Author Archives: Keenan Cromshaw

Cover Letter for American Red Cross-Keenan Cromshaw

Red Cross Internship Cover Letter

March 5th, 2016

National Red Cross

American Red Cross National Headquarters

2025 E Street, NW

Washington, DC 20006


Dear Selection Committee,

My interest in the medical field and my previous involvement with the Red Cross serving as a blood donor has incited me to seek a non-paid internship position with your organization. Some of the internships I am interested in (from the list on your website) are Disaster Services Mass Care, Disaster Services Operations, Service to the Armed Forces Service Delivery Unit, Service to the Armed Forces Policy and Program Development Unity, and Service to the Armed Forces Youth in Military Medical Facilities.

My skills and experience will significantly help the Red Cross to achieve their mission. I am currently looking to be admitted to the UNC Chapel Hill School of Nursing to ultimately become a Registered Nurse. I have also earned a 4-year Army ROTC scholarship and achieved rank of Eagle Scout along with my CPR certification. I believe that the courses associated with the admittance to the school of Nursing are very relevant to any medical related internship spots. My involvement in the ROTC program and my experience as a Boy Scout have given me valuable skills to help critically think, analyze, and very importantly lead. Moreover, I have had valuable customer service experience in various restaurants that will help me in any kind of position that involves interpersonal communication and will help to improve relations with anyone involved with the Red Cross. Overall, I believe my experiences and skills will ultimately help me to solve problems for your organization. Some other skills and experience that might be relevant to your internship include:

  • Familiarization with first aid
  • Great organizational skills
  • Enjoyment in working in a team

I believe that any Red Cross internship opportunities would also be very advantageous for my future aspirations. As stated before, I am working to become a registered Nurse and also possibly become a Nurse Practitioner or even a Nurse Anesthetist. Holding any of these kinds of internships would provide many benefits, but the primary ones would be:

  • Gaining valuable medical related experience
  • Gaining experience working in a team and solving problems
  • Acquiring knowledge of the way the Red Cross runs its operations.

Overall, I believe the internship opportunities the Red Cross offers would both be advantageous to achieving my personal future goals and also for the advancement of the Red Cross because of my experience and skills. The Red Cross is an extraordinary organization that I would love to be a part of. Your consideration is greatly appreciated.


Keenan Cromshaw

American Red Cross Internship Candidate

450 Ehringhaus Drive, Room #541

University of North Carolina, Chapel Hill

Chapel Hill, NC 27514

Keenan Cromshaw profile for internship

I have found a potential volunteer and/or shadowing opportunity at the New Hanover Regional Medical center in my hometown of Wilmington, NC. I still have yet to get a lot more info on these potential opportunities and there could be a chance of getting an internship in the future as I talk more with the hospital administrators. Since I don’t have a lot of info about these volunteer, shadowing, and intern opportunities I will write about what I know and what I’d like in this internship.

In this potential internship, I would be able to work beginning about May 12th until about the second week of August. I could work about 30 hours per week during this time. I would prefer to work in the emergency department performing duties that will help to gain experience and knowledge about emergency department professions. I would also greatly benefit from shadowing doctors, PA’s, and nurses in the hospital in order to gain a better understanding of daily life and the benefits/drawbacks of their professions.

Since the hospital is very close to my home, I will not need to worry about room and board. Money, of course, is preferable, but certainly not a requirement as I just want experience and new knowledge about the medical professions in this internship.

Why is U.S. healthcare so expensive as compared to Europe?

 Helathcare cost photo








Photo credit: Stockphoto. April 6, 2015


Keenan Cromshaw

 Americans have the highest healthcare costs as a percentage of GDP and therefore pay the most per capita for healthcare as compared to any European nations. Despite this, we have lower marks in overall health indicators, such as life expectancy. Essentially, our healthcare system is sick. But why is this? The answer, like many, is very complex.

One of the biggest factors as to why the U.S. spends more on healthcare is the fact that the U.S. has a much higher rate of obesity as compared to every other European nation. In short, we’re fat! The United States in 2009 (and the rates are higher now) had an obesity rate of nearly 35%–nearly 5% higher than the next OECD nation (Mexico), about 10% higher than the next European nation (the UK), and almost 20% higher than the OECD (Organization for Economic Cooperation and Development) average. A 2012 study by the Obesity Prevention Source revealed that costs related to obesity in 2005 totaled nearly $190 billion, a number that is likely significantly higher now.

Data also shows that the United States has a significantly higher rate of diabetes as compared to the majority of European nations. Obesity and diabetes usually lead to higher medical costs due to conditions and treatments related to these diseases, such as hypertension and even cancer. As many can imagine, costs from these conditions and treatments will certainly inflate the costs of healthcare. The simple fact is that if you have a greater amount of unhealthier people, the higher the total healthcare costs.

One of the best (and probably the one most people can agree on) solutions is to simply get more Americans healthier! Americans need to both exercise and eat better to achieve this. When more people are healthy (and less people are obese), they go to the doctor less, need less treatments, and ultimately spend less on healthcare.

Another huge factor as to why U.S. healthcare is so expensive is due to the fact that many taxpayers and insurance payers pay for a phenomenon called “defensive medicine.” Defensive medicine is essentially medical practitioners ordering unnecessary diagnostic tests, procedures, and treatment plans that may include surgery. The tests to determine a patient’s condition can be extremely expensive along with procedures and treatment plans. These added costs are paid for mainly by insurance companies including Medicare and Medicaid, driving up the costs of healthcare.

The reasons why medical practitioners do this can be varied. Sheer uncertainty of a patient’s condition may prompt practitioners to order diagnostic tests and treatment plans, but a cause that many people believe is very prevalent is the notion that medical practitioners are afraid of having malpractice lawsuits against them. The total costs of defensive medicine practices in the United States may range up to $650 billion annually according to a recent study, although numbers may range lower. Nevertheless, this is still a significant reason as to why our healthcare is expensive and can and should be cured.

Reforming laws regarding malpractice may significantly help to decrease the amount of defensive medicine practiced by showing healthcare providers that they can provide ethical and effective healthcare without fearing an unjust lawsuit.

The next factor as to why the U.S. spends more on healthcare is the fact that the U.S. spends more than all of Europe combined on buying and researching prescription drugs ($365 billion compared to $216 billion). U.S. pharmaceutical research costs alone account for nearly 17.9% of total pharmaceutical revenue-which totals about $67 billion and accounts for nearly 40% of pharmaceutical market growth, the most of any country in the world.

Interestingly, the U.S. has a much higher usage of generic drugs (that are much cheaper as compared to band name drugs), yet spend a higher per capita amount for prescription drugs in general. The reason for this discrepancy is likely because Americans typically buy the MOST POPULAR drugs from brand name prescription companies (which are more expensive). These pharmaceutical companies also hold on to the patents of these drugs until they become non cost effective, decreasing competition. Additionally, the majority of prescription drugs in development are anti-cancer drugs, which are typically more expensive than other medications. The U.S. also prescribes more medicines per capita on average on prescription medicines compared to Europeans, thus driving up medical costs.

Decreasing the amount of time a brand name company has to hold on to the patent of a drug would help to increase competition and lower prices by allowing generic companies to sell the drug at a cheaper price. Moreover, insurance companies increasingly cover non cost-effective drugs/treatments (drugs/treatments that have a high cost of development but are used little and/or have marginal positive health effects) that premium holders are told are necessary, and thus raise insurance premiums. Regulating which drugs can be covered by analyzing cost vs effect would help to decrease total insurance costs and encourage research of cost effective pharmaceuticals.

The U.S. has a higher per capita usage and ownership of advanced diagnostic technologies such as MRI’s and CT scans. This means not only do we own more of the technology per capita, but these machines are used at a rate much higher than those of European nations. The price of using these machines is also typically higher in the United States. All three of these factors compound to drive up insurance costs and put a burden on premium payers and taxpayers at large.

But of course that’s not it. People in the United States also receive a greater amount of surgeries than their European counterparts per capita, which helps to further drive up medical costs. The higher use and ownership of diagnostic medical technology along with the higher rate of surgical procedures may also tie into defensive medicine practices, as the high use of many of these technologies and procedures helps lead to the conclusion that many of these things are NOT entirely necessary to diagnose and treat a patient. Keeping medical practitioners accountable by both decreasing the fear of malpractice lawsuits and also increasing patient-practitioner communication will help to ensure wasteful practices and procedures are reduced.

The last large factor as to why U.S. healthcare is so expensive is because of the immense complexity and inefficiency of healthcare administration. Healthcare administration is essentially everything but the actual diagnosis and treatment of disease, which could include insurance to patient communication, forms medical providers use to document aspects of their patients’ diseases, communication between insurance companies and healthcare providers, and much, more. Administration costs in 2012 reached an estimated $361 billion– and the numbers are rising every year. Some believe that the costs of this administration could be cut nearly in half through a variety of methods (which I won’t go into detail about) that essentially include standardization of records and increased and/or more efficient communication between healthcare providers, insurance companies, and patients.

In conclusion, healthcare in the United has many unique problems that must be individually addressed with precise care. Increasing the overall health of Americans, decreasing fear of malpractice claims, increasing patient-practitioner communication, abating administrative inefficiencies, and restructuring/amending pharmaceutical regulations will ensure healthcare costs go down.

Why is U.S. healthcare so expensive as compared to Europe?-Query Letter by Keenan Cromshaw

February 1st, 2016

Keenan Cromshaw
450 Ehringhaus Drive
Chapel Hill, NC 27514

Medical Communications Group
Ms. Sarah Boyd
24950 Country Club Drive, Suite 200
North Olmsted, Ohio 44070

 Dear Ms. Boyd,

I am pleased to submit to you a paper about a question many of us ask: How and why is U.S. healthcare so expensive as compared to European healthcare. My name is Keenan Cromshaw and I am a freshman at the University of North Carolina at Chapel hill currently working towards a biology degree with aspirations to go to medical school and become an emergency room physician. I believe that this paper would greatly help to enrich Medical Economics and their viewers as it is both a topic that pertains to your journal and is a very relevant and important topic that is being discussed today. We frequently hear about the high costs of insurance premiums, medicines you buy, the debt after surgery, etc. and reducing these costs would help out Americans everywhere mentally, physically, and financially.

My paper will discuss the many aspects of this complex problem and how we can stop it. The main points highlighted will be first how the U.S. has a much higher rate of obesity and conditions related to obesity (like diabetes) as compared to every other European nation leading to much greater medical costs. Next, I will discuss how United States taxpayers and health insurance premium purchasers pay an extremely large amount of money for the phenomenon known as “defensive medicine”, which is essentially medical practitioners who order unnecessary tests, procedures, and treatments plans due to a variety of reasons. After this, the point will be made that the U.S. spends more per capita on research, development, and purchasing of prescription drugs than their European counterparts due to a variety of reasons such as how more medicine is prescribed per capita than Europeans. Lastly, I will discuss how the U.S. has both a higher rate of ownership and usage of advanced diagnostic technologies such as MRI’s, CT scans, mammography tests, etc., which drives up medical costs. Furthermore, statistics will be shown that indicate the U.S. has a much higher number of expensive surgeries than Europe- often deemed as unnecessary. The remainder of the article will discuss how we can stop these problems in order to help everyone in the United States reduce healthcare costs and increased medical efficacy and efficiency.

Once again I believe this paper will greatly help to augment and bring attention to an important and growing issue. Thank you for your consideration!

Keenan Cromshaw

Why is U.S. healthcare so expensive as compared to Europe?-Keenan Cromshaw

Keenan Cromshaw

Why is U.S. healthcare so expensive as compared to Europe?

  1. “ObamaCare Insurance Premiums.” Obamacare Facts. Web. 25 Jan. 2016. <>.

In this article about Obama Care, we see that AVERAGE healthcare premiums across the U.S. are rising steadily since the year Obama Care has been passed. We see that lower income families and small businesses may see a decrease in premium costs, but higher income families and businesses have a large increase in healthcare costs. Average premiums also vary greatly from state to state.

2.  “Economic Costs.” Obesity Prevention Source. 2012. Web. 25 Jan. 2016. <>.

This article explains that obesity costs in the U.S. as a percentage of healthcare spending are higher than every other developed nation, which amounts to over $190B (2005 data) per year in healthcare costs. This is a primary cause in the higher cost of healthcare due to diseases related to obesity, such as diabetes, cancer, and hypertension. For example, people who suffer from these diseases must receive certain expensive treatments and medications to reduce their specific condition, such as insulin pumps for diabetics.

3. The Global Obesity Picture » The Downey Obesity Report.” The Downey Obesity Report RSS. Web. 25 Jan. 2016. Published June 24th, 2012. Morgan Downey. <>.

This article presents data that shows the U.S. has a higher obesity rate than any other developed nation, supporting the claim that obesity rates are extremely high in the U.S. as compared to Europe and thus raise healthcare costs.

4. “Diabetes Prevalence – Country Rankings.” Diabetes Prevalence – Country Rankings. N.p., 2010. Web. 27 Jan. 2016.

This information sheet shows the prevalence of diabetes among every nation in the world. The data indicates that the U.S. has a significantly higher rate of diabetes than any other European nation, driving up medical costs due to costs associated with diabetes, such as doctor appointments, insulin pumps, etc. This trend in diabetes is likely due to the high rate of obesity in the U.S.

5. Tursman, Judy Packer. “The Defensive Medicine Balancing Act.” Medical Economics. 09 Jan. 2015. Web. 25 Jan. 2016.

This article explains that “defensive medicine” in the U.S. may cost anywhere between $54 and $650 billion. This is mainly caused by an increased number of unnecessary tests and procedures motivated by a variety of factors. Some of the main factors for this increase in defensive medicine are the increased amount of doctors who fear malpractice lawsuits, the sheer uncertainty of a condition, and the lack of patient-physician communication.

6. Herrick, Devon M. “Unnecessary Regulations That Increase Prescription Drug Costs.” Unnecessary Regulations That Increase Prescription Drug Costs. N.p., 07 Mar. 2013. Web. 25 Jan. 2016.

This article explains that increased government regulation has decreased competition and consumers’ buying power, raising costs of pharmaceuticals dramatically through a variety of methods. Though the government has good intentions, many of its policies have decreased the competition between companies and thus has raised the cost of pharmaceuticals.

7. “U.S. Pharmaceutical Industry – Statista Dossier | Statista.” Statista. July 2015. Web. 27 Jan. 2016. <>. link to the PDF of graphs are found in the website (linked by the url)

In this data sheet by Statista, we see multiple graphs of statistics about the pharmaceutical industry in the U.S. and in the rest of the world. The data shows that the U.S. owns approximately 40% of the pharmaceutical market value, sells almost twice as much pharmaceuticals ($365 billion) as all of Europe COMBINED (216 billion), and spends approximately $67 billion (about %17.9 of total pharmaceutical revenue) annually in pharmaceutical research alone. The U.S pharmaceutical market also contributes the most to pharmaceutical market growth (40%), showing that the U.S. has more robust research, development, and opportunity for pharmaceutical companies. Furthermore, the top 20 most used drugs in the U.S. are owned primarily by brand name pharmaceutical companies, which typically have much higher prescription drug costs for the same drug. Lastly, the U.S. pharmaceutical industry has a very large number of cancer related medicines (which are typically more expensive) in development, which would drive up costs.Based on population data (approximately 323 million people), the U.S. spends $1130/person in pharmaceutical costs, while Europeans spend $290/capita.

8. “Analyzing Brand-name and Generic Drug Costs in the U.S. and Eight Other Countries – Knowledge@Wharton.” KnowledgeWharton Analyzing Brandname and Generic Drug Costs in the US and Eight Other Countries Comments. 19 Nov. 2003. Web. 28 Jan. 2016. <>.

This study explains discrepancies in average costs of U.S. generic prescription drugs vs. average costs of generic European prescription drugs. The study shows that U.S. generic drug prices are MUCH lower than brand name prescription drug prices and that the U.S. prescribes a higher percentage of these drugs than other European nations. Furthermore, generic drug prices are even lower than European nations’ prices. The cost of high prescription costs in the U.S. can partially be attributed to the fact that the majority of the most popular drugs in the U.S. are sold by brand name pharmaceutical companies and not generic drug companies.

9. Squires, David A. “Explaining High Health Care Spending in the United States: An International Comparison of Supply, Utilization, Prices, and Quality.” Explaining High Health Care Spending in the United States: An International Comparison of Supply, Utilization, Prices, and Quality (2012): n. pag. May 2012. Web. 27 Jan. 2016.

This article explains that higher costs in medical care can partially be attributed to a higher number of advanced medical diagnostic technologies (MRIs, CT scanners, PET scanners, and mammograms) per capita than any other European nation and also a greater UTILIZATION of these technologies in the U.S. than any other European nation. The U.S. does have better cancer survival rates (due to higher cancer treatment costs) but overall life expectancy is lower than many of these European nations.

10. Lafortune, Gaetan, Gaelle Balestat, and Anne Durande. “Comparing Activities and Performance of the Hospital Sector in Europe: How Many Surgical Procedures Performed as Inpatient and Day Cases?” Comparing Activities and Performance of the Hospital Sector in Europe: How Many Surgical Procedures Performed as Inpatient and Day Cases? (n.d.): 18. Dec. 2012. Web. 28 Jan. 2016.

This factsheet shows data about certain surgeries performed in many European nations. The factsheet also verifies and helps to adjust for discrepancies in the way surgeries are measured. Compared to U.S. statistics, the average number surgery procedures per 100,000 people is much higher, thus driving up costs.

11. “Inpatient Surgery.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 2010. Web. 28 Jan. 2016. <>.

This CDC factsheet shows that Americans, on average, have more surgical procedures done per capita than European nations especially for spinal fusion and knee replacement. This drives up healthcare costs significantly.