This study was undertaken to determine the dynamics of why Vietnamese refugees may not optimally use existing health services in the United States. A random sample of 75 refugees was interviewed by a bilingual translator. Multivariate analysis of variance was used to analyze the effects of time of arrival on whether the following are barriers to care: not having a translator available in health care facilities, feeling understood by health care providers, being able to understand the written and verbal instructions of providers, and not having a primary provider. The hypothesis, that time-of-arrival groups would differ significantly on these variables, was supported (F = 4.81; df = 8,136; P less than .001). Concern about not having a translator in health care facilities ranked first in distinguishing the groups (F = 17.09; df = 2.71; P less than .001), followed by primary provider (F = 5.68; df = 2.71; P less than .01), feeling understood by the provider (F = 5.15; df = 2.71; P less than .01), and being able to understand written and verbal instructions given by the provider (F = 4.25; df = 2.71; P less than .05). The time-of-arrival groups also differed significantly on supplemental analyses. Subjects expressed willingness to seek more frequent health care if translators were available in health care facilities (F = 18.22; df = 2.72; P less than .001) and to change health care sites to gain a translator (F = 13.74; df = 2.72; P less than .001).