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

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 lợ