19. Michael Knisely, Instructor
“Peer Review” Focuses and Questions
Instructors evaluate essays essentially within the following four
basic focuses of
1) Content, 2) Organization, 3) Mechanics (technical aspects),
and 4) Style.
You, both as a reader and the writer, can give and get feedback
within these domains. To this end, please consider and respond
to the following questions as you read and consider another
author’s writings, as well as using these to critique your own
work.
Not all these questions that follow will apply to every piece of
writing you consider. Try to “answer” as many questions as you
can. Be specific as you include both praise and suggestions for
revision, using the “sandwich” method of analysis (where praise
is the “bread” and suggestions are the inner “works” of the
sandwich).
I.Content:
1.What is the best point, illustration, or “moment” that the
author creates in this
essay? Why does it appeal to you?
2.Which point or paragraph could use more detail, extending an
example to help illustrate and enhance a point that the author is
trying to make?
3. What is the writer’s main “purpose” in writing this piece?
What audience do
you think that the writer is addressing?
20. II.Organization:
1.What organizational strategy seems to be at work in this
piece?
a.simple chronological movement in time
b.chronological, with one or more “flashbacks” to alter the time
sequence
c.“issue-driven” development (series of non-chronological
ideas, often
arranged with points moving from least to most important)
2.Why does using this particular organizational strategy work
well to “further”
the purpose of the writer and the work?
3.What alternative organizational strategy might also be
successful?
4.How does the introductory paragraph “hook” the reader’s
interest? How does the conclusion summarize and/or reinforce
the thematic content of the essay? Could the ending benefit
from a more physical gesture, more of a visual image to carry
the reader both back to the heart of the essay, and/or into the
future?
Page 2
Peer Review Focuses:
III.Mechanics (Punctuation, Spelling, Usage issues):
1.What issues of punctuation and usage do you see in this
piece?
(What did YOU used to be guilty of, until someone showed you
21. how to identify those issues in your own writing?)
2.What capitalization and spelling concerns do you have with
this piece?
3.What “kudos” can you give for mechanics, or use of MLA
format guidelines?
IV.Style:
1.What word, phrase, or sentence is the essay’s best example of
effective “diction”?
a.vocabulary, word choices
b.syntax (word ordering in sentences)
2.Discuss the effectiveness of sentence “variety,” in terms of
length and syntax.
3. Discuss any effective “transition” words or phrases that
carry the reader
smoothly from one idea or paragraph to the next.
4.What aspects of the writer’s “written voice” could use more
attention?
(Consider the effectiveness of word choices, syntax, sentence
variety, transitions)
Zhu 1
Hongteng Zhu
22. August 19, 2019
Michael Knisely
English 121
Research on Feasibility of Three Options to Solve the High Cost
and Delayed Ambulance Transportation in the United States
Introduction
One of my friends recently called ambulance service when he
was injured in a car accident. It costed him nearly $1000 for a
simple ride while waiting for ambulance to come for 30
minutes. His experience fostered me to examine the ambulance
service conditions in the U.S. According to Frakt’s article in
2018, in the United States, it is estimated that nearly 2 million
of people have difficulty in receiving proper ambulance
services, which results in negative health outcomes. This
difficulty in receiving proper ambulance services comes from
two aspects. First, the ambulance services are very limited in
number. This often results in delayed response to patients,
which is particularly terrible for those in urgent needs. Second,
the ambulance services are very expensive in the United States.
The charge for using ambulance services are based on several
factors, including transportation distance, facility usage, and
physician engagement. The cost can easily reach several
thousand for a simple ambulance transportation. It has been
even reported by DiGangi in 2018 that it cost a patient $2700
for only two-mile transportation. What makes things even worse
is that many health insurances do not cover or only cover part
of the ambulance cost, leaving the financial burden on patients
and their family.
Apart from the difficulty faced by the patients in the United
States in receiving proper healthcare transportation, the U.S.
government is also facing challenges in constructing ambulance
service. In 2011, the government has spent approximately $14
billion on ambulance services. This huge number places a great
burden on the health care spending and budget for the entire
country. In addition, it is reported by Frakt in 2018 that there
are a considerable amount of fraudulent bills to request
23. Medicare paying for the ambulance service, reaching about
30%.
From the above scenario, it can be seen that addressing
ambulance service is a complex issue. It is not easy to address
the delayed and unsatisfied high cost of transportation services
to receive timely health care services because of the issue is
complex. It requires the collaboration of multiple parties, such
as hospitals, governments, insurance providers, patients, etc. It
also imposes a great challenge on the traffic conditions in the
United States. But it is necessary to address the concerns of the
patients who need transportation to health care because no one
can guarantee that they would not need to go to hospitals in
their life and because sometimes it is really urgent in needing
the transportation to health care.
The target audience for this research is government, hospitals
and ride-hailing service providers (like Uber and Lyft). Three
solutions, including setting up programs of visiting doctors,
setting up mobile health centers, and/or integrating ride-hailing
providers to partner up with health care providers in offering
fast and cheap transportation to and from hospitals, are
proposed here with an illustration of their benefits, obstacle and
ways to mitigate the obstacles.
Solution
1 Visiting Doctors
Benefits
Setting up programs of visiting doctors will benefit patients
most. In this program, doctors will go out of hospitals and visit
the houses of patients to help them identify simple diseases and
deliver drugs to them. In this program, patients do not even
24. need to step out of their houses to receive medical care services.
They do not need to travel back and forth to hospitals to seek
health care services. This can be especially beneficial for those
elderly or disabled people because of the more difficulty in
traveling they face. Another benefit is the cost saving for
patients. They do not need to call an ambulance that is
surprisingly expensive. They do not need to take a taxi that can
impose a financial burden on them. In addition, it is also time-
saving for them. They do not need to spend time on traveling
nor on queueing in the hospitals, waiting for the services, as
analyzed by Flanagan et al in 2010.
Obstacles
Despite the apparent benefits the visiting doctors have, there are
also several obstacles for this solution. First of all, this program
imposes high demands for doctors. Apart from doctors working
in the hospitals to service those traditional patients, extra
groups of doctors are needed in this program for traveling in a
county or district. It can be difficult, as revealed by Elliott et al
in 2017, for many hospitals to set aside this obstacle
considering that the number of health care workers in the
United States is so limited.
Another major obstacle is the cost for hospitals or government.
Government or hospitals will have to pay extra for the traveling
costs of the doctors in this program. In addition, they also need
to pay for hiring more doctors to join this program. It can be
25. difficult to achieve this goal in the short term due to the lack of
financial resources.
How to Mitigate the Obstacles
To mitigate the above obstacles, it is important for
governments, hospitals, and communities to negotiate together
on how to allocate financial resources to support the extra cost
in this program. The fund may come from taxpayers, Medicare,
or other specifically raised ones. Recruiting more college
students in the major of pharmacy or related fields to solve the
long-term shortage of doctors can be another strategy even
though it takes much longer to achieve the goal.
Option 2 Mobile Health Centers
Benefits
Setting up mobile health centers benefit the residents in the
entire communities where the centers are located because they
can receive health care services within walking distance. This is
time-saving and cost-saving for residents in the communities.
At the same time, it can alleviate the traffic pressure in the
United States, to reduce traffic jam with fewer transportation
trips back and forth to hospitals. Mobile health centers will also
help the government save money in investing in ambulance
services. Another key benefit is that patients can save money by
reducing the chances of using ambulance services. The mobile
health centers can cover a larger area of service as compared to
health centers in the communities due to its easy mobility.
26. Obstacles
However, the major obstacle is the cost. It requires the
construction of health care service centers that can be
expensive. Constructing mobile health care centers may be even
more expensive than building a community health care center
because extra considerations are needed for the mobility and the
relevant facilities in the mobile centers. Another cost associated
with mobile health centers is the payment for the doctors hired
in the centers.
Another obstacle is the design issue. Since there are very few
such mobile health centers, designing becomes a big challenge
with comprehensive consideration and wide coverage for
disease treatments. Furthermore, the weight and mobility are
also key factors to be considered at the same time. As such, it
becomes a complex issue in implanting this solution
How to Mitigate the Obstacles
To mitigate the above obstacles, it is important for
governments, hospitals, and communities to negotiate and plan
carefully on how the financial resources can be allocated. Local
tax payment may be one option. The donation is also possible
from enterprises that are interested in investing it. Furthermore,
to address the obstacle of design, it is important for hospitals to
collaborate with automobile companies and medical equipment
companies to come up with a solution that can accommodate all
demands for the mobile health centers.
27. Option 3 Collaboration with Ride-Hailing Services (like
Uber/Lyft).
Benefits
Collaboration with ride-haling services as a complementary for
ambulance transport has several benefits. First of all, it is much
cheaper than ambulance services. Based on the charge standards
of Uber and Lyft, it is difficult to cost patients even one
thousand while ambulance services can easily reach this
number. In addition, the response time of ride-hailing services
would be much shorter as compared to the ambulance, according
to the article by Moskatel and Slusky in 2017. This can help
improve the health outcomes for some patients as they are more
willing to go to hospitals when fewer hurdles in traffic are
there. As one of the patient from San Diego, CA commented in
the news “Introducing Uber Health, Removing Transportation as
a Barrier to Care” that is published by Uber on May 1, 2018,
“my health crisis was a lot to manage. Knowing I had reliable
and comfortable transportation to and from my oncology
appointments was one less burden on a very long list”.
Obstacles
The major obstacle for using ride-hailing services (like Uber
and Lyft) is the demand for drivers, especially in some
emergency situation. The drivers may not want to take such
orders because of the urgency.
How to Mitigate the Obstacles
28. To address the obstacle, ride-hailing service providers may set
up a special group, like UberX, to serve healthcare
transportation only. This helps avoid the above issue of the
unwillingness of drivers. At the same time, some professional
training may be offered to this group of drivers. Like illustrated
by Geisser in 2015, UberX may be designed to offer some
rewards and some special responsibilities to help health care
transportation.
Conclusion
From the above analysis, it can be seen that addressing the slow
response time and the high cost of ambulance services in the
United States is a must. Three solutions, including setting up
programs of visiting doctors, setting up mobile health centers,
and/or integrating ride-hailing providers to partner up with
health care providers in offering fast and cheap transportation to
and from hospitals, are proposed with analysis of their benefits,
obstacles, and ways to mitigate the obstacles. It requires careful
planning and consideration of stakeholders in determining and
implementing. It is promising for ride-hailing to serve as a
compensation for the ambulance service as Georgetown Home
Care, a health care provider for elderly patients in Washington
has started to use such ride-hailing services to transport patients
to and from hospitals with caregivers on their side.
Works Cited
29. DiGangi, Christine. “This Man's 2-Mile Ambulance Ride Cost
$2,700. Is That Normal?” USA Today, Gannett Satellite
Information Network, 20 May 2017,
www.usatoday.com/story/money/personalfinance/2017/05/20/am
bulance-health-care-services-costs/334338001/.
Flanagan, Priti, et al. “Doctors Making House Calls:Innovative
Role or Overkill?” The Canadian Journal of Hospital Pharmacy,
vol. 63, no. 6, 2010, doi:10.4212/cjhp.v63i6.959.
Flanagan, Priti, et al. “Doctors Making House Calls:Innovative
Role or Overkill?” The Canadian Journal of Hospital Pharmacy,
vol. 63, no. 6, 2010, doi:10.4212/cjhp.v63i6.959.
Frakt, Austin. “Uber, Lyft and the Urgency of Saving Money on
Ambulances.” The New York Times, The New York Times, 1
Oct. 2018, www.nytimes.com/2018/10/01/upshot/uber-lyft-and-
the-urgency-of-saving-money-on-ambulances.html.
Moskatel, L. S., & Slusky, D. J. (2017). Did UberX Reduce
Ambulance Volume? (No. 201708). University of Kansas,
Department of Economics.
Geisser, Lauren. "Risk, Reward, and Responsibility: A Call to
Hold Uberx, Lyft, and Other Transportation Network Companies
Vicariously Liable for the Acts of Their Drivers." S. Cal. L.
Rev. 89 (2015): 317.
Uber. “Introducing Uber Health, Removing Transportation as a
Barrier to Care”. Uber, 2 Mar, 2018,
https://www.uber.com/newsroom/uber-health/
30. Specifics:
1. Biblical integration must be included in a thoughtful manner
as articulated in the required reading and presentations.
1. Citations from the required reading and presentation must be
included in answering the assigned questions.
1. Student follows discipline-specific formatting guidelines.
1. Word count is sufficient.
1. Main Thread entries SHOULD BE AT LEAST 600 words will
receive no credit if less.
![1
UniversityofCalifornia,Berkeley Fall2015
DepartmentofCityandRegionalPlanning Wurster106
Mon.&Wed.11:00am‐12:30pm SaraHinkley
Officehours:Monday12:30‐1:30,Wurster106&byappt.
[email protected]
CP113B:COMMUNITYANDECONOMICDEVELOPMENT
COURSEDESCRIPTION
Thiscourseintroducesthepolitical,economic,andsocialissuesatsta
keinthetheoryand
practiceofcommunityeconomicdevelopment.Thisincludes(1)alter
nativestotraditional
economicdevelopmentstrategies,focusingonequityandsustainabil
ity,and(2)
community‐basedstrategiesforimprovingaccesstojobs,housing,an
dopportunity.
Thegoalofthecourseistointroducestudentstothedifferentscalesatw
hichcommunity
andeconomicdevelopmentareapproached;theevolutionofgoals,the
ories,andtoolsin
thefield;andthecontroversiesandtensionsinvolvedincommunitych
ange.Studentswill
comeawayfromthecoursewell‐versedinthescopeofpoliciesthatadd
ressissuesof
inequality,poverty,unemployment,accesstoservices,affordableho
using,andjobs.You
willalsobeabletodescribetheforcesthathaveshapedthefieldoverthe](https://image.slidesharecdn.com/1universityofcaliforniaberkeleyfall2015depart-221013041610-8b9c781c/85/1UniversityofCalifornia-Berkeley-Fall2015Depart-docx-1-320.jpg)
