Health Cannot Be Taken for Granted: America Needs a Better Healthcare System

By Antonio Roca

WRI 111: Writing Seminar

To read student-editor Brandi Bangle’s comments on the writing moves found in this essay, click on or hover over the footnotes within the text.

I was abruptly woken by screams. They were loud and filled with terror. It was dark outside still; I noticed through the small gaps in the curtains. ¹ The screams continued. The screams were my sister’s and grandmother’s, I realized. They were coming from upstairs. “What happened?” I wondered. Fear started to fill my mind while my heart pumped faster and disturbingly louder. My mind started playing countless horrible scenarios. Had someone entered the house? Are we in danger? Has someone I love been hurt? Or worse? ² I laid in shock on my bed for what seemed to be an eternity when a second set of screams snapped me back to reality. I jumped from my bed and without clearly thinking I ran upstairs to an unknown and dangerous situation.

The wood made a cracking sound as I placed my foot on the first stair. Countless times before, I had silently walked upstairs to evade being noticed. I knew every move to avoid making a sound. But there was no time for caution, at least not in my mind. I continued to rush upstairs, already breathing heavily.

I entered my parents’ room, where the screams were coming from. My parents had gone away for vacation and as always, when they went away, my grandmother came to take care of us. My fourteen-year-old sister and eight-year-old brother slept with her in my parents’ bedroom. As I was entering the room, the screams pierced my ears. I could make out my brother’s name from the screams “ALVARO.” “ALVARO.” Inside the room, my grandmother was pacing around in the corner screaming with her eyes closed. My sister was standing next to the bed, her eyes full of terror and shock. I noticed my little brother in my parents’ bed, next to my sister. He was violently moving around. Unconscious. ³ His skin with a greenish tint and his eyes and mouth half-opened. I rushed towards him. My grandmother screamed my name followed by something else I couldn’t understand; my attention was fixed on my brother. He was the only thing that mattered at the moment. I placed my hand on my brother’s forehead. It was extremely hot. ⁴

Is my brother dying? Worries flooded my head. It was obvious that he was not okay. I begged to God for my brother’s safety and channeled all my will to regain my composure. Rational thoughts started to come in. I asked my sister and grandmother: What happened? They told me they were woken up by my brother’s aggressive movements. They tried to wake him up but he was unresponsive. That’s when the screaming started. ⁵

I cannot remember who got the idea, but my sister called my uncle. He is a doctor and conveniently our neighbor. He would know what to do, hopefully. My sister went running downstairs to open the door while I stayed next to my brother. He had stopped moving. I started shaking him and talking to him hoping to get one sign of reason from him. I only received moans. Did he have a stroke? No, it can’t be. God, don’t let it be. Save my brother. ⁶ I was panicking inside but acted calm to make my grandmother feel that everything would be alright, even though I had no idea.

Within three minutes my uncle arrived, and I stepped aside. He felt the temperature on my brother’s forehead. “He is too hot, we need to control his temperature,” he said. He instructed me to turn on the shower. To put the water at room temperature. It couldn’t be too cold. I headed to the shower while my uncle carried my little brother. He placed my brother in the water. “Fria, fria. [Cold, cold.]” My heart rose a little. Those words came out of my little brother’s lips. A sign of reason. Thank God. Some hope. But I still wondered: Will he be okay?

We took my brother out of the shower, I touched his forehead one more time—he didn’t feel as hot anymore. After all that had happened we knew that he had to be taken to the hospital. We clothed him and headed to the cars. I got my phone, my wallet, the insurance card, then the keys which I then handed to my uncle. He drove, while I held my brother, leaving my sister and grandmother at home. The clock marked about 4:00 a.m. In about an hour and a half, I was supposed to be ready for my school bus. I had my school’s United Nations model, an event where we were supposed to argue over a policy on behalf of a country. Something that I had never done before, it was supposed to be a fun new experience. I wondered if I would be able to make it. I had to wear a suit, but I was still in my pajamas. ⁷ And even worse I was holding my brother, still hot and mostly unresponsive. Did the event really matter when my brother’s health was at stake? It didn’t, I concluded. We rushed through the dark empty streets; it took us about 10 minutes to reach the hospital. ⁸

I entered the emergency room and tried to explain the situation while my uncle carried my brother inside. They asked about insurance. What? That was absurd. My brother may be dying and you are telling me that you first need to check the details on a plastic card? Could that not be done later? Through my confusion and aggravation, I complied. ⁹ They took my brother inside. Only one person could enter with the patient, so I was told to wait outside. I could not help but wonder what was happening there. I prayed for the best.

My uncle came out of the room and assured me that everything would be okay. Fortunately, my brother already looked better. I could instantly feel the pressure alleviate from my forehead. My brother was going to be fine: What else could I ask for? It appeared that my brother had had a seizure caused by fever. I was told to get the car and head home. My aunt would come and pick up my uncle. Everything will be okay. ¹⁰ By the time I turned on the engine of the old mechanic car, it was already 4:50 a.m. I turned the radio on to disturb my thoughts. It did not work. I could not help to think about what would happen if I lost my baby brother.

Reaching my home, I went upstairs to share the news with my grandma and sister. My uncle had already called them. My sister had gone back to sleep, and I was told to go to bed. The adrenaline caused by the previous chaos had already left my body, and I could feel my muscles and eyelids starting to fail. Completely exhausted, I quickly fell asleep.

What caused my brother to have that fever? I do not know. However, I know that we were lucky. Not everyone has the privilege of having a doctor as a neighbor. And even worse, not everyone has affordable access to healthcare. ¹¹

I am 10 years older than my brother, but even with that age gap, we are extremely close. I love to play with him and do kid stuff, such as playing nerf or Minecraft. As I am writing this today, I am catching my breath from an intense session of sword fighting (and yes, I am 19 and supposed to be mature now). ¹² I love my little brother so much, and I cannot bear to imagine what life would be like without him. Unfortunately, many people lose loved ones every day. And even more heartbreaking is knowing that with the proper access to healthcare, many of those lives could have been saved. ¹³

The American healthcare system is severely underperforming to fulfill the needs of the nation. The 2018 census concluded that about 27.5 million Americans did not have healthcare insurance (Berchick et al.). And of those insured, 29% reported being underinsured, meaning that their insurance does not properly cover their expenses. Because of this they are subjected to high deductibles and out-of-pocket expenses (Fox and Brod). As a result, many Americans are not receiving the care they need and are forced with the inhumane dilemma of choosing health or another necessity like providing food for their families. ¹⁴ A 2019 poll suggests that 25% of American households are delaying medical care for serious medical conditions because of cost (Saad). People should not be forced to choose other necessities, such as having food on the table, at the cost of the deterioration of their health. It is not uncommon for Americans, uninsured and insured, to enter debt because of healthcare expenses, in many cases leading to bankruptcy. For example, Susan LeClaire, an insured American from Palm Beach, Florida, had to file for bankruptcy and is close to filing for it a second time, as she can not afford the cancer treatment her life depends on; about 530,000 more Americans find themselves filing for bankruptcy yearly because of medical bills (Sainato). ¹⁵ To make matters worse, the cost of healthcare is expected to rise at a rate of 5.5% yearly for the next decade (“Healthcare Costs for Americans”). My family is privileged to live in Colombia, a country with more affordable healthcare, and that my brother did not require any intensive treatment; otherwise we may have also needed to sacrifice well-being to pay for the medical bills. ¹⁶ Healthcare is a fundamental human right and should be ensured for individuals. Each human life is valuable and everybody deserves to be spared from suffering if possible; be it from chronic pain, death or the passing of a loved one.

Unfortunately, America is failing to deliver the right to healthcare. A 2009 Harvard Medical School study found that about 45,000 people die annually because of causes related to lack of healthcare (Cecere). Even though this number may be slightly smaller today because of reforms such as the Affordable Care Act (ACA), which was amended in 2010 and sought to increase health insurance coverage and cost, the number of preventable deaths continues to be unsettling. The people more affected are those with fewer resources, which include communities of color, as they are unable to afford proper healthcare. Medicaid, a government healthcare program for low-income Americans, only covers about 40% of the low-income populations (Zelený and Bencko). The same Harvard Medical School study found that uninsured Americans have a 40% higher risk of death than insured Americans (Cecere). Another high-risk group includes people with preexisting conditions. Because the American healthcare is market-based, meaning that companies strive for profit and are pressured to do so by a competitive environment, it leads to companies excluding people with preexisting conditions as they represent the higher cost. Or it results in companies demanding high deductibles and cost-sharing of higher-risk patients, the ones with higher need for healthcare. The current healthcare system is regressive, affecting disproportionately lower-income families as it represents a higher percentage of their income, taking away their opportunity to achieve a higher standard of living. We have to ask ourselves: Does the American Dream live when the USA’s current system decreases people’s opportunity for a better life instead of improving it? ¹⁷

The current COVID-19 health crisis has shown further problems with the American healthcare system. In 2018, 49% of Americans were insured through their employer (“Health Insurance Coverage”). This has proven to be a vulnerability, as the current outbreak and its economic impact has left many Americans jobless and therefore without health insurance. By April 7, almost 5 million Americans have lost health insurance, and it is expected that by June 30 the number will rise another 13.5 million (Fauke), leaving people without access to healthcare when they need it the most. ¹⁸ The White House has said they will help pay for the treatment (O’Brien), but the costs will still be too high for some Americans preventing them from getting the treatment they need. Improving healthcare availability improves overall public safety as it could help prevent or decrease the spread of infectious diseases.

Changing to a single-payer system in America could potentially help solve most of the struggles the US has with healthcare. ¹⁹ Not only would it save lives and increase the well-being of millions in America, but it would also have additional benefits. Currently, the USA health system is the most expensive system costing about $3.6 trillion (18% of USA’s GDP) (Crowley et al.). Per capita, the USA spent $10,246 in 2017, more than any other country and more than twice that of Canada (“Current Health Expenditure Per Capita”), which has a single-payer system. Twenty-two economic analyses conducted from different organizations and different political perspectives concluded that embracing a single-payer system would reduce cost: “Savings from simplified payment administration and reductions in drug prices and other efficiencies ranged from 3 to 27 percent, with the largest savings found in plans that lowered drug costs” (Kurtzman). ²⁰ According to a study by the Institute of Medicine (IOM) the indirect costs of healthcare in the economy, because of decreased worker productivity, may exceed $1 trillion per year (“Public Health and the U.S. Economy”). So implementing a single-payer healthcare system would benefit the economy.

Improving the healthcare system by increasing the coverage and affordability, such as in a single-payer system, will save lives and improve the well-being of millions of Americans. We will be protecting the most vulnerable people and giving them an opportunity to improve their lifestyle as they would not have to put their limited resources towards healthcare. Furthermore it would help save money, improve the economy and increase public safety. ²¹ My experience with my brother made me realize how medical emergencies could happen to anyone at any time; this is the sobering reality. ²² Because of this, it is important that we adopt a system that is not only able to help save lives but that also protects the well-being of the patient and families instead of deteriorating it. A universal healthcare system has the potential of doing this.

Works Cited

Berchick, Edward et al. “Health Insurance Coverage in the United States: 2018.” The United States Census Bureau, 2019, https://www.census.gov/library/publications/2019/demo/p60-267.html.

Cecere, David. “New Study Finds 45,000 Deaths Annually Linked to Lack of Health Coverage.” Harvard Gazette, 2009, https://news.harvard.edu/gazette/story/2009/09/new-study-finds-45000-deaths-annually-linked-to-lack-of-health-coverage/.

Crowley, Ryan et al. “Envisioning a Better U.S. Health Care System for All: Coverage and Cost of Care.” Annals Of Internal Medicine, vol. 172, no. 2_Supplement, Jan. 2020, pp. S7-32. American College Of Physicians, doi:10.7326/m19-2415.

“Current Health Expenditure Per Capita (Current US$) | Data.” Data.Worldbank.Org, 2019, https://data.worldbank.org/indicator/SH.XPD.CHEX.PC.CD.

Dickman, Samuel L. et al. “Inequality and the Health-Care System in the USA.” The Lancet, vol. 389, no. 10077, 2017, pp. 1431-1441. Elsevier BV, doi:10.1016/s0140-6736(17)30398-7.

Fauke, Clare. “Nearly 5 Million Lost Health Coverage in Past Three Weeks; 13.5 Million Likely to Become Uninsured By June 30 – PNHP”. Physicians For A National Health Program, 2020, https://pnhp.org/news/nearly-5-million-lost-health-coverage-in-past-three-weeks-13-5-million-likely-to-become-uninsured-by-june-30/.

Fox, Bethanne, and Maya Brod. “Underinsured Rate Rose from 2014-2018, With Greatest Growth Among People in Employer Health Plans | Commonwealth Fund.” Commonwealthfund.Org, 2019, https://www.commonwealthfund.org/press-release/2019/underinsured-rate-rose-2014-2018-greatest-growth-among-people-employer-health

“Public Health And The U.S. Economy.” News, 2013, https://www.hsph.harvard.edu/news/magazine/public-health-economy-election/.

“Health Insurance Coverage of the Total Population.” The Henry J. Kaiser Family Foundation, 2019, https://www.kff.org/other/state-indicator/total-population/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D.

Kurtzman, Laura. “Single-Payer Systems Likely to Save Money in US, Analysis Finds – PNHP.”

Physicians For A National Health Program, 2020, https://pnhp.org/news/single-payer-systems-likely-to-save-money-in-us-analysis-finds/.

O’Brien, Sarah. “Here’s What You Need to Know When it Comes to Paying for Coronavirus Treatment.” CNBC, 2020, https://www.cnbc.com/2020/04/09/heres-what-you-need-to-know-about-coronavirus-treatment-costs.html.

“Healthcare Costs for Americans Projected to Grow at an Alarmingly High Rate.” Peter G. Peterson Foundation, 2019, https://www.pgpf.org/blog/2019/05/healthcare-costs-for-americans-projected-to-grow-at-an-alarmingly-high-rate.

Saad, Lydia. More Americans Delaying Medical Treatment Due to Cost.” Gallup.com, 9 Dec. 2019, https://news.gallup.com/poll/269138/americans-delaying-medical-treatment-due-cost.aspx.

Sainato, Michael. “‘I Live on the Street Now’: How Americans Fall into Medical Bankruptcy.” The Guardian, 2019, https://www.theguardian.com/us-news/2019/nov/14/health-insurance-medical-bankruptcy-debt.

Zelený, Tomáš, and Vladimír Bencko. “Healthcare System Financing and Profits: All That Glitters Is Not Gold.” Central European Journal of Public Health, vol. 23, no. 1, Mar. 2015, pp. 3–7. PubMed, doi:10.21101/cejph.a4027.

A Word from Antonio

Perhaps the hardest part of my essay was deciding on what to base it off of. The assignment entailed making an argument using a narrative of one’s own life. This deeply worried me as I believed that I did not have any extraordinary experiences that made me an expert in any topic. After running some ideas with Professor Elisabeth Whitehead I came to realize the power of this particular experience; I may not be an expert in the topic of healthcare but I do believe that I have something to share. Healthcare is a necessity in every person’s life and addressing its issues could not only improve the wellbeing of our communities but improve lives. Because of this I found it necessary to write this essay.

Once I decided on my topic, pieces started coming together in my mind. Before I even started I knew what the structure was going to be, as I have always been a methodical person and wrote my essays following a clear, familiar structure. Once I sat down to write my essay a rhythm came into my mind, and I decided to follow it, which resulted in my short pulsating sentences. It took some effort remembering the details of my story and some more effort to portray them to my reader. I also enjoyed the research aspect of the paper; I feel like I learned a lot about the American healthcare system and now I possess a more informed opinion.

The feedback of my classmates and Professor Whitehead really helped me develop my essay. I got a lot of insight on how to make my narrative more interesting, such as how to improve the visual effect of the storytelling. With the feedback I also got new perspectives that I had not considered beforehand which helped me make a clearer argument. Overall I believe this assignment helped me improve my skills as a writer.

From Professor Elisabeth Whitehead

Commentary

Antonio begins his essay with a quick and jagged breath. Staccato sentences. Clipped phrases and fragments of thoughts. He is disorientated, awoken in the middle of the night by his young brother’s screams. Antonio’s ability to remember, immerse himself in this difficult memory, and then accurately convey the emotional truth of this moment is one of the greatest strengths of his essay. Through his choices in sentence structure, utilization of specific sensory details, and honest voice, we, as readers, are drawn into the opening narrative. Antonio takes his time as writer to bring us into the moment, into his thoughts and vulnerabilities, before introducing us to the larger argument of this advocacy essay. The delayed thesis allows his readers to connect fully to him and his family, and to understand his experience and perspective, before listening to his argument, maybe allowing that listening to take place, especially for an audience who could potentially disagree with him on a controversial issue. Antonio then works to balance the emotional perspective of the opening narrative and further establish his credibility with substantial and relevant research.

It could be easy at this point for the author to get lost in his research, for his voice to shift, and for the two halves of the essay to feel too separate from one another. But through the strength of the opening narrative, the fact he didn’t rush the opening narrative, giving us time to build a relationship with the actors in this story, we are able to keep the story close, and connect the statistics and research to Antonio’s experience. He makes sure to remind us from time to time, to bring us back, even (or especially) in a paragraph heavy with statistics, that these are not just numbers, but these numbers represent real human beings. He allows his story to be the thread that carries us through, humanizing the issue.

Assignment

Essay 4: Narrative Advocacy

For your fourth paper, develop an argument built on the foundation of personal narrative on an issue of concern to you.

Narrative arguments make it possible for writers to illustrate a point by appealing to their audience, invoking experience, and creating a sense of identification with the controversy at hand. Key to creating an effective narrative argument is establishing credibility (your audience must believe you and trust your presentation) and establishing representativeness (the audience needs to understand that your narrative reflects a larger problem beyond the scope of its events).

Choose a subject that is tightly focused. You will want to keep your work balanced rhetorically by accompanying the emotional appeal of your story with strong credibility and with logical evidence (both anecdotal and researched) to support your claims.

Think in terms of an experience that made you realize that something was wrong or that something needed to be changed, and from which you gained essential knowledge about yourself and about the workings of the world around you. Tell a story that allows you to establish your position on the controversy and provide support for your claims. A well-told story often engages in vivid description. Create presence in your details. Your readers should really feel that they too, by reading your account, are there beside you, and can hear, see, smell, and touch those surroundings. Clean and vivid details can help set scene and tone. Therefore, be specific, descriptive, and engaging.

Successful papers will provide a rhetorically balanced narrative argument and will be clearly and engagingly written. You should conduct enough research to provide relevant, external support for your position. Your paper should include at least three sources (books, magazines, journals, newspapers, interviews, films, and/or texts from the academic databases), but use as many sources as you need.

Editor Comments

1
We are immediately dropped into the heat of the moment with this sensory language. Fear fills our body as we imagine what it would be like to be Antonio. ↩︎
2
This rapid fire series of questions causes us to spiral in our thoughts with Antonio, bringing about a disorienting feeling. ↩︎
3
The fact that the word “unconscious” is standing alone calls attention to the significance and severity of his brother’s condition. ↩︎
4
This extremely short sentence also works to highlight just how serious his brother’s condition was. We are left hanging at the end of this paragraph, which only furthers the concern we feel. ↩︎
5
Again, choosing to end a paragraph with a sentence fragment heightens our emotions. Here, we are filled with anxiety. ↩︎
6
Antonio quickly answers his own questions here with short sentences, bringing us along through his frantic thoughts. ↩︎
7
This detail brings a real-life element to the narrative. Even though Antonio is experiencing a seemingly life or death moment, his mind still briefly goes to the mundane activities of everyday life. ↩︎
8
Here Antonio’s mind quickly returns to the urgent, life-threatening situation at hand. He evaluates what truly matters, and we realize how insignificant “important” events in everyday life are when compared to this. ↩︎
9
A real-life frustration, one which many of us can relate to or at least imagine, is portrayed here through short sentences and questions. Antonio’s choices as a writer here further our empathized feelings of annoyance. ↩︎
10
Antonio again uses short sentences, this time to covey what he is being told to do, which is relatable for many of us young people. They give a commanding feeling–one that we get when we are told, in summary, that we are to let the adults take care of this. This lack of control leaves Antonio breathless and trying to convince himself that everything will be okay. ↩︎
11
This acknowledgement provides a smooth transition into the larger argument of the essay. ↩︎
12
This brief tangent and aside gives us an inside look on a sweet yet realistic moment between siblings. It also provides us with a sense of relief, as we now know that his brother is presently okay. ↩︎
13
Through his personal connection with his brother, Antonio cuts to the deeply human core of a larger issue plaguing the nation. ↩︎
14
A definite and firm stance is taken with the word choice “inhumane dilemma.” ↩︎
15
The combination of a specific, human case and a statistic gives a convincing, well-rounded view of the problem at hand. ↩︎
16
The reference to Antonio’s personal experience in Columbia stands to starkly contrast the current reality of the US. ↩︎
17
Antonio uses a question to encourage us to challenge, or at least consider, our own views of the USA and the American Dream in regard to healthcare. He ensures not to place blame on us by specifically referencing “we,” which includes himself. ↩︎
18
Attention is called to the harsh realities of the current pandemic, specifically referencing startling statistics that have left people “without access to healthcare when they need it the most,” an intentional word choice. This also calls attention to the seriousness of the issue being discussed. ↩︎
19
An explicit solution is suggested here. This makes the audience realize that Antonio is not merely vocalizing his concerns, but that he actually desires real change. ↩︎
20
Quotes that speak to the viability of the discussed solution strengthen Antonio’s credibility as an author. ↩︎
21
All of the main points are noted again, which encourages the reader to walk away with these ideas in mind. They cement the strength of the argument. ↩︎
22
Antonio makes one final mention of his own experience, reminding us how deeply it impacted him. ↩︎