A study on the equivalence between English and Vietnamese translation of insurance terms in US HI plans

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 1. 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

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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. As researchers, we ourselves have cherished a wish of finding as many terms of non-equivalence group as possible towards making a glossary of HI terms in the US insurance plans for use and reference among insurance circle. REFERENCES Bac, N.T. (2003). MA Thesis: A Study on the English-Vietnamese Translation of the Terminology in the Materials for Electronics and Electrical Engineering. VNU, College of Foreign Languages. Baker, M. (1992). In Other Words: A Coursebook on Translation.London and New York: Routledge. Baker, M. (1998). Routledge Encyclopedia of Translation Studies. Routledge. Bell, R.T. (1991). Translation and Translating: Theory and Practice. New York: Longman Inc. Carford, J.C. (1965). A Linguistic Theory of Translaiton. Oxford :OUP. Cẩn, N.T. (1999). Ngữ Pháp Tiếng Việt (Tiếng-Từ Ghép-Đoản Ngữ). NXB ĐHQG Hà Nội. Châu, Đ. H. (1981). Từ Vựng Ngữ Nghĩa Tiếng Việt. NXBGD. Châu, Đ.H. (1999). Các Bình Diện Của Từ và Từ Tiếng Việt. (In lần thứ ba). NXB ĐHQGHN. Chi, N.H & Thước, L. (1935). Sách Mẹo Tiếng Nam. Hà nội: NXB Lê Văn Tần (printed in Nguyễn Như Ý. 1996. Từ Điển Giải Thích Thuật Ngữ Ngôn Ngữ Học. Hà nội: NXBGD) Giáp, N.T. (1998). Từ Vựng Học Tiếng Việt. Hà Nội: NXB Đại Học và Trung Học Chuyên Nghiệp. Halliday, M.A.K (1985). An Introduction to Functional Grammar. London: Edward Amold. Hatim, B and Mason, I. (1990). Discourse and the Translator. Essex: Longman. Hiền, T.T.T (2005) MA Thesis: A Study on English Compounds Terms and Their Vietnamese Equivalents in Information Technology. VNU, College of Foreign Languages. Koller, W. (1979). Equivalence in Translation Theory, in Chesterman, A. (1989). Readings in Translation Theory, Loimaan Kirjapaino. Lang, L.V. (1977). Về Vấn Đề Xây Dựng Thuật Ngữ Khoa Học. Hà Nội: NXB Lao Động và Xã Hội. Mai, N.T. (2003). Ma Thesis: A Study on the Translation of IFA Terminology between English and Vietnamese. VNU, College of Foreign Languages. Newmark, P. (1995). Approaches to Translation. Prentice Hall International (UK) Ltd. Newmark, P. (1995). A Textbook of Translation. B and Jo Enterprise Pte Ltd. Thomasson, M. HIin the United States. EH.Net Encyclopedia, edited by Robert Whaples. April 18, 2003. URL Vân, H.V. (1998). Một Số Vấn Đề Có Liên Quan Đến Việc Dịch Cụm Danh Từ Tiếng Anh Sang Tiếng Việt. Nội San Ngoại Ngữ Số 5-1998. Trường ĐHNN, ĐHQGHN. Venuti, L. (1995). The Translation Studies Reader. Routledge-London and New York. Ý, N.N. (1996). Từ Điển Giải Thích Thuật Ngữ Ngôn Ngữ Học. Hà Nội: NXBGD. 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 tham gia vào một chương trình BH State-Mandated Benefits Các quyền lợi được hưởng trong chương trình BHYT theo quy định của tiểu bang Cap số tiền tối đa mà người tham gia BH phải trả trong một hoá đơn y tế Recidivism . số lần vào điều trị nội trụ cho cùng 1 loại bệnh 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 admitting physician Bác sĩ chịu trách nhiệm tiếp nhận quí vị vào viện hoặc các cơ sở chăm sóc sức khoẻ admitting privileges Quyền được trao cho một bác sĩ trong việc tiếp nhận bệnh nhân có bảo hiểm vào viện và sẽ bị thu lại nếu bác sĩ đó vi phạm chính sách và quy trình yêu cầu dual choice lựa chọn hai chương trình BHSK thay vì một chương trình , hoặc là HMO và PPO, hoặc là HMO và POS triple option lựa 1 trong 3 chương trình HMO, PPO và “Dịch vụ tính tiền” expanded special low income Chương trình Medicare mở rộng dành cho những người có thu nhập thấp dưới mức chuẩn Flat dollar amount khoản tiền xuất túi cố định theo quy định của từng chương trình, giống như tiền đồng trả Appendix 8 (communicative) English terms Vietnamese equivalents managed care plan Chương trình quản lý, chăm sóc sức khỏe cafeteria plan Chương trình BHSK tự chọn basic health plan plus Chương trình BH SK căn bản phụ custodial care chăm-sóc chuyên-nghiệp lẫn trông nom critical access hospital bệnh viện di động guaranteed issue quyền lợi được BH election lựa chọn chương trình BHSK phù hợp open enrollment kỳ ghi danh hàng năm well-baby care Săn sóc phòng bệnh wellness office visit Khám định kỳ office visit Đến khám bệnh tại phòng mạch triage Biện pháp sàng lọc thứ tự các bệnh nhân cần ưu tiên fee schedule Giá biểu liệt kê các mức thanh toán tối đa domestic partner Bạn đời fee-for-service/indemnity plan tiền trao cháo múc dịch vụ tính tiền full-service plan Chương trình bao trả theo chi phí thực service insurer agreement Thoả thuận giữa hãng BH với các nhà cung cấp dịch vụ y tế participating physician Bác sĩ thuộc mạng lưới encounter fee Phí khám bệnh local government health plan Chương trình BHSK của tiểu bang preadmission certification kiểm tra trước khi được nhập viện health exposure Rủi ro về sức khoẻ impaired risk Rủi ro xấu (non) formulary thuốc (không ) khuyến dùng Appendix 9 (Literal translation) English terms Vietnamese equivalents community rating Đánh giá cộng đồng look-back period Khoảng thời gian xét lại out-of-network Ngoài mạng lưới out-of-plan Ngoài chương trình credentiality Tính khả năng portability Tính có thể chuyển đổi được availability Tính sẵn sàng continuity Tính liên tục employee only coverage BHSK một mình nhân viên employee +1 and more coverage BHSK nhân viên +1 trở lên out-of-pocket money tiền xuất túi prior authorization được chấp thuận trước precertification được chứng nhận trước

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