Rhetorical Analysis
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A Problem That is Causing Pain
Rhetorical Analysis of “The Overlooked Reason Our Health Care System Crushes
Patients”
Madison Kenyon
College of Humanities and Social Sciences, Grand Canyon University
ENG-105
Dr. Zafonte
10/2/2023
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In Chavi Karkowsky's article titled "The Overlooked Reason Our Health Care System
Crushes Patients," published by The New York Times on July 20, 2023, she highlights the
administrative burden within the U.S. healthcare system and its impact on patients. This burden,
often hidden from public view, results in significant barriers and obstacles that patients must
navigate, leading to delays in care, missed appointments, and in some cases, health
consequences. Karkowsky argues that administrative barriers and delays in healthcare access can
lead to severe consequences for patients (Karkowsky,2023). Karkowsky shares a personal
experience as a healthcare provider which shows the healthcare system's ability to mobilize
resources in emergencies and its failure to address minor administrative issues that can have
profound impacts on patients’ lives. Throughout the article, Karkowsky uses several different
rhetorical devices such as pathos, logos, and ethos to share the pain and struggles patients face at
the hands of administrators in healthcare.
The article highlights a critical issue within the healthcare system. Karkowsky describes a
pregnant patient who fell ill due to a urinary tract infection that escalated into a life-threatening
condition. The medical team quickly provided emergency care saving the woman and her baby
from any other complications. However, Karkowsky also points out that this same system failed
the patient by not providing a simple $12 medication that could have prevented the entire ordeal
because there was a mix up with insurance papers.
This problem lands most heavily on those
who cannot afford it. People such as vulnerable people with diseases and long-term illnesses
(Karkowsky, 2023). The disconnect between the care providers aim to offer and the care patients
receive represents what Karkowsky calls the "administrative burden of health care". The article
concludes going back to the patient with the kidney infection, underlining the importance of trust
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in the healthcare system while also outlining solutions like all medical documents should be the
same format so there will be no mix ups or confusion when patients do need medication that
could save their lives (Karkowsky, 2023). While the medical team in the hospital earned the
patient's trust through their life-saving care, she remained skeptical about the broader healthcare
system's ability to provide her with the help and medicine she needs which addresses the main
problem that often administrative problems are the cause of patients not getting the care or
medicine they need.
The author establishes credibility through her professional experience as an obstetrician,
which lends her expertise on healthcare issues. In the article, the author uses various rhetorical
strategies, including ethos, to convey the message that administrative burden within the
healthcare system is causing unnecessary suffering and delays in patient care. Ethos is used
effectively in the article to establish the author's credibility and authority about healthcare. Chavi
Karkowsky is a medical professional and shares her individual experiences from her work in the
healthcare system. By presenting herself as someone with firsthand knowledge of the system's
challenges, she positions herself as a trustworthy source on the topic. Additionally, the article
references other experts and professionals, such as Andrew Friedson, the director of health
economics at the Milken Institute, and Michael Anne Kyle, a research fellow at Harvard Medical
School.
These references to credible sources strengthen the overall ethos of the article, as it
demonstrates that the author's claims are supported by experts in the same field as her. The
article also relies on real-life patient cases to illustrate the impact of administrative burden on
individuals seeking healthcare. By sharing these stories, the author humanizes the issue, making
it relatable to a bigger audience. This use of personal narratives adds an emotional layer to the
argument and reinforces the author's ethos by showing her commitment to patient care.
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Karkowsky effectively uses pathos by sharing a compelling patient story at the beginning
of the article. The story evokes emotions and empathy in the readers, making them more
receptive to her argument about the issues caused by administrative burdens. Firstly, Karkowsky
introduces a pregnant patient in a critical condition. The patient's description of her struggles to
get a simple antibiotic prescription pulls sympathy from the audience, which brings feelings of
frustration and helplessness. The use of words such as "sick," "dangerously low," and "painful
contractions" shows the audience how bad the situation was and the negative things this patient
had to go through. Additionally, Karkowsky shares real patients' experiences to further
emphasize the emotional toll of administrative burden. By recounting instances of patients
missing appointments or going through a lengthy process to prove their eligibility for healthcare
coverage, the author makes this issue relatable towards the audience. Karkowsky's description of
the patient's reluctance to trust the healthcare system beyond the immediate medical team tugs at
the readers' heartstrings. This skepticism reflects the emotional toll of navigating a system that
has once already failed patients. The author portrays the patient's gratitude towards the medical
team as a contrast to her mistrust of the broader system, which touches with sympathy as not all
healthcare workers are the problem, it is the way the system is run.
Karkowsky provides evidence and cites research to support her claims. For instance, she
references a study by Michael Anne Kyle to substantiate the impact of administrative tasks on
patient care and “found that about a quarter of insured adults reported their care was delayed or
missed entirely because of administrative tasks” (Kyle, 2023, para. 12). The author also tells us
information and a specific case study of a pregnant patient with a kidney infection. The details of
the patient's symptoms, medical response, and the delay caused by administrative issues are
presented to illustrate the bigger problem. Chavi Karkowsky uses logos effectively throughout
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the article by providing information, statistics, economic analysis, practical solutions, and a call
for accountability. These logical appeals strengthen the argument that administrative burden in
the healthcare system is a significant problem that needs immediate attention.
In conclusion, Chavi Karkowsky's article sheds light on the often-overlooked
issue of administrative burden within the healthcare system and its impact on patients' well-
being. Karkowsky effectively argues that administrative burden poses a significant threat to
patient health and can result in dire consequences, particularly for people who rely on
medication. The article suggests potential solutions, such as simplifying healthcare paperwork
and introducing care coordinators to navigate the healthcare system with you, although it
acknowledges the challenges in implementing these ideas due to the current billing structure of
the healthcare system (Karkowsky,2023). Karkowsky emphasizes the need for an evaluation of
the true costs of administrative burden, including the time spent by patients and providers, as a
crucial step toward addressing this issue. Overall, Karkowsky's persuasive article calls for a
reevaluation of the healthcare system's priorities and underlines the importance of prioritizing
patient well-being over the administrative issues. It challenges healthcare policymakers and
stakeholders to recognize and address the human suffering caused by administrative burden,
advocating for a more patient-centered and efficient healthcare system.
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References
Karkowsky, C. (2023, July 20). The Overlooked Reason Our Health Care System Crushes
Patients. The New York Times. https://www.nytimes.com/2023/07/20/opinion/healthcare-
bureaucracy-medical-delays.html
6
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