The document discusses challenges in teaching writing and content to ESL students. Latisha argues there is a healthcare crisis in the US, as insurance deductibles and costs rise, putting financial strain on many. Heather agrees there is a serious healthcare crisis, as costs rise and many cannot afford care, leading to delayed treatment. Both discuss issues like the uninsured not seeking preventative care, rising costs, and the inadequacy of existing public programs. Melissa and Shimika discuss challenges in teaching ESL students writing like lack of vocabulary, confidence, and readiness, and ways teachers can help through repetition, modeling, and engaging lessons that build skills.

1. Discussion
Healthcare Crisis
Respond to at least two of your classmates’ postings
LATISHA’S POST:
I do believe there is a healthcare crisis in the United States. I
feel that it does not matter if you have insurance or not the
times are changing and this is causing a lot more out of pocket
expenses before insurance will make the first payment. I
witness this first hand. I used to be able to go to a provider for
medical issues and would not have any out of pocket expenses
(deductibles) to meet before the insurance will actually pay,
beside the copay. Now most insurance companies require you to
meet a deductible before they pay anything. This puts more
financial strain on people, not just the uninsured. It seems it is
better to be uninsured and just pay out of pocket for services.
People who are uninsured are more likely not to get medical
services and are more likely to need hospitalization due to life
threatening issues such as pneumonia or diabetes that are not
controlled by medication (Krager, 2018). They are also more
likely to use the emergency room for services than a provider
(Krager, 2018). Children that are not insured have higher
chances of developmental delays due to not seeing a doctor
(Krager, 2018). Many people are uninsured because the cost of
insurance premiums are very high and they still have to try and
make ends meet (Krager, 2018). Although Medicare is the
second largest social insurance in the United States there are
still things that it does not cover for those that receive
Medicare. For example someone on Medicare can only spend 20
days in a skilled nursing facility hen they will need a copay
after 20 day and will have to pay out of their own pocket after
100 days (Krager, 2018). This is an issue that causes most
people to get services at home and have the family pay out of

2. pocket for a nurse or sitter or CNA. People have become
anxious and fearful about getting and maintaining their health
insurance due to payments (Krager, 2018). The rise of hospital
care is a major health care expenditure (Krager, 2018).
Premiums for employer-sponsored health insurance continues to
rise as well, which is reducing paycheck that employees are
bringing home, with no raise to compensate the cost of health
insurance (Krager, 2018). On top of the increase for premiums
the cost for provider visits can be very costly (Krager, 2018).
References
Krager, H. &. (2018). American social welfare policy: A
pluralist approach. Upper Saddle River, New Jersey: Pearson.
HEATHER’S POST:
There is no question the US has a serious healthcare crisis that
has been going on for as long as I can remember. There are
many people who either cannot afford insurance or have
insurance but cannot afford to pay deductibles or co-pays. Both
of those reasons are leading to people not going to the doctor
for minor issues resulting in more serious medical emergencies.
We are now at a point where insurance plans have become so
expensive even companies are not providing coverage for their
employees. In the past it was standard for every employer to
offer some kind of healthcare policy to all staff and those
policies would also cover immediate family members. Now a
days there are many businesses who do not offer those
healthcare plans anymore and when they are offered they are for
employees only. Back in 2001 “more than 41 million
Americans—or roughly one in seven—went without health
coverage for the entire year in 2001” (McCarthy, 2003 para. 3).
The US has programs like Medicare, Medicaid, VA, etc. that is
supposed to help those who qualify but the treatments provided
to those people are horrible and do not truly help. The
article What’s Next for the US Health Care System After
COVID-19? States those programs are “Not well funded in the
best of times, the safety net is stretched beyond capacity” due to

3. the current Covid-19 situation.
One of the amazing things about science and medicine is things
are forever changing and advancing for the better. Which is one
of the reasons the life expectancy has continued to increase.
However, the more advancements that are made in healthcare
the more expensive things become. One example is the use of
laparoscopic surgeries. It is great that surgeons are able to
complete operations without cutting open a patient and this
increases healing time. The down side to this is the cost of that
procedure is going to increase because of the cost of the robot
and having to find a surgeon who has been fully trained to use
the equipment. There is also no set price for any procedures,
someone might pay $100 in California but will pay $1000 in
New York for the same thing.
I do not envy the people in positions who have to try and fix
issues such as these. I wouldn’t even know where to begin to fix
the health care system. Every action is going to have a negative
reaction and is going to make a large number of people upset. I
know there are a lot of people who want universal healthcare to
be implemented which always sounds good in theory but just
like everything in life there are negatives that have to be
thought of prior to making that decision. In Canada “many
Canadians are forced to seek care in overtaxed emergency
departments, where wait times can be excessive; crowding has
been associated with delays in treatment of conditions ranging
from asthma to myocardial infarction” (Cram, Dhalla, & Kwan
2017 P. 564).
References:
Blewett, L. A., & Osterholm, M. T. (2020). What’s Next for the
US Health Care System After COVID-19? American Journal of
Public Health, 110(9), 1365–1366.
Cram, P., Dhalla, I., & Kwan, J. L. (2017). Trade-offs: pros and
cons of being a doctor and patient in Canada. Journal of general
internal medicine, 32(5), 563-565.

4. McCarthy, M. (2003). US health-care system faces cost and
insurance crises: rising costs, growing numbers of uninsured,
and quality gaps trouble world’s most expensive health-care
system. (Special Report). The Lancet, 362(9381).
Writing and Content in the ESL Classroom
Guided Response: Review several of your classmates’ posts,
and respond to at least two. Compare the answers of your
classmates to yours. Notice any similarities and differences to
teaching adults versus K-12. You might choose to respond to
one person who is writing about the adult context and one who
is writing about the K-12 context. For distinguished peer
responses, respond with a minimum of five sentences that add to
the conversation, and refrain from evaluative posts (i.e., You
did a good job.).
MELISSA’S POST
I will be speaking on the K-12th grade ELLs
Describe some challenges with teaching writing and content in
an ESL classroom.
There are many challenges that teachers are faced with when
teaching writing and content to their ESL students. One of them
is getting the child motivated to learn all areas of the English
language and keeping the child engaged when they struggle with
their self-confidence. Many children who come to the public
school system from non-English speaking homes, come with
extreme anxiety, worry, and fear. They are in shock which is
referred to as culture shock, and this leads to them being
distant, withdrawn, and silent. The author of Improving Writing
Skills: ELLs and the Joy of Writing states, “the students' worry
that they are making huge, embarrassing errors or that their
ideas aren't very good in the first place, then we begin to
understand the complexity involved in writing in a second
language (Robertson, K. n.d.). What Robertson is saying is that
the children’s lack of confidence could hinder the child’s

5. academic progress and that if teachers are not aware of these
challenges, they cannot set realistic goals and create appropriate
learning objectives for their children.
Explain how teachers help students overcome those challenges.
Teachers can help their students overcome these challenges by
making the environment warm and welcoming for their students.
They can provide activities in both the native language and the
English, and they can provide visual aids and tools for the
children to follow along with. Additionally, teachers can use
repetition in their lessons to help the child master the skills they
are trying to teach. Knowing that children learn best through
repetition and modeling is a great way to help the children
overcome their challenges. Finally, not pointing out every
mistake the child makes will help the child to feel more
comfortable with taking risks.
Determine how teachers can help students with the vocabulary
needed to write.
Teachers can help the students by focusing on writing skills and
metacognition and with that in a meaningful way and not just
focus on the reading skills. Teachers can use writing in all
content areas to encourage the students to continue to put their
thoughts down on paper. Teachers can have the children tell
story’s and then use the whiteboard or journals to help the
students put those stories down on paper. Teachers can create
games and fun activities for their students using the vocabulary
that they are being introduced to. Finally, preparing appropriate
lesson plans that meet the needs of the students and are not too
advanced or too easy for the students. The lesson must be
created to be at a skill level just above their current level so
that the children can be challenged.
Defend how BICS and CALP language proficiencies can impact
a student’s writing.
Children being proficient in BICS can socialize in an effective
way. These children can keep a conversation going while on the
playground, and while in other social settings, and are more

6. comfortable speaking in front of others. To build the child’s
Basic Interpersonal Communication Skills BICS teachers can
create lessons that incorporate peers working together,
teambuilding activities, and small group discussions. It is
important that teachers understand that BICS is a social
language that is built to help children communicate in social
settings. Teachers need to teach the child cognitive academic
language proficiency CALP skills to help the student in the
classroom and when taking tests. It is important to note that
CALP is strictly academic language whereas BICS is strictly
social language. Both are very important for the children to be
successful in learning and becoming fluent in the English
language.
References
Acacia University (2017). Writing strategies for ESL
students (Links to an external site.) (Links to an external
site.) [Video file]. Retrieved from
https://www.youtube.com/watch?v=Gd3ezbUBbLo
Mahmoud, S. S., & Oraby, K. K. (2015). Let them toil to learn:
Implicit feedback, self-correction and performance in EFL
writing. (Links to an external site.) (Links to an external
site.)Theory and Practice in Language Studies, 5(8), 1672-1681.
doi:10.17507/tpls.0508.18
Piper, T. (2015). Language, learning, and culture: English
language learning in today’s schools. Retrieved
from https://content.ashford.edu (Links to an external site.)
Robertson, K. (n.d.). Improving writing skills: ELLs and the joy
of writing. (Links to an external site.) (Links to an external
site.) Retrieved from
http://www.colorincolorado.org/article/improving-writing-
skills-ells-and-joy-writing
SHIMIKA’S POST
Describe some challenges with teaching writing and content in
an ESL classroom.

7. Some challenges with teaching writing and content in an ESL
classroom are lack of vocabulary, grammar, spelling, and
student readiness. Lack of vocabulary demonstrates that the
student is unable to express their ideas, beliefs, and feelings
through words. Grammar explains the structure of words and
how they are formed in sentences. Spelling, although they may
be so simple for most it causes anxiety for most ESL and can
prevent them from moving forward. Student readiness is based
upon the student if the student is not willing and motivated for
writing it will not be successful.
Explain how teachers help students overcome those challenges.
Teachers can help students overcome challenges by providing
the students with electronic dictionaries, that will pronounce
and define words. Teachers can implement lots of activities that
involve reading and grammar. Lessons should include
assignments with repetitive instruction, which will help the
student with memorization. The most important concept is to get
the students motivated, to even want to participate. The more
interesting it is, the better input the teacher will receive from
the students.
Determine how teachers can help students with the vocabulary
needed to write.
Teachers can help students with vocabulary needed to write in
many ways. Teachers can pre-teach words, before the class
discussion takes place. Teachers could demonstrate how to use
the dictionary, to help with pronunciation and word
meanings. Direct instruction which means presenting consistent
and clear instructions in a way that it can be comprehended.
Associate words with things that are familiar to the student. The
teacher should display real objects, pictures and a word wall
should be displayed in the classroom, which will allow the
students to visualize what the words look like
Defend how BICS and CALP

8. language proficiencies can impact a student’s writing.
BICS and CALPS language proficiency impact a student’s
writing because it identifies where the student is at in language
proficiency assessment. BICS deals with social language. Social
language is how you communicate with others. CALP focus
more on academic language that is learned mostly inside the
classroom. Social language is how you may communicate with
friends and academic language is more professional. They
both impact a student’s writing by how they are communicated.
Social language would include run-on sentences, incorrect
spelling, and grammatical errors., however with
academic languages these items will be corrected.
Piper, T. (2015). Language, learning, and culture: English
language learning in today’s schools. Retrieved
from https://content.ashford.edu (Links to an external site.)
Acacia University (2017). Writing strategies for ESL
students (Links to an external site.) (Links to an external
site.) [Video file]. Retrieved from
https://www.youtube.com/watch?v=Gd3ezbUBbLo (Links to an
external site.)