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Steven J. Kulback, MD
Birmingham, Ala

JAMA. 1995;274(10):795.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Drs Ebert and Heckerling¹ discussed the use of a paid interpreter with deaf patients. I can tell you in a nutshell why physicians are not using paid interpreters to see their deaf patients. For a level II visit for a deaf patient who has Medicare, total reimbursement in my geographic area is only $26.46. An interpreter costs $25 per hour with a 1-hour minimum. With an office overhead of a little over 50%, I lose money every time I see that patient.

The Americans With Disabilities Act is another example of an unfunded government mandate. Until Medicare pays for the cost of a paid interpreter, physicians are not going to be willing to use interpreters, or perhaps to even see deaf patients. Legislation designed to improve access to medical care for the handicapped may instead further limit their choices of physicians who will agree to see . . . [Full Text PDF of this Article]

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