a single word in English is defined as a sound or a combination of sounds that symbolizes and communicates a meaning and may consist of a single morpheme or of a combination of morphemes. (TheFreeDictionary at: www.thefreedictionary.com/ - 74k - Jul 13, 2007). For example, the single word ‘need’ has only one morpheme, but ‘inconceivable’ written as a single word has three morphemes: in, meaning ‘not’, conceive meaning ‘think or imagine’, and able meaning ‘able to be, fit to be’. One important feature of morpheme is that some just have grammatical functions such as making plurality (limitations), and tense (insured). Compound words in English share certain common features with the Vietnamese ones. Take now a definition of compounds as illustration. Jackson and Amvela (2000:70) stated that compounds may be defined as stems consisting of more than one roots. (cited in Hien, T.T.T, 2005). I.3. Translation theory I.3.1. Definition of translation Kelly, L.G-a prominent figure in linguistic circle stated “Without translation, there is no history of the world”. How can it that be? What has he based on to make such a claim? And what is translation that is of great importance as implied by Kelly? In an attempt to find the answer to the last question, I have find myself thrown into confusion by quite a few definitions proposed by different linguists. Follows are some of them: According to Cartford (1965), translation is “the replacement of a text in one language (SL) by an equivalent text in another language (TL)”. In Bell, R.T (1991:5), the author collected and edited the following definition: “Translation is the expression in another language (or TL) of what has been expressed in another, SL, preserving semantic and stylistic equivalences.” Hatim & Mason (1990:3), however, focus more on the communicative purpose of translation rather than the semantic and stylistic features: “Translation is a communicative process which takes place within a social context”. Newmark (1995:5) simply defines translation as the rendering of a written text into another language in the way the author intended in the text.” Though put different, these definitions share one common thing, which is to find equivalents that best or appropriately preserve features of the original in terms of semantics, grammatical structures, lexis, cultural context as well as communication situation among other things to be considered. I.3.2. Translation equivalence Equivalence has been put in the heart of almost all the theories about translation. Hence, it is understandable that a great attempt has been made by several linguists in defining equivalence or translation in terms of equivalence as Pym (1992, cited in Baker, 1998) who has pointed to its circularity: equivalence is supposed to define translation, in turn, defines equivalence. A close look at different approaches to the question of equivalence will help further illustrate the point: Newmark (1995: 48) states: “The overriding purpose of any translation should be to achieve ‘equivalent effect, i.e. to produce the same effect (or one as close as possible) on the readership of translation as was obtained on the readership of the original”. According to him, equivalence effect is regarded as the desirable result rather than the aim of any translation except for two cases: (a) If the purpose of the SL text is to affect and the TL translation is to inform or vice versa; (b) If there is a pronounced cultural gap between the SL and the TL text. In the view of Koller (1979), there are five types of equivalence: Denotative equivalence: the SL and the TL words refer to the same thing in the real world. Connotative equivalence: this type of equivalence provides additional values besides denotative value and is achieved by the translator’s choice of synonymous words or expressions. Text-normative equivalence: The SL and the TL words are used in the same or similar context in their respective languages. Pragmatic equivalence: With readership orientation, the SL and TL words have the same effect on their respective readers. Formal equivalence: This type of equivalence produces an analogy of form in the translation by their exploiting formal possibilities of TL, or creating new forms in TL. Kade (1968) and other writers on lexical equivalence, in particular in the area of terminology, categorizes equivalence relationships as follows: One-to-one: There is a single expression in the TL for a single expression in the SL. One-to-many: There is more than one expression in the TL for a single SL one. Many-to-one: There is more than one expression in the SL, but there is only a single expression in the TL that is equivalent to them. Many-to-many: There is more than one expression in the SL and they are equivalent to more than one in TL. Whole-to-part/Part-to-whole: A TL expression is only equivalent to part of the concept designated by a single expression in the SL, or the equivalent in the TL has a broader meaning than the concept in the SL. One-to-zero: There is no expression in the TL for a single expression in the SL The one-to-zero or nil equivalence problem has always been a big obstacle to even experienced translators in every field. I.3.3. Translation methods, strategies and procedures Due to time constraint and within the framework of the thesis, we will present only translation methods, procedures and strategies that match the content of the study, or can serve as a firm foundation for the research. I.3.3.1. Literal translation It would be useful to study word-for-word translation before having a look at what literal translation is. Word-for-word translation, according to Newmark (1995:69), transfers SL grammar and word order, as well as the primary meanings of all the SL words into the translation.” This translation is supposed to be effective only for brief simple neutral sentence. Literal translation ranges from one word to one word (hall-salle) through group to group (a beautiful garden-un beau jardin), collocation to collocation (make a speech-faire un discour), clause to clause (when that was done-quand cela fut fait) to sentence to sentence (The man is in the street-L’homme e’tait dans la rue). I.3.3.2. Communicative translation Communicative translation attempts to render the exact contextual meaning of the original in such a way that both content and language are readily acceptable and comprehensible to the readership. Newmark (1995: 42) claims that in communicative translation, the translator has the right to correct or improve the logic; to replace clumsy with elegant, or at least functional, syntactic structure; to remove obscurities; to eliminate repetition and tautology; to exclude the less likely; to exclude the less likely interpretation of an ambiguity; to modify and clarify jargon, and to normalize bizarreries of idiolect, i.e. wayward uses of language. Further, one has the right to correct mistakes of fact and slips, normally stating what one has done in a footnote. I.3.3.3. Transference Transference is the process of transferring a SL word to a TL text, which include loan words, transcriptions. When it comes to the role of a translator with respect to this translation procedure, h/she has to decide whether or not to transfer a word unfamiliar in the TL. Generally, only cultural objects or concept should be transferred to show respect for the SL’s culture. Words and expressions that are normally transferred are: names of all living and most dead people: geographical and topographical names including newly independent countries except for those which already have recognized translation; Name of periodicals and newspapers, titles of untranslated literary works, plays, films, names of private companies and institutions, public or nationalized institutions; street names, addresses, etc. I.3.3.4. Shifts or transpositions A ‘shift’ (Catford’s term) or ‘transposition’ (Vinay and Darbelnet) is a translation procedure involving a change in the grammar from SL to TL. Newmark (1995:85) mentions four sub-types of shifts: (1) the change from singular to plural or in the position of the adjective; (2) the change when a SL grammatical structure does not exist in the TL. (3) the change where literal translation is grammatically possible but may not accord with natural usage in the TL; (4) the replacement of a virtual lexical gap by a grammatical structure. I.3.3.5. Paraphrase This is an amplification or explanation of the meaning of a segment of the text. According to Baker (1992; 40), the main advantage of the paraphrase is that it achieves a high level of precision in specifying propositional meaning. I.3.4. Technical translation Newmark (1995:151), in an attempt to distinguish technical translation from institutional translation, claims that technical translation is one part of specialized translation, potentially non-cultural, therefore, universal. According to Sofer (1991, cited in Mai, N, 2003), the translation of a text may be called technical when it requires specialized terms in a particular field. A close look at the two definitions can help identify that though put differently, technical translation is viewed as specialized translation by both two linguists. Newmark (1995: 152) go even further, suggesting that there are three varieties or levels of technical language: (1) academic style associated with academic papers, (2) professional style which refers to formal terms used by experts and (3) the popular one including familiar alternative terms. I.4. Translation of terminology I. 4.1. Definition of neologisms In the view of Newmark (1995:140), neologisms can be defined as newly coined lexical units or existing lexical units that acquire a new sense. Neologisms are perhaps the non-literary and the professional translator’s biggest problem. According to him, since they usually arise first in a response to a particular need, a majority of them have a single meaning and can therefore be translated out of context, but many of them soon acquire new meanings in the target language. Newmark (1995:141) proposes twelve types of neologism (Old words with new senses; New coinages; Derived words; Abbreviations; Collocations; Eponyms; Phrasal words; Trasferred words; Acronyms; Pseudo-neologisms; and The creation of neologisms) and the way to deal with each but only the ones relevant to the study are presented below: I. 4.2. The translation of neologisms I. 4.2.1. Old words with new senses Old words with new senses, as claimed by Newmark (1995: 141), do not normally refer to new objects and processes, hence non-cultural and non-technical. They are usually translated either by a word that already exists in the TL, or by a brief functional or descriptive terms, say, “HI plans-chương trình BHYT” or “premium-phí BH”. Existing collocations with new senses may be cultural or non-cultural; if the concept or object exists in the TL, there is usually a recognized translation or through translation. If the concept does not exist or the TL speakers are not aware of it, an economical descriptive equivalent has to be given. ‘Reimbursement account’ proves itself a good an example. I. 4.2.2. Collocations Newmark (1995:145-146) claims that new collocations (noun compounds or adjectives plus nouns) are particularly common in social sciences. Collocations or terms in insurance such as ‘co-pay plan’, ‘Medical spending account’, or ‘Deductible plan’ can serve as a good example. These terms represent problems as some of them like ‘Consumer PPO plan’ do not exist in TL. And in such cases, what a translator is expected to do is to transfer them and then add a functional-descriptive term. Otherwise, we might create our own neologisms, but it is not as easy as it sounds. I. 4.2.3. Acronyms Acronyms are an increasingly common feature of all non-literary texts and an acronym is defined by Newmark (1995: 200) as “the initial letters of words that form a group of words used (vertiginously) for denoting an object, institution or procedure”. Sometimes, the acronym can be specially coined for the text and can be found there, so it would be a waste of time if one tries to look for it in the numerous reference books. What’s more, there are many cultural reasons why the acronym may or may not be worth transferring (depending on the standard contextual factors as readership, translation prospects…). In science the letters are occasionally joined up and become internationalisms (‘laser’, ‘master’), requiring analysis only for less educated TL readership. In translation, the importance of the acronyms decides on the way they are translated. It can be transferred if they stand for institutions or names of companies. When a political or social organization become important, it is common to transfer its acronym and translate its name. A standard equivalent term, or a descriptive term if the standard does not yet exist. I.5. Chapter conclusion This part has fulfilled it task of gathering information about terminology, its general features, and the translation of terminology. The translation theory, especially a variety of relevant translation strategies and procedures have been reviewed so that it can shed light on how HI terms in the US HI plans are currently translated. CHAPTER II THE TRANSLATION OF HEALTH INSURANCE TERMS OF EQUIVALENCE GROUP II.1. An overview of equivalence relationships in the translation of HI terms From the collected data we can group equivalence relationships into four categories, excluding the one-to-zero which will be studied in chapter III: one-to-one equivalence one-to-many equivalence many-to-many equivalence many-to-one equivalence The four following tables present some typical examples of each type: One-to-one equivalence Utilization review đánh giá mức độ sử dụng Utilization management quản lý sử dụng Exclusion điều khoản loại trừ Renewability tính tái tục Dependent người phụ thuộc One-to-many equivalence Group health plan BHSK theo nhóm Chương trình sức khỏe chung Tổ hợp BHYT lớn Preexisting Condition Bệnh tật sẵn có Tình trạng sức khỏe trước khi mua BH Deductible Mức miễn thường Khoản khấu trừ Underinsured Được BH (thiếu/dưới mức/mua với mức thấp) Many-to-one equivalence Hospitalization Insurance Hospital expense coverage Hospital confinement indemnity BH chi phí nằm viện Coordination of benefits Duplication of benefits phối kết hợp quyền lợi (Waiting/elimination/qualifying) period thời gian chờ đợi Subscriber / Participant Enrollee người tham gia BH Many-to-many equivalence Qualified impairment health insurance Special class health insurance Substandard health insurance BH những người tàn tật được công nhận đủ tiêu chuẩn BH tình trạng suy nhược được chấp nhận BHSK dưới mức tiêu chuẩn Impaired risk Substandard risk rủi ro dưới mức chuẩn rủi ro xấu The variety of equivalence realtionships can be attributed to the following factors: There is, to a more a lesser extent, some overlapped area between the US and Vietnamese insurance as a result of Vietnam’s insurance adapted from the US one. The various sources from which the data was collected 1. BlueCross BlueShield at: www.southcarolinablues.com/bcbs/blue_glossary.nsf/glossary 2. United Healthcare-Trung Tâm Tài Nguyên at: www.uhcasian.com/Vietnamese/guests/G_4_4_6.htm 3. HIresource center at: www.healthinsurance.org/insterms.lasso 4. SHIBA HelpLine English-Vietnamese Glossary at www.insurance.wa.gov/publications/consumer/vietnamese/Vietnamese_SHIBA_Glossary.pdf - Supplemental Result 5. improvement and better insurance at: www.pjico.com.vn/webplus/attachments/22ecf7c0260e8cf54e27b3531fb86963-Voca-I1.doc - Supplemental Result 6. Thuật ngữ BH nhân thọ I-Glosary I at: www.baoviet.com.vn 7. Vietnam Insurance Training Center 8. Aon-care Vietnam Resource Center 9. Prudential Vietnam Resource Center Thanks to the overlap mentioned above, happy marriages in terms of HI concepts can be found in some situations, yielding such one-to-one equivalence relationship. What the translator has to do is just an easy job. He finds terms referring to the same concepts that are lexicalized in Vietnamese for the terms in English. It should be noted that such an easy job may be a hard task for those who do not have a background knowledge of HI in the two countries or who have never met the term. Take now the term ‘renewability’. If something is claimed to have the feature of ‘renewability’, that means it can be restarted from the beginning, or it can grow again or is replaced after it has been destroyed or lost, or the time for which it is valid can be extended. Therefore, if it is rendered into Vietnamese as “tính có thể làm mới” or ‘khả năng có thể làm mới’, it seems to be quite reasonable. However, it is not an appropriate equivalent and sounds like an explanation rather than a translation, hence less technical and succinct than ‘tính tái tục’. Another confusing problem arises when there exist two or more competing terms for the same concept in the Vietnamese version. The one-to-many equivalence relationship serves as a vivid illustration. The translator has to struggle for a smart choice among all the Vietnamese equivalents available to gurantee the comprehensibility of the translated version for a particular readership. Let’s take ‘deductible’-the amount of loss that the insured pays before the insurance kicks in- as an example of the problem. It has two Vietnamese equivalents as “mức miễn thường” and “khoản khấu trừ”. The former is a commonly used term among insurance circle in Vietnam, whereas the latter is used in Vietnamese community in the US. According to a native American experienced translator, if ‘mức miễn thường’ were used in translated versions for the readership there, it would be almost incomprehensible though it is accurate and sounds more professional. Clearly, the readership plays a decisive role in the translator’s choice of equivalents since what is preferred by him may not be understandable to the intended readers. As far as ‘many-to-one’ equivalence relationship is concerned, it poses no problem to translators in the sense that the context in which the term is used can give the translator a hint to figure out its meaning. And it appears that among more than one terms referring to a same concept in the SL, there must be one which is more widely used than others. The likelihood of encountering a completely new term used to express a common concept, therefore, may be minimized. For example, ‘participant’ (người tham gia BH) is more universally used than ‘subscriber’ and ‘enrollee’, with the latter making sense only in the US sub-culture of insurance. ‘Many-to-many’ equivalence relationship, as implied by its name, refers to the situation in which there are more than one SL expressions which are equal to more than one equivalent in the TL. Though the translator does not have to struggle as hard as he has to do with non-equivalence problem, he still has to put some thoughts into choosing the most comprehensible and appropriate equivalent to specific readership when it comes to a specific situation. For example, ‘impaired risk and ‘substandard risk’ both refer to a situation of a person whose physical condition is less than standard or who has a hazardous occupation or hobby. Each has its own equivalent as ‘rủi ro xấu’ and ‘rủi ro dưới mức tiêu chuẩn’ respectively. The former is highly recommended in the US for Vietnamese-American whose level of education in not high and the latter for the opposite group. In Vietnam, both are used equally. Again, the importance of the readership to the choice of lexical word is undeniable, requiring the translator to firstly characterize the readership of the TL before working on the text. From scratch, the researcher assumed that there would be more than one equivalence relationships since the data was collected from different sources in Vietnam and in the US where both American-American and Vietnamese American translators work with insurance documents. Expectedly, however, all the translators employ common translation strategies and procedures when dealing with HI terms in the US health plans, which will be studied after we have investigated the structural patterns of these terms. II.2. Classification of HI terms in the US health insurance plans according to their structural patterns HI terms are divided into two sub-groups according to their structural features: single terms and compound terms. II.2.1. Single terms II.2.1.1. Single terms in the form of a noun The terms that are nouns (also including those deriving from verbs) can be divided into subgroups as follows: Sub-insurance terms A fairly big number of HI terms collected for this study are ordinary words that lose their normal sense and take on the specialist meaning, e.g., the normal sense of ‘policy’ is ‘a set of ideas or plans that is used as basis for making decisions, especially in politics, economics or business’ (chính sách). Its specialist meaning is a document which shows the agreement that you have made with an insurance company (đơn BH). Right below are other examples: English terms Vietnamese terms participant người tham gia/mua BH exclusions điều khoản loại trừ rider điều khoản riêng loaị trừ representation lời khai của người được BH limitations điều khoản hạn chế subscriber người tham gia/mua BH These terms can create difficulties for translators because words commonly met in general English take on a specialized meaning within, say, insurance context. Although the user already knows the general meaning, he may be thrown into confusion when coming across it in a context with a totally different meaning he has never experienced before. High-insurance terms It is commonly known that every subject has its set of highly technical terms, which is an intrinsic part of the learning of the discipline itself. Without background knowledge of the field, it would be hard for the user to understand these terms. Followings are good examples of high-insurance terms: coinsurance BH phụ/đồng BH underwriting việc xét nhận rủi ro y tế co-payment đồng trả/cùng trả tiền formulary thuốc khuyến cáo reimbursement sự bồi hoàn If equipped with little knowledge of both English language and HI in Vietnam and the US, the user will definitely find these terms really hard-to-crack. II.2.1.2. Single terms in the form of an adjective Unlike technical terms in the form of a verb, almost all the terms in the form of an adjective do not have their nouns to be used as alternatives eligible hội đủ điều kiện usual thông thường reasonable vừa phải guaranteed được đảm bảo underinsured uninsured BH dưới mức không được BH One important feature of these adjectives is that all of them usually collate with one or two certain nouns to form collocations: eligible employees/dependents ( người phụ thuộc/nhân viên hội đủ điều kiện) usual/customary/reasonable fees (phí thông thường/thông dụng/vừa phải ) guaranteed issue (quyền lợi được BH) uninsured employees (nhân viên không được BH) We have examined single HI terms that account for significant proportion of the total collected terms. II.2.2. Compound terms These are terms which are composed of two words or more; these words, which are of different part of speech, combine and create terms that have the form of nominal group (Halliday’s term). II.2.2.1. The nominal group It would be insufficient not to study the experiential structure of the nominal group, so the following section will focus on such a brief investigation. According to Halliday (1985: 180), the nominal group structure comprises the Thing, commonly called head noun, preceded by various items including Deictic, Numerative, Epithet, Classifier, and followed by Qualifier. The following table will exactly illustrate the structure: Deictic Numerative Epithet Epithet Classifier Thing Qualifier Those two splendid old electric trains with pantographs All the items functioning as pre-modifier and post-modifier will be briefly presented in the following table: Item Function Example Deictic The Deictic element indicates whether or not some specific subset of the Thing is intended. It is either (i) specific or (ii) non-specific This, these, my… A, each, every… Numerative The Numerative element indicates some numerical feature of the subset : either (i) quantity or (ii) order, either exact or inexact one, two first, second, few, little, many Epithet This item, usually in the form of an adjective, indicates some quality of the subset. This can be (i) an objective property of the thing itself; or (ii) it may be an expression of the speaker’s subjective attitude towards it. old, short, heavy wonderful, splendid, silly Classifier The Classifier indicates a particular subclass of the thing in question. It can be (i) an adjective or (ii) a noun. medical insurance health insurance, drug coverage Thing The Thing is the semantic core of the nominal group, which may be common noun, proper noun, or personal noun. Qualifier The Qualifier element follows the Thing and characterizes it. It can be a relative clause or a prepositional phrase. The money which is reimbursed to the insured person As far as Classifier is concerned, it needs more detailed discussion since apart from adjectives and nouns which serve as classifiers; verbs also enter into the nominal group, functioning as Epithet or Classifier in one of the two forms: (i) present (active) participle, V-ing, e.g. participating, as in participating physician (ii) past (passive, or intransitive active) participle, V-en, e.g. insured, as in insured employee or covered in covered expense. When serving as Epithet, these forms usually have the sense of the finite tense to which they are most closely related: the present participle means ‘which is (was/will be)…ing’, the past participle means ‘which has (had/will have) been…ed’. Examples: a prevailing phenomena ( a phenomena which is prevailing) two satisfied customers (two customers who have been satisfied) When these forms function as Classifier, they typically have the sense of a simple present, active or passive: present (active) ‘which…s’, past (passive) ‘which…ed’. Examples: qualifying period (period that qualifies)) expected morbidity (morbidity that is expected) Often the participle itself further modified, as in self-funding employer, pre-existing condition, state-mandated benefits, tax-advantaged account. Sometimes, the same word may function either as Epithet or as Classifier, with different meaning. Let’s look at ‘fast’ in ‘fast trains’. ‘Fast’ serves as Epithet in the sense that it means ‘trains that go fast’, and functions as Classifier since it classifies a subtype of train, that is ‘express train’. It is noted that usually several classifiers cluster around a thing to indicate subclasses of more concreteness. Nouns, adjectives, participles, positioned near the Thing, are most common classifiers in English Examples: wellness office visit classifier(Cs) Cs thing II.2.2.2. Health insurance terms in the US health plans in the form of the nominal group A number of high-frequency nominal groups have been found among terms collected for this study. II.2.2.2.1. Terms consisting of Classifier (noun) +Thing As implied by the name, these terms consists of two nouns with the first one functioning as Classifier. It distinguishes the Thing (the second noun) from other concept of the same group. For example, health in ‘health insurance’ (BHSK) helps distinguishes this type of insurance from many other types such as ‘disability insurance’ (BH thương tật), ‘car insurance’ (BH xe ô tô), ‘home insurance’ (BH nhà ở). Other examples of this group: health exposure (rủi ro về sức khỏe) network provider (nhà cung cấp thuộc mạng lưới) fee schedule (giá biểu liệt kê các mức thanh toán tối đa) indemnity plan (dịch vụ tính tiền) benefit period (thời kỳ thụ hưởng) II.2.2.2.2. Terms consisting of Classifier (adjective) +Thing A term in this group is formed by an adjective that serves as Classifier and the Thing. Examples: creditable coverage (việc được BH chính đáng) customary fee (phí thông dụng) dental coverage (BH răng) supplemental insurance (chương trình BH phụ/bổ sung) eligible employees (nhân viên hội đủ điều kiện) The Classifier, as discussed in (II.2.2.1), can be further modified by another sub-classifier that takes on the form of a noun or an adjective: basic health plan (chương trình BHSK cơ bản) group health plan (BHSK theo nhóm) hospital expense coverage (BH chi phí nằm viện) prescription drug coverage (BH chi phí theo đơn thuốc) substandard HI (BHSK dưới mức tiêu chuẩn) And several classifiers cluster around a Thing to indicate subclasses of more concreteness like the followings: qualified impairment HI (BH người tàn tật được công nhận đủ tiêu chuẩn) special class HI (BH tình trạng suy nhược được chấp nhận) prepaid group practice package (BH trọn gói chi phí y tế tập thể trả trước) II.2.2.2.3. Terms consisting of Classifier/Epithet (present participle) +Thing In this group, some V-ing function as (i) Epithet and some as (ii) Classifier : If you do not go to participating physician, you may get lower level of coverage. Eliminating this two-year waiting period would provide stable HI to a vulnerable group of adults who are unable to work. However, when interpreted in different situations, some others can be either Classifier or Epithet: self-funding employer (BH của hãng cho nhân viên) pre-existing condition (bệnh tật có sẵn) II.2.2.2.4. Terms consisting of Classifier/Epithet (past participle) +Thing Like V-ing participle, some V-ed ones can serve as either Classifier or Epithet, and what function it carries depends on different situations: covered expense (chi phí được bao trả) insured person (người được BH) impaired risk (rủi ro xấu) experienced morbidity (tỷ lệ bệnh tật theo kinh nghiệm) II.2.2.2.5. Terms consisting of Thing + Qualifier The Qualifier in this group is usually ‘of noun phrases’: evidence of insurability (bằng chứng về khả năng có thể BH) coordination of benefits (phối hợp quyền lợi) schedule of benefits (bảng liệt kê các quyền lợi được hưởng) certificate of insurance( giấy chứng nhận BH) We have investigated the structural patterns of the nominal group in English in general and of HI terms in the form of the nominal group in particular. We have also made an attempt in classifying and dividing them into ‘single term’ and ‘compound term’ groups. Single terms are further grouped into sub-insurance terms and high insurance terms. There are subgroups of terms under the head ‘compound terms’. The next part will focus on what translation strategies and procedures have been used currently to translate HI terms that do not belong to non-equivalence group, and then draw out the ones that may be best applicable. II.3. The common strategies and procedures used in the translation of HIterms of equivalence group II.3.1. The translation of single terms – Old words with new senses The number of HI single-terms in English, both low-insurance and high-insurance ones, takes up a fairly significant proportion in comparison with compound terms. They, therefore, create a certain level of difficulty to translators. Almost all the terms in this section can be grouped under the heading “Old words with new senses”. They already exist in the language and are commonly used with their basic nuclear meaning. However, onced used in a professional narrow scale, these terms acquire new typical meaning of the field as analysed with vivid examples in (II.2.1). What should be noted here is that with regard to equivalence in form, not all Vietnamese terms can be seen as the equivalents for the single terms in English in quite a few cases. The discernible difference can be detected with ease. Take now the single term ‘representation’. It is clearly a term in the form of a single word. When it is rendered into Vietnamese as ‘lời khai của người được BH’, it is no longer a single word. Rather, it is a noun phrase and has the form of ‘head noun (lời khai) + of (của) + postmodifier (người được BH)’. The other two examples help further illustrate the non-equivalence problem in forms. They are ‘coinsurance’ and ‘formulary’ that take ‘đồng BH’ and ‘thuốc khuyến cáo’ respectively as their Vetnamese equivalents. In these cases, the Vietnamese terms are not single words, but compounds as defined by Cẩn, N.T. (1999: 49). Even, the sinlge term ‘underwriting’ has its Vietnamese equivalent ‘việc nhận xét rủi ro y tế’ in the form of a free group of words as defined by Nguyen Nhu Y (1996:64). Such a group is comtemporarily made to meet the need of the reality to be described or to meet the subjective demand of the speaker or the writer. (See more examples in Appendix 1) II.3.2. The translation of compound terms by rank shift or transposition The translation of the following groups of terms involves a change in the grammar from SL to TL, which is the so-called transposition or a shift. Group 1: Terms translated with transposition procedure that involves an automatic change in the word order from SL to TL Since this is the only translation procedure concerned with grammar, most translators make transposition intuitively. Specifically, what they have to do with the terms in this group is the change in the position of adjectives or modifying elements due to the difference in word order between English and Vietnamese. Vân (1998) claims that English nominal group differs from the Vietnamese one in terms of the order of Classifiers and Epithets in relation with the Thing, and this is presented in the table below: English Vietnamese Classifier/Epithet + Thing Thing + Classifier/Epithet Examples of terms translated by this procedure are as follows: Classifier (noun) +Thing English terms Vietnamese terms benefit period thời kỳ thụ hưởng utilization management quản lý sử dụng cost containment kiểm soát chi phí sub-standard risk rủi ro dưới mức tiêu chuẩn health insurance BHSK Classifier/Epithet (adjective) +Thing medical insurance BH y tế dental insurance BH nha khoa/răng common fee chi phí thông thường major plan chương trình chính supplemental plan chương trình phụ/bổ sung It is no exaggeration to say that it is an easy transposition procedure. The translator just has to do two things: (1) firstly identify the divisions between the elements in the group and (2) then convert the position of the elements from English word order into their corresponding word order in Vietnamese. Terms of longer nominal group, within expectation, can also be easily dealt with this way: English word order Vietnamese word order medical benefits exemption miễn trừ các quyền lợi y tế group health plan chương trình BHSK theo nhóm hospital expense coverage BH chi phí nằm viện dental expense coverage BH chi phí nha khoa Individual health insurance BHSK cá nhân This type of transposition can be of great help in that it is applicable to the translation of nominal groups of different types, especially longer groups as follows: English word order Vietnamese word order guaranteed renewable health insurance BHSK tái gia hạn được bảo đảm conditional renewable HI BHSK tái tục có điều kiện major medical expense coverage BH chi phí y tế chính creditable drug prescription coverage BH theo đơn thuốc chính đáng (See more examples in Appendix 2) The Vietnamese equivalents that sound stiff or fail to accord with natural usage in Vietnamese are categorized under the heading “Literal translation” which will be touched upon in the “non-equivalence” section. Group 2: Terms consisting of Classifier (past participle) + Thing Exactly, the terms in this group can be translated by either (i) automatic transposition or (ii) by rank-shift that involves a change in grammatical structure of certain items in SL. To be more specific, a nominal group in English corresponds to a clause in Vietnamese as follows: (i) expected morbidity = số liệu thống kê bệnh tật dự tính A change in the position of V-ed acting as Classifier is needed so that the Vietnamese version can sound natural and accords to the word order in the Vietnamese nominal group. (ii) expected morbidity = số liệu thống kê bệnh tật (đã) được dự tính Syntactically, (ii) is longer than (i), but semantically clearer though both are comprehensible to the readership. Usually, though the shorter is more preferred for the economy of the text, and it sounds more technical and succinct, the longer one still gets the priority for the comprehensibility of the version in Vietnamese: Other examples: English terms Vietnamese terms uncovered expense các chi phí không được bao trả standardized plans các chương trình đã được chuẩn hoá insured employees nhân viên đã được BH uncompensated care dịch vụ chăm sóc không được bồi thường (See more examples in Appendix 3) II.3. 3. The translation strategy which involves the deletion of “OF” Group 3: Terms consisting of Thing + Qualifier (noun + of +noun/noun phrase) Within this study, we have collected 13 nominal groups in the form of ‘Thing + Qualifier (of phrase)’. If, when rendering these terms into Vietnamese, we translate the preposition ‘of’ as ‘của’, the version in Vietnamese will not sound naturally as the way it should normally be. Put differently, it definitely fails to accord with the natural usage in Vietnamese: evidence of insurability bằng chứng của khả năng có thể BH schedule of benefits bảng liệt kê của các quyền lợi được hưởng If such translation is seen in the light of literal translation, it is grammatically acceptable. However, a translation is not simply the converting of grammatical elements from SL in to TL. The translator, among many other things to take into consideration when doing his job, has to decide when and what to add or omit to make the translated version readable and natural. Concerning the translation of the terms in this group, the deletion of “of” is widely made, yielding such equivalents as follows: English terms Vietnamese terms duplication of benefits kết hợp quyền lợi summary of plan bản tóm tắt chương trình BH explanation of benefits giải thích quyền lợi được hưởng schedule of benefits bảng liệt kê các quyền lợi được hưởng (See more examples in Appendix 4) In so doing, the translators can avoid lengthy expression which may, to some extent, distract readers. One noteworthy thing here is that this translation strategy should only be employed only when the advantages of producing smooth translation clearly overweigh the value of exactly rendering a certain meaning in a given context. II.4. Concluding remarks As presented above, quite a few native American and Vietnamese translators with different level of background knowledge do the translation of HI terms in the US health plans into Vietnamese, and so naturally they were expected to turn to different translation strategies or procedures when dealing with the same terms. Interestingly, though some of them admitted having no concept of translation theories, they all have employed commonly used translation strategies (deletion of preposition OF) and procedures (transposition or rank-shift) in dealing with HI terms of equivalence group. It may be concluded that amateur and professional translators in any field all turn to these translation strategies and procedures in their job, either consciously or unconsciously since they have already gained their rightful place in translation. CHAPTER III THE TRANSLATION OF HEALTH INSURACNE TERMS OF NON-EQUIVALENCE GROUP Examples of nil equivalence: Non-equivalence or One-to-zero equivalence employee +1 and more coverage BH nhân viên +1 trở lên community rating đánh giá cộng đồng gatekeeper bác sĩ HMO điều hợp chăm sóc bệnh nhân và kiểm soát hiệu quả chi phí bằng cách giảm thiểu dịch vụ không cần thiết HMO (Health Maintenance Organization) BH HMO Medicaid chương trình Medicaid III.1. The source of non-equivalence problem in the translation of HI terms Though it is a luxury for a translator to say that something cannot be translated, there are exceptions for a number of reasons as Mona Baker (1992) shows in her famous book titled ‘In other words-A course book on translation’: Culture-specific concepts The SL concept is not lexicalized in the TL The SL is semantically complex The SL and TL make different distinctions in meaning The TL lacks a superordinate The TL lacks a specific term Differences in expressive meaning Differences in forms Differences in frequency and purpose of using specific forms The use of loan words in the source text The non- equivalence problem mentioned in this study, however, is not attributed to all of the causes listed above. We are going to briefly provide an overview of HI in the US and in Vietnam. This will help give an insight into why HI terms in the US HI plans are translated the way they are now in the Vietnamese versions. The development of the US HI dates back to 1907, whereas Bảo Việt-the oldest insurance carrier in Vietnam, offering all kinds of insurance including health insurance- has been in operation for just only as long as 40 years, 60 years younger than the US counterpart. A big gap in the development of the sub-culture of insurance between the two countries is, therefore, inevitable. More noticeably, the US is the only industrialized nation that did not choose the compulsory HI path, whereas in Vietnam employees working in legally operated establishments are offered with only one type of compulsory health plan. Put differently, American employees enjoy full freedom in choosing to enroll in the health plan which best suit their needs and income. Once a year, employers hold an open enrolment for their employees to choose to stay with the plan they enrolled the year before or to switch to another. They are well informed or updated about any changes in health plan thanks to the information provided directly to their home by the employer. By contrast, employees in Vietnam, especially workers, have no idea about to what extent they are covered. Regarding the type of coverage, only state-mandated medical insurance is available. Another sharp difference is that our government has no coverage for the low-income or people over 65 years who did not work in the past as in the US. In fact, the US government designs specific health plans for specific people in an attempt to guarantee that everyone is covered. Vietnam is too poor to do so and that is the very reason why there are many health plans in the US we have never heard about. In a nutshell, the differences in the level of the development of HI between the US and Vietnam, and the diversity of health plans in the former are the source of non-equivalence problem in the translation of HI terms in the US health plans. The following section will focus on the analysis of how the problem is currently handled. III.2. The strategies, procedures and methods employed in dealing with non-equivalence problem in the translation of HI terms III.2.1. The translation of terms with transference procedure (the use of loan words) The strategy proves itself a great tool in dealing with technical terms in general and HI terms in the US health plans in particular. Specially, readers’ better knowledge of internationally recognized language as English can also be named as a reason why this strategy is more and more popularly used. Group 4: HI acronyms These acronyms are created and used for the purpose of one text to designate products, appliances, processes and international institutions within the particular text. In translation, they can be either decoded or transferred: if they appear for the first time they are usually accompanied by both English (in case readers know English, they themselves can figure out their real essence) and Vietnamese full forms; and if they are repeated or used at other points in the target language text, the full forms are withdrawn. Source language acronyms are often retained for convenience and to avoid repeatability. Example 1: First time: Source language: Members have to choose a primary care physician (PCP), who becomes the personal doctor… Target language: Những người tham gia BH phải chọn một bác sĩ chăm sóc chính (primary care physician _PCP). Người đó sẽ trở thành bác sĩ riêng của họ. Second time forward: Source language: No matter what health problem you encounter, it is required that you always call your PCP first and… Target language: Cho dù quý vị gặp vấn đề gì về sức khỏe, việc đầu tiên quý vị phải làm là liên lạc với PCP của quý vị và… The second example can better illustrate the convenience of using of acronyms in the translated version: Source language: A Preferred Provider organization (PPO) (1) plan combines the benefits of fee-for-service with the features of an HMO. If patients use health care providers (doctors, hospitals, etc.) who are part of the PPO (2) network,... Some PPOs (3) require people to choose a primary care physician who will... Other PPOs (4) allow patients to choose specialists on their own. A PPO (5) may offer lower levels of coverage for care given by doctors and other professionals not affiliated with the PPO (6). Target language: Chương trình BH của Tổ chức cung cấp dịch vụ ưu đãi (Preferred Provider Organization-PPO) (1) kết hợp các quyền lợi của chương trình dịch vụ tính tiền với các quyền lợi của chương trình HMO. Nếu bệnh nhân sử dụng dịch vụ của các nhà cung cấp chăm sóc sức khỏe thuộc mạng lưới PPO (2) …Một số PPO (3) yêu cầu mọi người chọn một bác sĩ chịu trách nhiệm chính cho mình…Các PPO (4) khác cho phép các bệnh nhân tự chọn bác sĩ của mình ngoài mạng lưới. Các bệnh nhân sử dụng các dịch vụ của các bác sĩ hoặc chuyên gia không thuộc mạng lưới của PPO (5) sẽ được PPO (6) bao trả với mức thấp hơn. (See more examples in Appendix 5) Even at a glance, one can recognize that the translated version would be more than clumsy if the borrowed foreign acronyms are not made use of. In fact, they are more and more frequently used by translators as an effective strategy to deal with this type of non-equivalence problem arising from the gap in the subculture of insurance. What should be noted is that acronyms collected in this study such as HMO, PPO, POS and EPO stand for the names of organizations which do no exist in Vietnam, hence completely unknown to Vietnamese speakers. So far, no direct equivalents have been found, and we find that all of these terms are translated rather literally with the lexical rendered out of context. Their names, when translated into Vietnamese, can not themselves tell readers about their functions. The translation, however, would be lengthy or cumbersome if an explanation is provided in parentheses. In an attempt to facilitate readers’ thorough understanding about different insurance plans so that they have made right decision at annual open enrolment, a glossary in the target language is added by translators to facilitate enrollees’ understanding about different health plans. This helps lead to their sound decisions at annual enrollment. Group 5: Terms referring to the name of health plans unavailable in the subculture of insurance in Vietnam In this study, there are only 6 items which appear exactly the same form as they are in the source language text: Table 1: Terms referring to the name of health plans English terms Vietnamese equivalents Medicaid plan Chương trình Medicaid (loại hình BH dành cho người nghèo) Medicare plan Chương trình Medicare (loại hình BH dành cho người trên 65 tuổi) Medi-gap plan Chương trình Medi-gap (chương trình bao trả các chi phí vượt quá mức bao trả của chương trình Medicare) Medicare Advantage plan Chương trình Medicare Advantage (chương trình cho phép người thụ hưởng được lựa chọn các nhà cung cấp dịch vụ y tế ngoài Medicare) Medicare Specialty plan Chương trình Medicare Specialty (loại hình BH dành cho các đối tượng có bệnh lý đặc biệt) Spend-down plan Chương trình Spend-down (dành cho những người có thu nhập bị giảm hoặc thất thoát về tài sản) To compensate for the untranslatability, some translators add a functional-descriptive equivalent in parentheses as shown in Table 1. This is of great help for those who are not good at English; otherwise, the intended readers will definitely find it impossible to understand what, say, “Spend-down plan” is. If the name of a plan appears at other points in the text, the functional-descriptive equivalents will be withdrawn since readers have presumably got hold of the concerned perception. III.2.2. The translation of terms by paraphrase Paraphrase has been employed by both professional and amateur translators in all fields either consciously or unconsciously, though as a last resort in many contexts. This is simply an explanation of the meaning of the source item(s). In the following section, we will investigate how a number of HI terms are translated by paraphrase. Group 6: Terms referring to culture-specific concepts As analyzed above in (III.1), there exist sharp differences in the sub-culture of insurance between the US and Vietnam. In fact, the former is much more developed, resulting in totally unknown insurance concepts, which are expressed via a number of US HI terms, to Vietnamese. Since they are not lexicalized at all in Vietnamese, translators have to paraphrase them, using either related words or unrelated words to unpack the meaning of the terms in question. Here are some typical examples: Table 2: Terms translated by paraphrase English terms Vietnamese equivalents donut hole giai đoạn 3 trong chương trình Medicare mà theo quy định thì người tham gia BH phải tự trả các chi fí y tế self-funded plan BH bao trả theo chi fí y tế thực của hãng cho nhân viên thông qua quỹ được đóng góp theo tỷ lệ phần trăm nhất định giữa chủ hãng và nhân viên staff model mô hình HMO cho cá nhân accrete bổ sung thêm thành viên mới vào chương trình BH trợ cấp y tế Medicare của chính phủ dành cho người trên 65 tuổi delete loại ra khỏi diện được BH bởi chương trình BH trợ cấp y tế Medicare của chính phủ dành cho người trên 65 tuổi No-gap [Bác sĩ] cam kết không tính phí cao hơn mức thanh toán tối đa của BH cho một dịch vụ nào đó. Known-gap [Bác sĩ] tính phí cao hơn mức thanh toán tối đa của BH nhưng cam kết giữ số chênh lệch này trong một phạm vi quy định. (See more examples in Appendix 7) Clearly, from Table 2, all the seven terms are explained or paraphrased rather than being translated. The reasons why translators have to resort to this strategy are easily isolated, that is the unavailability of the Vietnamese equivalents and the subculture-sourced concepts unknown in Vietnamese. “Self-funded plan” can serve as a very good example of , the latter. Unlike Vietnam where all employers pay a fixed premium to an insurance carrier, in the US, several employers set up a special trust fund to earmark money (corporate and employee contribution) to pay incurred claims. Probably, only by explaining the term can translators be sure that the intended meaning of the term is fully conveyed to the intended readers. Regarding “donut hole”, “no-gap”, and “known-gap”, they can not be found in dictionaries, even in insurance dictionaries, leaving translators no choice but to paraphrase them in an understandable way. Nevertheless, this strategy reveals in itself two disadvantages. Firstly, a paraphrase does not have the status of a stable lexical item, hence failing to transfer its associated expressive, evoked, or any kind of associative meaning into the target language. Secondly, when one term in the source language is replaced by a lengthy explanation in the target v cfeuydlanguage it is undoubtedly cumbersome and even awkward. III.2.3. The translation of terms with communicative method Within this research, the researchers find that the translators go for communicative method for a generous transfer of foreign elements in to the target culture as well as the target language where necessary. Group 7: Terms referring to culture-specific concepts In (III.2.2), we have studied how terms referring to culture-specific concepts are dealt with by paraphrase. Seemingly, such terms have been best translated by the procedure or strategy of paraphrase because of the non-equivalence problem analyzed in the above section. However, there are terms which also refer to culture-specific concepts, but solved with communicative method rather than by paraphrase. To some or many extent, the translators who employ the strategy do get profound knowledge of the sub-culture of insurance in both the two countries. This can be manifested by the way they handle the terms and choose the lexical words in Vietnamese. The contextual meaning of the terms is rendered in such a way that both content and language are readily acceptable and comprehensible to the intended readers. Examples: Table 3: Terms translated with communicative method English Vietnamese equivalents cafeteria plan chương trình BHSK tự chọn fee-for-service/indemnity plan tiền trao cháo múc dịch vụ tính tiền wellness office visit khám định kỳ office visit đến khám bệnh tại phòng mạch triage sàng lọc các bệnh nhân cần ưu tiên fee schedule giá biểu liệt kê các mức thanh toán tối đa well-baby care săn sóc phòng bệnh cho trẻ nhỏ domesic partner bạn đời (See more examples in Appendix 8) “Well-baby care” is a health care service designated for children as dependents in health plans for covered workers. The goals of well baby care are 1) to immunize; 2) to provide parents with reassurance and counseling on safety, nutrition and behavioral problems; and 3) to identify and treat physical and developmental problems. How to find an equivalent that can fully convey the three goals of the service to the readers in the source language with no available concept may be hard for translators. The problem seems to be compounded by the term itself since the lexical words can not say anything about the function of the service. The translator, in this case, may assume that what he has to do is to make “well-baby care” understandable to the intended readers in the sense that it is a good health service to their children in terms of both prevention and care. And the Vietnamese equivalent “săn sóc phòng bệnh” seems to do its good job, finding its way through even the most difficult readers. Some may thought of paraphrase as a last resort, but it seems that communicative method has proved itself a better solution. “Cafeteria plan”-a completely alien concept of insurance to Vietnamese readers-is also a very good example of the effectiveness of communicative as a translation method. During the process of finding data for this study, the researcher came across with more than one translated version for the term, including “chương trình phòng ăn” and “chương trình cafeteria”. The former is the so-called “literal translation” with no reference to health insurance, and the words are translated singly by their most common meanings or out of the context. The latter, though less ridiculously rendered, still needs an explanation while it can be better translated with communicative method if the translator has really understood what it is. “Cafeteria plan” is a customized health plan, under which employees can choose among two or more benefits to best feed their real needs and utilizes the benefits selected. The translator who has translated the term into Vietnamese as “Chương trình BH sức khỏe tự chọn” must have firstly investigated into the definition of the plan so that he can adapt and make the thought and cultural content of the term more accessible to the reader. Though undoubtedly a great tool in dealing with non-equivalence stemmed from the gap in the sub-culture of insurance in Vietnam and the US, communicative method has one disadvantage. Specifically, in a number of cases, some loss of meaning in Vietnamese equivalents compared with the original meaning intended in the English terms cannot be avoided. Take now the translation of “domestic partners” as an illustration. “Domestic partners” are commonly defined as two adults who share an emotional, physical and financial relationship similar to that of a married couple but who either choose not to marry or cannot legally marry. They share a mutual obligation of support for the basic necessities of life. “Bạn đời” reflects the translator’s good choice of lexical words, and it seems to be impossible to find a smoother and more colloquial equivalent that would be more accessible to the readership than this one. However, if we take a look at the definition of the term, we can easily recognize some degree of the loss of meaning wished to convey by the person who created that word. In common sense in Vietnamese, “bạn đời” is used to refer to someone’s legally married husband or wife, whereas “domestic partners” are not necessarily such that. Someone may suggest “nhân tình” and “bạn tình” as its equivalent, but both of them still fail to convey the full meaning of the term. This can be proved by employing “back translation” which will yield such an equivalent as “lovers” who normally do not share financial relationship as “domestic partners”. Another example is the translation of “idemnity health plan”, also called “fee-for-service”. Two equivalents “tiền trao cháo múc” or “dịch vụ tính tiền” for the term have been used so far among insurance circle with the former much more natural and familiar to the readers. A glance at the equivalents can tell readers that they have to pay for the services themselves anytime they go to any physician or provider they have chosen. What is lost here is that they can file claims for reimbursement later. If paraphrase, though yielding a long explanation, is used to deal with the term, it will not involve any loss of meaning like that. We may not exaggerate in saying that the loss of meaning in translation, more or less, is inevitable because there exists a big lexical gap between the two languages, especially a lack of equivalent technical terms in Vietnamese. Though communicative assumes that exact translation may be possible and may be perfect (Newmark, 1995: 68), it still fails to transfer the exact message intended in a number of HI terms collected for this study from English into Vietnamese. III.2.4. Literal translation Among the collected data, there are ten terms which are translated literally with the lexical words rendered out of context. The lexical gap between the two languages again poses a difficult task to translators who then have to turn to this translation method as a last resort regardless of the ridiculousness or awkwardness of the equivalents. Group 8: Terms referring to concepts that are not lexicalized in the target language These terms express concepts which are known in Vietnamese, but simply not lexicalized, that is not “allocated” Vietnamese words or phrases to express them. The following table features some terms of this non-equivalence problem collected for this study: Table 4: Terms that are not lexicalized in Vietnamese English terms Vietnamese equivalents community rating đánh giá cộng đồng look-back period khoảng thời gian xét lại out-of-plan ngoài chương trình portability tính chuyển đổi employee +1 and more coverage BH nhân viên +1 trở lên (See more examples in Appendix 9) “Look-back period” is a good example of the discussed problem. The term refers to the six-month time lapse before a person enrolls in a new HI plan. If a person receives medical advice, suggestions, prescription drugs, diagnosis, or treatment for a health problem during the look-back period, he or she is considered to have a preexisting condition. Meanwhile, the Vietnamese equivalent “khoảng thời gian xét lại” fails to give readers any hint or clue to the concept in the sub-culture of insurance, making no sense in the given context. ‘Period’ and ‘look-back’ are literally rendered into Vietnamese as ‘khoảng thời gian ’and ‘xét lại’ respectively before being put together to make a compound. If the word order of the term had not been changed, it would have become word-for-word translation. The translator may have not acquired background knowledge needed for his job, resulting in the failure to produce on the intended readers an effect as close as to that obtained on the readers of the original. Even, he makes the term difficult to understand. It is no exaggeration to say that literal translation is out of question when dealing with non-equivalence problem. According to Newmark (1995: 70), literal translation above word level is the only correct procedure if the source language and target language meaning correspond, or correspond more closely than any alternative. Unfortunately, non-equivalence means such a happy match can not be found in any circumstances. Let’s look at one more example which serves as proof of the inapplicability of the method in dealing with the terms in group 8. “Community rating” has its Vietnamese equivalent as “đánh giá cộng đồng”. It may easily produce a misleading effect on readers who may equate it with a number of things. For example, they may assume it is a procedure under which a community is rated based on a number of specific criteria. In fact, it is a method of developing HI premium rates (or for any other type of insurance) wherein actuaries figure out what a population's total costs will be, then estimate what portion is allocated to each individual, family, single+spouse, etc. Clearly, the lexical words are translated singly, hence yielding inarguably inaccessible concepts to the reader. It would be much better if a functional-descriptive equivalent is provided as an explanation to clarify the meaning of the term in question. Paraphrase, though long, can fulfill its function of making the source language meaning understandable in the target language. Brevity, as a result of word literally combined, might not always be the best choice in translation. III.3. Concluding remarks Clearly, the task of handling HI terms of non-equivalence group is of greater level of difficulty compared to dealing with terms of equivalence group. In fact, it demands the translator to make a smart choice of the translation strategies/procedures/methods so as to render the terms in questions appropriately in terms of the intended readership, and accurately with regards to the message wished to be conveyed. To this end, transference procedure, paraphrase as a translation strategy, communicative method and literal translation have been the choice of the translators in different situations or for different groups of terms, though each embodies in itself both advantages and disadvantages as a matter-of-fact. PART C: CONCLUSION We have made an attempt to make an investigation into the equivalence between English and Vietnamese translation of insurance terms in US HIplans. The study has been kept on the right track to find the answers for the set research questions. In this part, we would like to briefly summarize translation methods, procedures and strategies employed to deal with groups of terms that have equivalents and the terms of non-equivalence group. We would also like to make some suggestions for the translation of HIterms in the US HIplans since we have thoroughly examined the current situation of the translation of the terms. Suggestions are made in terms of methods, procedures and strategies that can be best used to the purpose of terminology standardization. 1. The terms of equivalence group Group 1: Terms translated with transposition procedure that involves an automatic change in the word order from SL to TL Group 2: Terms consisting of Classifier (past participle) + Thing Procedure: Either (i) automatic transposition (English nomimal group = Vietnamese nominal group) or (ii) rank-shift (English nominal group = Vietnamese clause) Group 3: Terms consisting of Thing + Qualifier (noun + of +noun/noun phrase) Strategies: translated with the deletion or omission of the preposition ‘OF’ 2. The terms of non-equivalence group Group 4: Acronyms Procedure: Transference (usually transferred, sometimes decoded and translated) Group 5: Terms referring to the name of health plans unavailable in the subculture of insurance in Vietnam Procedure: Transference, usually accompanied with a functional-descriptive equivalent in parentheses Group 6, 7: Terms referring to culture-specific concepts Strategies and methods: Paraphrase OR Communicative method depending on the intended meaning of the term Group 8: Terms referring to concepts that are not lexicalized in the Vietnamese Methods: Literal translation 3. Suggestion for the methods, procedures and strategies 3.1. Suggestion for transference coupled with functional-descriptive terms As clearly seen in this study, it is no wonder why transference has gained much preference in the translation of technical terms in general, and of HI terms in particular. Naturally, however, this procedure has both advantages and disadvantages. In terms of the advantages, it is of great help in dealing with non-equivalence problem since there are quite a few concepts unknown in the TL. In such cases, the translator has no option but to directly borrow the English word into the target language. One widely accepted benefit of employing this strategy is that it enables the translator to give a short, precise translation easily without having to go deeply into the meaning of the term, hence limiting or avoiding false translation, especially when the term in question is completely new. In addition, when the borrowed words are accompanied with functional-descriptive terms, the concern that it is impossible for the readership to induce or figure out the meaning of the term will no longer exist. Regarding the disadvantages, the task of preserving the purity and clarity of Vietnamese and avoid attacking the national characteristics of terminology appears to be harder more than ever if borrowed or loan words are used frequently. Besides, the way these borrowed terms are read and written definitely, to more or lesser extent, make it difficult for readers, especially when a TL term as‘Medi-gap’ keeps exactly the same form in the SL. Both sides considered, the advantages appear to overweigh the disadvantages, resulting in its popularity. The fact shows that those working in the field of insurance even use them without an explanation in the form of a functional-descriptive term. 3.2. Suggestion for transposition procedure Different types of transposition are used to translate many groups of terms and to eliminate different problems. Undoubtedly, it is a useful translation procedure in the sense that it can help deal with the differences in word formation and structural patterns between the two languages. 3.3. Suggestion for paraphrase strategy This translation strategy is one of the effective options in dealing with non-equivalence problem. The concept the writer wishes to convey to the readership do not exist in the TL, and if it is dealt by some translation strategy, a certain loss of meaning may not be avoided. Moreover, this strategy is too useful to be outlawed since it can help clarify meaning and make the term in question comprehensible to the readership. However, as there is a trade-off between lengthy explanations with the economy of the translated version, the translator should always take into consideration this very fact. In so doing, he can guarantee this strategy is not abused. 3.4. Suggestion for communicative method With the heart of the meaning being the message in communicative translation, the method normally makes the text smoother, lighter, more idiomatic and easier to read. Communicative translation also finds its way through non-equivalence problem, making the seemingly impossible task of finding a TL equivalent for a term unknown in SL possible in several cases as ‘cafeteria plan-chương trình BHSK tự chọn’. The method allows the translator more freedom to manipulate his translation skill. More concretely, he may make a generous transfer of foreign elements into his own culture as well as his language necessary. Therefore, it is not by chance that many translators go for the method. Though it is not always possible to state which method is better for a particular text, standardized language including terminology should be translated communicatively, whether a standardized equivalent exists or not, unless the term is used descriptively rather than operatively in the original text. Nevertheless, one big problem of communicative translation is to decide to what extent one should simplify and therefore emphasize the basic message. If a technical term is oversimplified or the translator, in an attempt to further beautify his translated version, fails to fully transmit the intended meaning of the term, a certain degree of lost meaning is unavoidable. The way ‘domestic partners-bạn đời’ is translated into Vietnamese, which is analyzed in III.2.3, may serve as a typical example of the problem. On balance, regardless of its problem, communicative translation has still gained its rightful place in the choice of translators. Nevetheless, if a certain loss of meaning is unavoidable as a trade-off with the aesthetic value, that is, the beautiful and natural sound as in some cases mentioned in III.2.3, it is suggested that the English version be added. 3.5. Suggestion for literal translation Literal translation is the basic translation procedure in that translation starts from there. Put differently, it is the first step in translation. Many translators firstly translate the term or text in question literally to figure out its literal meaning before making the final version accurate, smoother, sound natural and most importantly, accessible to the readership. Clearly, if literal translation is employed as the only method in dealing with the terms in group 8, it is not the right choice of translators in that the translated versions are clumsy and incomprehensible. One may find it difficult to understand what is really meant by ‘tính có thể chuyển đổi được’ (portability), and some others may misunderstand the intended meaning allocated to ‘community rating’ when it is literally rendered into Vietnamese as ‘đánh giá cộng đồng’. Inarguably, literal translation is out of question when there is any kind of translation problem as non-equivalence, especially non-equivalence above word level. It definitely fails to produce as nearly as possible the same effect on the intended readership as was produced on the readers of the original. To conclude, it is a strong recommendation that translators should get away from literal translation unless the SL and TL meaning correspond more closely than any alternative. 4. Suggestion for further studies Within limited time, we have not been able to collect all translated versions for comparison and analysis. However, we are fully aware that it is impossible to do so since in almost all the US states there are quite a few translators doing the translation of health plans into Vietnamese for Vietnamese community there. What can still be done towards an exhaustive research into the equivalence between English and Vietnamese translation of insurance terms in US HI plans is the collection of terms of disability income insurance for analysis and induction. 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APPENDICES Appendix 1 Eligibility tính hội đủ điều kiện Participant người tham gia/mua BH Renewability tính tái tục Exclusions điều khoản loại trừ Limitations điều khoản hạn chế Dependent người fụ thuộc Limitations điều khoản hạn chế Rider điều khoản riêng loaị trừ Underwriting việc xét nhận rủi ro y tế Contribution đóng góp (nguyên tắc công bằng trong các BHSK) Representation lời khai của người được BH Coinsurance BH phụ/Đồng BH Subcriber người tham gia/mua BH Renewal có thể được tái tục Eligible hội đủ điều kiện Usual thông thường Resonable vừa phải Guaranteed được đảm bảo Underinsured BH thiếu/dưới mức/mua với mức thấp/được BH dưới mức uninsured không được BH Deductible mức miễn thường/Khoản khấu trừ Customary thông dụng Formulary thuốc khuyến cáo Appendix 2 (Noun 1+ Noun 2) English terms Vietnamese equivalents benefit period thời kỳ thụ hưởng utilization management quản lý sử dụng cost containment kiểm soát chi phí sub-standard risk rủi ro dưới mức tiêu chuẩn health insurance BHSK subscription date ngày đăng ký overage dependent người phụ thuộc quá tuổi vị thành niên utilization review đánh giá sự sử dụng co-pay plan chương trình đồng trả prescription drugs thuốc theo toa prepayment scheme/plan chương trình BH trả trước lifetime maximum số tiền BH tối đa cho cả đời (Adjective + Noun) English terms Vietnamese equivalents reasonable fee phí vừa phải medical insurance BH y tế dental insurance/coverage BH nha khoa/răng common fee phí thông dụng/phổ biến major plan chương trình chính supplemental plan chương trình BH phụ/bổ sung customary fee phí theo thông lệ elective services dịch vụ tự chọn usual fee phí thông thường creditable coverage việc được BH chính đáng eligible employees nhân viên hội đủ điều kiện (Noun/Adjective + Noun + Noun) English terms Vietnamese equivalents group health plan chương trình BHSK theo nhóm hospital expense coverage BH chi phí nằm viện individual health insurance BHSK cá nhân medical benefits exemption miễn trừ các quyền lợi y tế dental expense coverage BH chi phí nha khoa individual health insurance BHSK cá nhân basic health plan BHSK cơ bản health care services các dịch vụ chăm sóc sức khỏe major medical plan chương trình y tế chính medical payment insurance BH chi phí y tế commercial health insurance BHSK thương mại catastrophic health insurance BHSK cho bệnh khó trị/nan y (Adjective/V-ed + Adjective/Noun +Noun + Noun) English terms Vietnamese equivalents guaranteed renewable health insurance BHSK tái gia hạn được bảo đảm conditional renewable health insurance BHSK tái tục có điều kiện major medical expense coverage BH chi phí y tế chính creditable drug prescription coverage BH theo đơn thuốc chính đáng high deductible health plan Chương trình BH có mức khấu trừ cao prepaid group practice package BH trọn gói chi phí y tế tập thể trả trước Appendix 3 (V-ed Noun) English terms Vietnamese equivalents Short , more technical Long, but clearer (un)covered expense các chi phí (không) được bao trả standardized plans các chương trình đã được chuẩn hoá insured employees những nhân viên đã được BH uncompensated care dịch vụ chăm sóc không được bồi hoàn experienced morbidity tỷ lệ bệnh tật theo kinh nghiệm expected morbidity số liệu thống kê bệnh tật dự tính impaired risk rủi ro xấu uninsured employees những nhân viên không được BH underinsured employees những nhân viên được BH dưới mức/thiếu Allowed amount mức cho phép Appendix 4 (Noun of Noun) English terms Vietnamese equivalents evidence of insurability bằng chứng khả năng có thể BH coordination of benefits phối hợp quyền lợi duplication of benefits kết hợp quyền lợi schedule of benefits bảng liệt kê các quyền lợi được hưởng explanation of benefits giải thích quyền lợi được hưởng certificate of credible coverage giấy chứng nhận việc được BH chính đáng evidence of coverage bằng chứng về việc được BH extension of benefits mở rộng các quyền lợi được hưởng freedom of choice tự do lựa chọn length of stay thời gian/số ngày nằm viện summary of plan bản tóm tắt/sơ lược chương trình BH date of subscription ngày đăng ký episode of care chương trình/phác đồ chăm sóc Appendix 5 English terms Vietnamese equivalents HMO (Health Maintenance Organization) BH HMO (Tổ chức bảo đảm sức khoẻ) POS (Point of Service) BH POS (Điểm dịch vụ) PPO (Preferred Provider Organization) BH PPO (Tổ chức các nhà cung cấp dịch vụ ưu tiên) EPO (Exclusive provider organization) BH EPO (Tổ chức chữa trị độc quyền) PCP (Primary care practitioner ) Bác sĩ chăm sóc chính DHMO (Dental Health Maintenance Organization ) BH DHMO (tổ chức đảm bảo sức khỏe bao trả chi phí nha khoa) HDHP (high deductible health plan) BH HDHP (chương trình BH có mức khấu trừ cao) HRA (Health Reimbursement Account) BH HRA (chương trình BH với tài khoản bồi hoàn chăm sóc y tế) FSA (Flexible spending account ) Tài khoản chi tiêu linh hoạt MSA (Medical Savings Account) Tài khoản tiết kiệm y tế HSA (Health savings account) BH HAS (chương trình BHYT có mức khấu trừ cao với tài khoản tiết kiệm y tế) Appendix 6 English terms Vietnamese equivalents Medicaid Chương trình Medicaid (loại hình BH dành cho người nghèo) Medicare Chương trình Medicare (loại hình BH dành cho người trên 65 tuổi) Medi-gap Chương trình Medi-gap (chương trình bao trả các chi phí y tế không được bao trả theo chương trình Medicare thông thường) Medicare Advantage Chương trình Medicare Advantage (chương trình cho phép người thụ hưởng được lựa chọn các nhà cung cấp dịch vụ y tế ngoài Medicare) Medicare Specialty Chương trình Medicare Specialty (loại hình BH dành cho các đối tượng có bệnh lý đặc biệt) Spend-down Chương trình Spend-down (loại hình BH dành cho những người có thu nhập bị giảm hoặc thất thoát về tài sản) Appendix 7 (paraphrase) English terms Vietnamese equivalents expatriate health plan BH dành cho người nước ngoài sống và làm việc ở một nước khác self-funded plan self-funding employer Chương trình BH SK của hãng cho nhân viên Creditable drug prescription coverage Chương trình bao trả theo đơn thuốc, tương đương Medicare Part D No-gap [Bác sĩ] cam kết không tính phí cao hơn mức thanh toán tối đa của BH cho một dịch vụ nào đó. Known-gap [Bác sĩ] tính phí cao hơn mức thanh toán tối đa của BH nhưng cam kết giữ số chênh lệch này trong một phạm vi quy định. staff model mô hình HMO cho cá nhân accrete bổ sung thêm thành viên mới vào chương trình BH trợ cấp y tế Medicare của chính phủ dành cho người trên 65 tuổi delete loại ra khỏi diện được BH bởi chương trình BH trợ cấp y tế Medicare của chính phủ dành cho người trên 65 tuổi donut hole giai đoạn 3 trong chương trình Medicare mà theo quy định thì người tham gia BH phải tự trả các chi fí y tế period of confinement Thời hạn quy định đối với việc được chăm sóc khi bị bệnh được bao trả theo đơn Bh, thường là 6 tháng Any Willing Provider Laws luật liên quan đến việc cho phép các nhà cung cấp dịch vụ vhăm sóc sức khỏe tham gia vào chương trình PPO or HMO enrollee người đăng ký