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Juanita Ruiz a 47- year-old Hispanic female, has a heart attack and is admitted to the hospital. She is a single mother and domestic worker with no health insurance. Doctors intervene, she survives, and her doctor prescribe her five medications. The hospital social worker helps her begin the process of enrolling in Medicaid. She is unable to afford all of them after paying for her hospital bills, so she only goes home with the cheapest one. Two weeks later, she has a clot, then another heart attack, then dies on the way to the emergency room. How would you intervene to decrease the likelihood of this outcome happening to others?

I massage my temples as I formulate an answer to this homework assignment, because there are so many opportunities that could have prevented this that I hardly know where to start. While I could think of many medical or even community interventions, the issue that most irks me is that there is a problem with the inherent structure of the system. I chuckle because I know I've been given s 500-word constraint to essentially solve the nation's healthcare crisis on my first day of class at my Master's of Public Policy program. I mean, this is where I thought I would be by graduation, but I suppose the early bird gets the worm.

My passion for the health industry began from a young age. I was born with Marfan Syndrome, a connective tissue disorder that affects many different areas of your body: heart, eyes, and bones naming a few. I have had three bone surgeries to help me live a normal life, but I consider myself to be lucky, because the condition has been monitored and controlled since I was diagnosed at a young age. Both my younger sister and I inherited this condition from our father, who unfortunately was not diagnosed as early on as we were. He was born in Vietnam in 1960, and because doctors there at the time were unequipped to diagnose his condition properly, it went undetected until his aorta root in his heart burst. My dad has had two open heart surgeries, one of which was recent, in 2013. Thankfully, my sister and I will likely not have to worry about aortic dissection happening to us, because we have been taking medications to prevent this since we were young. Despite having the same condition as my father, the outcome for us will likely be very different because of the difference between healthcare establishments and knowledge between what we have available in the United States and in Vietnam a few decades ago. In this way, health care is amazing because it can dramatically change prognoses of diseases and lives.

Because I was constantly surrounded by doctors and nurses in my youth, that is what I understood health care to be, and by extension, I wanted to become a physician. I embarked on that journey idealizing the image of a physician who could do anything and save everybody, and not fully understanding the role and the specific sort of skill set that it entailed. I found myself struggling with that path for several reasons. First, I was not inclined to subjects such as chemistry and physics which I had trouble relating to people. Secondly, I realized that physicians do not have the power to affect the sort of change that I desire to. As I learned more about the many determinants of health, which included structural systems, I became aware of the limitations of physician ability; doctors can only treat the individuals that present themselves in front of them.

During the summer of 2014, I became a part of the Project Vietnam Foundation (now renamed the VNHope Allance),  a non- profit organization in which healthcare professionals, administrators, and students work together to facilitate a medical mission in the rural areas of Vietnam to set up pop-up primary care clinics for the locals. While most of my own experience in this program was in doing hands-on work and one-on-one patient interaction, I was able to recognize the challenges of having organized this. It was difficult as an organization to work within the constraints of the Communist government of Vietnam, which had officers tailing the mission participants and strictly dictated anything from which communities we were allowed to visit to how long we were allowed to work. During the course of the mission, we saw thousands of patients per day in the mountainous northern community of Ba Vì, providing them with primary care, dental, and vision checkups. Many people were afflicted with ailments that are not common here in the States, such as glaucoma and worms. We were able to provide medications and treatment to the best of our ability for as many people as we could, but for people with more serious conditions, there was nothing that we could do besides referring them to specialists in the capital. But how would they get to and from the capital? How would they pay for these procedures? Although I was proud of the impact and assistance we were able to provide to the Vietnamese locals, it was then that I could see for myself how powerless clinicians can be in the face of the larger system. I actively realized that healthcare is provided to people by policy, administration, and organizations moreso than individual providers.

During this time that I was starting to make realizations about myself and the kind of difference I would like to make, this country was also making similar realizations about the healthcare system. The Affordable Care Act had brought about so many changes to the system which led to mixed praise and outcry from all sorts of stakeholders, from insurance companies, religious groups, employers, to patients and families. My anthropological background had taught me that it was important to examine situations from all the different perspectives that could be affected, both intentionally and unintentionally, not just the special interest groups. Watching the debates, filibusters, and Supreme Court lawsuits angered me because I felt as if advocates for certain groups would negate the experiences in others in order to push their causes, and that people would primarily speak from narrow-focused viewpoints. I felt as if I I realized that in order to have a voice or influence in the field that I wanted to work in, I would need further education and credentials.

After a year of working in finance, I decided to pursue a Masters degree in public health policy because I felt that it would give me the expertise in health law, regulations, and compliance. [I want to put more here about what my Masters degree does for me but I don't want to get into the nitty gritty and sound like an advertisement for my program so I'm having trouble framing it.]

Juanita Ruiz is not a real person, but she represents the people who have to live their lives without access to affordable and quality healthcare. Having a law degree combined with my MPH will allow me to be an expert in public health policy so that I can be valuable in policy implementation and health related legal issues. I want to be able to be an advocate for Americans so that good health is not only reserved for the privileged. I want to help change the culture around our healthcare system so that we are no longer the country spending the most money per capita on healthcare with sub-optimal health outcomes. This is how I would like to intervene to decrease the likelihood of outcomes like Juanita Ruiz's from happening to others.

Things I feel are lacking in this: I feel like the end kind of falls apart a little bit, because I'm trying to show what kind of difference I want to make, but I feel like I'm blowing hot air and don't have anything to back it up with. It kind of feels like a bunch of empty claims and maybe turns into the "why law school" essay that we don't want to be writing...


microsystems vs macrosystems

Juanita Ruiz a 47- year-old Hispanic female, has a heart attack and is admitted to the hospital. She is a single mother and domestic worker with no health insurance. Doctors intervene, she survives, and her doctor prescribe her five medications. The hospital social worker helps her begin the process of enrolling in Medicaid. She is unable to afford all of them after paying for her hospital bills, so she only goes home with the cheapest one. Two weeks later, she has a clot, then another heart attack, then dies on the way to the emergency room. How would you intervene to decrease the likelihood of this outcome happening to others?

I massage my temples as I formulate an answer to this homework assignment, because there are so many opportunities that could have prevented this that I hardly know where to start. While I could think of many medical or even community interventions, the issue that most irks me is that there is a problem with the inherent structure of the system. I chuckle because I know I've been given s 500-word constraint to essentially solve the nation's healthcare crisis on my first day of class at my Master's of Public Policy program. I mean, this is where I thought I would be by graduation, but I suppose the early bird gets the worm.

My passion for the health industry began from a young age. I was born with Marfan Syndrome, a connective tissue disorder that affects many different areas of your body: heart, eyes, and bones naming a few. I have had three bone surgeries to help me live a normal life, but I consider myself to be lucky, because the condition has been monitored and controlled since I was diagnosed at a young age. Both my younger sister and I inherited this condition from our father, who unfortunately was not diagnosed as early on as we were. He was born in Vietnam in 1960, and because doctors there at the time were unequipped to diagnose his condition properly, it went undetected until his aorta root in his heart burst. My dad has had two open heart surgeries, one of which was recent, in 2013. Thankfully, my sister and I will likely not have to worry about aortic dissection happening to us, because we have been taking medications to prevent this since we were young. Despite having the same condition as my father, the outcome for us will likely be very different because of the difference between healthcare establishments and knowledge between what we have available in the United States and in Vietnam a few decades ago. In this way, health care is amazing because it can dramatically change prognoses of diseases and lives.

Because I was constantly surrounded by doctors and nurses in my youth, that is what I understood health care to be, and by extension, I wanted to become a physician. I embarked on that journey idealizing the image of a physician who could do anything and save everybody, and not fully understanding the role and the specific sort of skill set that it entailed. I found myself struggling with that path for several reasons. First, I was not inclined to subjects such as chemistry and physics which I had trouble relating to people. Secondly, I realized that physicians do not have the power to affect the sort of change that I desire to. As I learned more about the many determinants of health, which included structural systems, I became aware of the limitations of physician ability; doctors can only treat the individuals that present themselves in front of them.

During the summer of 2014, I became a part of the Project Vietnam Foundation (now renamed the VNHope Allance),  a non- profit organization in which healthcare professionals, administrators, and students work together to facilitate a medical mission in the rural areas of Vietnam to set up pop-up primary care clinics for the locals. While most of my own experience in this program was in doing hands-on work and one-on-one patient interaction, I was able to recognize the challenges of having organized this. It was difficult as an organization to work within the constraints of the Communist government of Vietnam, which had officers tailing the mission participants and strictly dictated anything from which communities we were allowed to visit to how long we were allowed to work. During the course of the mission, we saw thousands of patients per day in the mountainous northern community of Ba Vì, providing them with primary care, dental, and vision checkups. Many people were afflicted with ailments that are not common here in the States, such as glaucoma and worms. We were able to provide medications and treatment to the best of our ability for as many people as we could, but for people with more serious conditions, there was nothing that we could do besides referring them to specialists in the capital. But how would they get to and from the capital? How would they pay for these procedures? Although I was proud of the impact and assistance we were able to provide to the Vietnamese locals, it was then that I could see for myself how powerless clinicians can be in the face of the larger system. I actively realized that healthcare is provided to people by policy, administration, and organizations moreso than individual providers.

During this time that I was starting to make realizations about myself and the kind of difference I would like to make, this country was also making similar realizations about the healthcare system. The Affordable Care Act had brought about so many changes to the system which led to mixed praise and outcry from all sorts of stakeholders, from insurance companies, religious groups, employers, to patients and families. My anthropological background had taught me that it was important to examine situations from all the different perspectives that could be affected, both intentionally and unintentionally, not just the special interest groups. Watching the debates, filibusters, and Supreme Court lawsuits angered me because I felt as if advocates for certain groups would negate the experiences in others in order to push their causes, and that people would primarily speak from narrow-focused viewpoints. I felt as if I I realized that in order to have a voice or influence in the field that I wanted to work in, I would need further education and credentials.

After a year of working in finance, I decided to pursue a Masters degree in public health policy because I felt that it would give me the expertise in health law, regulations, and compliance. [I want to put more here about what my Masters degree does for me but I don't want to get into the nitty gritty and sound like an advertisement for my program so I'm having trouble framing it.]

Juanita Ruiz is not a real person, but she represents the people who have to live their lives without access to affordable and quality healthcare. Having a law degree combined with my MPH will allow me to be an expert in public health policy so that I can be valuable in policy implementation and health related legal issues. I want to be able to be an advocate for Americans so that good health is not only reserved for the privileged. I want to help change the culture around our healthcare system so that we are no longer the country spending the most money per capita on healthcare with sub-optimal health outcomes. This is how I would like to intervene to decrease the likelihood of outcomes like Juanita Ruiz's from happening to others.

Things I feel are lacking in this: I feel like the end kind of falls apart a little bit, because I'm trying to show what kind of difference I want to make, but I feel like I'm blowing hot air and don't have anything to back it up with. It kind of feels like a bunch of empty claims and maybe turns into the "why law school" essay that we don't want to be writing...


microsystems vs macrosystems

Hello, my name is Ash, and I'm currently a student in her last year of secondary school.
To be honest, this blog has been made so that I can practice my writing and delve deeper into my mind in order for me to realize what is important to me - what exactly makes me me?
It's a soul searching blog, and the ultimate goal is for me to write freely about myself and find inspiration and material for admissions essays.
As that is, anything that is written on this blog is my intellectual property. Uni.'s obviously use plagiarism checkers on all submitted work, so stealing any words that I have written will only ruin your future.
One thing I hate most is academic dishonesty.

cal berkeley.
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ucla.
ucsd.
dartmouth.
stanford.
harvard.
duke.
vandy.

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