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A (Very) Simple Way to Improve Your Writing

• Mark Rennella

It’s called the “one-idea rule” — and any level of writer can use it.

The “one idea” rule is a simple concept that can help you sharpen your writing, persuade others by presenting your argument in a clear, concise, and engaging way. What exactly does the rule say?

• Every component of a successful piece of writing should express only one idea.
• In persuasive writing, your “one idea” is often the argument or belief you are presenting to the reader. Once you identify what that argument is, the “one-idea rule” can help you develop, revise, and connect the various components of your writing.
• For instance, let’s say you’re writing an essay. There are three components you will be working with throughout your piece: the title, the paragraphs, and the sentences.
• Each of these parts should be dedicated to just one idea. The ideas are not identical, of course, but they’re all related. If done correctly, the smaller ideas (in sentences) all build (in paragraphs) to support the main point (suggested in the title).

Where your work meets your life. See more from Ascend here .

Most advice about writing looks like a long laundry list of “do’s and don’ts.” These lists can be helpful from time to time, but they’re hard to remember … and, therefore, hard to depend on when you’re having trouble putting your thoughts to paper. During my time in academia, teaching composition at the undergraduate and graduate levels, I saw many people struggle with this.

• MR Mark Rennella is Associate Editor at HBP and has published two books, Entrepreneurs, Managers, and Leaders and The Boston Cosmopolitans .  

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12 Ways to Quickly Improve Your Academic Essay Writing Skills

#scribendiinc

Written by  Scribendi

Anyone can learn to produce an academic essay if they begin with a few basic essay-writing rules. 

An academic essay must be based upon a solid but debatable thesis, supported by relevant and credible evidence, and closed with a succinct and thorough conclusion.

By adhering to the best way to write an essay, you can create valuable, persuasive papers even when you're under a time crunch!

What Makes a Good Essay?

As previously noted, the foundation of any good academic essay is its thesis statement. 

Do not confuse your thesis with your opening sentence. There are many good ways to start an essay , but few essays immediately present their main ideas.

After you draft your thesis, you can begin to develop your essay around it. This development will include the main supporting points of your essay, which will scaffold its main body. 

Essays also typically include a relevant and compelling introduction and conclusion.

Learn How to Write a Great Thesis Statement .

Understanding How to Write a Good Essay

When writing an academic essay, you must take a number of qualities and characteristics into careful consideration. Focus, development, unity, coherence, and correctness all play critical roles when it comes to distinguishing an exceptional essay from one that is less than perfect.

The following essay-writing tips can help writers organize, format, and support their essays in ways that fit their intended purpose and optimize their overall persuasiveness. Here are 12 essay tips for developing and writing your next academic paper.

1. Know What You Are Going to Write About Before You Start Writing

While untrained writers might just sit down and start typing, educated and experienced writers know that there are many steps to writing an essay.

In short, you should know what you want to say before you type a single word. The easiest way to narrow down a thesis and create a proper argument is to make a basic outline before you begin composing your essay.

Your outline should consist of rough notes that sketch out your introduction (including your thesis), the body of your essay (which should include separate paragraphs that present your main supporting points with plenty of evidence and examples), and your conclusion (which ties everything together and connects the argument back to your thesis).

2. Acquire a Solid Understanding of Basic Grammar, Punctuation, and Style

Before getting into more refined essay-writing techniques, you must have a solid grasp of grammar, punctuation, and style. Without these writing fundamentals, it will be difficult to communicate your ideas effectively and ensure that they are taken seriously.

Grammar basics include subject and verb agreement, correct article and pronoun use, and well-formed sentence structures. Make sure you know the proper uses for the most common forms of punctuation. Be mindful of your comma usage and know when a period is needed.

Finally, voice is tremendously important in academic essay writing. Employ language that is as concise as possible. Avoid transition words that don't add anything to the sentence and unnecessary wordiness that detracts from your argument.

Furthermore, use the active voice instead of the passive whenever possible (e.g., "this study found" instead of "it was found by this study"). This will make your essay's tone clear and direct.

3. Use the Right Vocabulary and Know What the Words You Are Using Actually Mean

How you use language is important, especially in academic essay writing. When writing an academic essay, remember that you are persuading others that you are an expert who argues intelligently about your topic.

Using big words just to sound smart often results in the opposite effect—it is easy to detect when someone is overcompensating in their writing.

If you aren't sure of the exact meaning of a word, you risk using it incorrectly. There's no shame in checking, and it might save you from an embarrassing word misuse later!

Using obscure language can also detract from the clarity of your argument—you should consider this before pulling out a thesaurus to change a perfectly appropriate word to something completely different.

4. Understand the Argument and Critically Analyze the Evidence

While writing a good essay, your main argument should always be at the front of your mind. While it's tempting to go off on a tangent about an interesting side note, doing so makes your writing less concise.

Always question the evidence you include in your essay; ask yourself, "Does this directly support my thesis?" If the answer is "no," then that evidence should probably be excluded. 

When you are evaluating evidence, be critical and thorough. You want to use the strongest research to back up your thesis. It is not enough to simply present evidence in support of an argument. A good writer must also explain why the evidence is relevant and supportive.

Everything you include should clearly connect to your topic and argument.   

5. Know How to Write a Conclusion That Supports Your Research

One of the most overlooked steps to writing an essay is the conclusion. Your conclusion ties all your research together and proves your thesis. It should not be a restatement of your introduction or a copy-and-paste of your thesis.

A strong conclusion briefly outlines the key evidence discussed in the body of an essay and directly ties it to the thesis to show how the evidence proves or disproves the main argument of your research.

Countless great essays have been written only to be derailed by vague, weakly worded conclusions. Don't let your next essay become one of those.     

6. Build a Solid Thesis to Support Your Arguments

A thesis is the main pillar of an essay. By selecting a specific thesis, you'll be able to develop arguments to support your central opinion. Consider writing about a unique experience or your own particular view of a topic .

Your thesis should be clear and logical, but it should also be debatable. Otherwise, it might be difficult to support it with compelling arguments.

7. Develop an Interesting Opening Paragraph to Hook In Readers from the Get-Go

No matter how you begin your essay, you must strive to capture the reader's interest immediately. If your opening paragraph doesn't catch the eye and engage the brain, any attempt at persuasion may end before the essay even starts. 

The beginning of your essay is crucial for setting the stage for your thesis.

8. Always Remember to Edit and Proofread Your Essay

Any decent writer will tell you that writing is really rewriting. A good academic essay will inevitably go through multiple drafts as it slowly takes shape. When you arrive at a final draft, you must make sure that it is as close to perfect as possible.

This means subjecting your essay to close and comprehensive editing and proofreading processes. In other words, you must read your paper as many times as necessary to eliminate all grammar/punctuation mistakes and typos.

It is helpful to have a third party review your work. Consider consulting a peer or professional editing service. Keep in mind that professional editors are able to help you identify underdeveloped arguments and unnecessarily wordy language, and provide other feedback.

Get Critical Feedback on Your Writing

Hire an expert academic editor , or get a free sample, 9. when developing your essay's main body, build strong and relevant arguments.

Every sentence in the main body of your paper should explain and support your thesis. When deciding how much evidence to include in an academic essay, a good guideline is to include at least three main supporting arguments.

Those main supporting arguments, in turn, require support in the form of relevant facts, figures, examples, analogies, and observations. 

You will need to engage in appropriate research to accomplish this. To organize your research efforts, you may want to develop a list of good research questions . 

10. Choose the Format of Your Essay before Writing It

The final shape that your essay takes depends a great deal on what kind of format you use. Popular college essay format types include the Modern Language Association of America ( MLA ), American Psychological Association ( APA ), and Chicago Manual of Style ( Chicago style).

These formats govern everything from capitalization rules to source citation. Often, professors dictate a specific format for your essay. If they do not, you should choose the format that best suits your field.

11. Create Clear Transitions between Your Ideas

Although unnecessary transition words are the enemy of clarity and concision, they can be invaluable tools when it comes to separating and connecting the different sections of your essay. 

Not only do they help you express your ideas but they also bring a cohesive structure to your sentences and a pleasant flow to your writing. Just be sure that you are using the right transition words for the right purpose and to the proper effect.

12. Always Include an Organized Reference Page at the End of Your Essay

As a key component of MLA, APA, and Chicago Style formatting, the reference or Works Cited page is an essential part of any academic essay.

Regardless of the format used, the reference page must be well organized and easy to read so that your audience can see exactly where your outside information came from. 

To produce a properly formatted reference page, you may have to familiarize yourself with specialized phrases and abbreviations, such as " et al ." 

How to Write a Good Hook for an Essay

The key to a good hook is to introduce an unexplored or absorbing line of inquiry in your introduction that addresses the main point of your thesis. 

By carefully choosing your language and slowly revealing details, you can build reader anticipation for what follows. 

Much like an actual worm-baited fishing hook, a successful hook will lure and capture readers, allowing the writer to "reel them in."

How to Get Better at Writing Essays

You can get better at writing essays the same way that you improve at anything else: practice, practice, practice! However, there are a few ways that you can improve your writing quickly so you can turn in a quality academic essay on time.

In addition to following the 12 essay tips and guidelines above, you can familiarize yourself with a few common practices and structures for essay development. 

Great writing techniques for essays include brainstorming and tree diagrams, especially when coming up with a topic for your thesis statement. Becoming familiar with different structures for organizing your essay (order of importance, chronological, etc.) is also extremely helpful.

How to Write a Good Introduction for an Essay

To learn how to write a good essay, you must also learn how to write a good introduction. 

Most effective essay introductions begin with relatively broad and general subject matter and then gradually narrow in focus and scope until they arrive at something extremely specific: the thesis. This is why writers tend to place their thesis statements at the very end of their introductory paragraph(s).

Because they are generally broad and often relate only tangentially to an essay's main point, there is virtually no limit on what the beginning of a good introduction can look like. However, writers still tend to rely on somewhat cliché opening sentences, such as quotations and rhetorical questions.

How to Write a Good Conclusion for an Essay

Briefly put, a good conclusion does two things. It wraps up any loose ends and drives home the main point of your essay. 

To learn how to write a good conclusion, you will want to ensure that no unanswered questions remain in the reader's mind. A good conclusion will restate the thesis and reinforce the essay's main supporting points.

Take Your Essay from Good to Great

About the author.

Scribendi's in-house editors work with writers from all over the globe to perfect their writing. They know that no piece of writing is complete without a professional edit, and they love to see a good piece of writing turn into a great one after the editing process. Scribendi's in-house editors are unrivaled in both experience and education, having collectively edited millions of words and obtained nearly 20 degrees collectively. They love consuming caffeinated beverages, reading books of various genres, and relaxing in quiet, dimly lit spaces.

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"The Complete Beginner's Guide to Academic Writing"

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The Complete Beginner's Guide to Academic Writing

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• How to Improve Your Essay Writing Quickly: A Step-by-Step Guide

About the Author Stephanie Allen read Classics and English at St Hugh’s College, Oxford, and is currently researching a PhD in Early Modern Academic Drama at the University of Fribourg.

Whatever your brand of brilliance – whether you’re a physics genius, a sporting hero or (like me) a blinky, bookish type – there comes a point in most students’ academic careers when being good at life means being good at essays.

You should also read…

• Focus and Precision: How to Write Essays That Answer the Question
• How to Conquer Your Nightmare Subjects

As the subjects you study get more advanced and complex, you’re increasingly asked to think, evaluate, and have opinions where you once might have simply made calculations or learned definitions. In general, the further you progress through your education, the more rote learning will be replaced by the kind of analysis usually best demonstrated by essays. If by some miraculous feat you manage to avoid writing anything substantial at high school, it’s something you’ll almost certainly have to face at university – yes, even if you’re studying a science subject (although the essays won’t usually be quite as long). One way or another, essay writing comes to us all.

The likelihood is that at some point in the not-too-distant future (unless you are both incredibly reluctant and startlingly resourceful) you will have to write an essay, either in exam conditions or in your own time, that will count towards a final grade in some way. If this is a scary prospect for you, there’s good news and bad news. The bad thing about essay writing is that it’s not something – like French verbs, or the ability to run long distances – that miraculously gets better on its own if you just keep having a go. To improve at essay writing, students often need a paradigm shift: to figure out exactly what isn’t working, and why, and to learn and apply a new way of doing things. The good news, on the other hand, is that the individual skills required to write a strong essay are things you can learn, practise and improve in. This article is all about pinpointing what those skills might be, and giving you some suggestions as to how you might develop them. Not all these tips will work for all of you, but being good at essay writing, like being good at any other school-related discipline, is all about trying different things, and devising your own way of doing things.

Getting organised

Before you even start planning an essay, I’d recommend you sit down and have a quick think about how you want to do it. First, what resources will you need? The internet, or library books? This might affect where and how you decide to work: I have wasted a huge amount of time trying to find versions of articles on the internet that I knew were in books at the library, or procrastinating because I wanted to work at home rather than leaving the house. I would recommend taking yourself to a library ninety-nine times out of a hundred. Secondly, if you’re working from books or downloadable articles, can you afford to work somewhere without the internet? The absence of Facebook and Instagram will guarantee your concentration will be about a hundred times better, which will show in the quality of your work. Next, make a little timeline for your essay. Make a list of everything you want to read and try to get hold of all your material before you start. Think about how long you’re going to spend reading and researching, planning, and writing – leaving a day or two before the deadline to make any significant changes, or just in case things don’t go to plan. I’d recommend allotting 3 hours to read a 20-page article, and about a day to write 2000 words. This might sound like a silly amount of planning, but the point of it is this: hundreds of all-nighters have taught me that essay-writing becomes incredibly stressful and painful when you’re up against the clock, and a reader can tell immediately if something is rushed or dashed off at 2am on the day of the deadline. What’s more, you simply won’t have your best creative ideas under pressure. If you’ve got time, have a look at this – comically eighties and slightly cringey – video about creativity . A lot of what the speaker says about thinking and playfulness is, in my opinion, directly applicable to essay-writing.

Gathering information

Some teachers set reading lists for essays, or make suggestions about where students should look for information; others ask you to find sources yourself. Even if your teacher does prescribe reading, it’s always worth seeing whether you can find something extra that will add breadth, depth or a fresh perspective to your argument. However, it’s important to think carefully about whether a source is reliable and valuable.

What sort of sources should I use?

The most appropriate sources will vary from subject to subject. Here are some common ones: – Academic articles: These are essays by scholars at universities, and usually published in journals or as books. They are always useful, and can be found by looking in the library (ask your teacher for recommendations!), having a poke around Google Scholar, or, if your school has a subscription, on the website JSTOR.org. Search for key words and phrases and see what comes up. – Newspaper articles: might be useful evidence for an essay in History, but may not be detailed or scholarly enough for Biology. If you use a newspaper article or opinion piece, think about the factors that might bias it and include your thinking in your essay! – Wikipedia: a very useful starting-point, and an increasingly reliable resource. However, avoid referencing it: a teacher or examiner might not like it and may take against your essay. Instead, look at the reference section at the bottom of the article and see where the writer has gathered their information from. – Online blogs: in general, stay away from these, as you don’t know who’s written them and how valuable their opinion is, or how reliable their facts. The exceptions are blogs by well-known experts.

How should I take notes?

It might feel like the world’s greatest faff, but taking good notes from your sources will save you a huge amount of time when you come to plan and write your essay: – Type out notes as you read, rather than simply underlining or highlighting – thus you’ll have a summary of the most important chunks of essays ready to use when you plan, rather than having to trawl through whole documents again looking for quotations. – For this reason, if you think you might want to quote something, copy it out in the exact wording of the writer. – Type notes in a different colour for each new source you read. In order to engage intelligently with what you’ve read, you’ve got to remember who said what, what they meant by it, who they were fighting against and whether you agreed with them or not. Colours are a really helpful visual aid to doing this. – At the end of each new essay or article, write a few lines summarising the author’s main points, and whether or not you agree with them. N.B. Your critical engagement with the scholars and authors whose work you’ve read will count for a huge chunk of marks. This does not mean listing a load of names and rehearsing their arguments; nor does it mean disagreeing with everyone for the sake of it. Instead, think about whether or not what they’re arguing holds true in your experience – or compare them to each other.

Planning is the single most important step in writing a good essay, and, frustratingly, also the step that’s most often rushed or neglected by students. If your essays often get criticised for having poor structure or unclear lines of argument, chances are you need to practise your planning. I use the following step-by-step process to turn my notes into a good plan; you can try it too, and see if it works for you. 1) Re-read your notes a couple of times, and underline anything you think is particularly important, interesting, or relevant to the area of the topic you want to discuss. As far as possible, try and organise your thoughts into sections, and see if you can link ideas together. Tip: It might be that you’ve got two or three different ideas for a topic, and you’re not sure which to go with: in this case, you can use a couple of different spider diagrams to see which works best. Where do the ideas link together most easily, or fall together into neat sections? Which question would you be able to answer most fully? 2) Sit back and look at your diagram(s), perhaps alongside your notes, and work out the main ‘point’ or conclusion you want to make in your essay. The best essays are characterised by a clear line of argument throughout – I don’t really buy the idea that essays should present both sides of a question. I always decide what I’m trying to say ; the point I want to conclude with, before I start. Now, the job you’ve got in writing the essay is to set this conclusion up. 3) Work backwards, using the links you’ve made on your spider diagram: what do you need to argue or show to make your point? Jot these ‘points’ down in a couple of words each. This forms the beginnings of a skeleton for your essay. 4) Start to fill out your skeleton with information from your notes, and any extra ideas you might have. If you’re writing a literature essay, it’s CRUCIAL that you include some close analysis of passages to support your argument. Jot down the sentences that link these in to the greater structure. 5) Fill out your skeleton more and more, until it’s essentially a rough draft in bullet points. Every twist or nuance of your argument should be in there; every introductory and concluding sentence for every paragraph, making it explicit how this paragraph answers your question.

6) At this point, it’s very helpful if you can get someone (a friend or a parent will do) to read over your plan and see if it makes sense. Does everything follow? Is it all relevant? Your plan should be so complete that the person who reads it will immediately be able to spot any flaws. Move things around, add or delete to incorporate their criticism: it’s much easier to change something in bullet-point format than when it’s all written out properly. Don’t expect this process to be quick or easy. For a 1500-word essay, I usually write a plan of about three sides, and spend at least three hours making sure that before I put pen to paper, every kink in my argument is ironed out. The pay-off of doing it this way is that the writing process is short and easy – a case of joining up the dots, polishing bullet-points into sentences – much better than coming up with ideas and organising thoughts at the same time as finding the words to express them. Get better and better: If you struggle with structure or clarity, practise your planning! Give yourself a limited amount of time (say, two hours), pick three previous essay questions from an exam or coursework paper, and plan your answers as thoroughly as possible. Get your teacher to look over your plans when you’re done.

The ‘actual writing’-bit can be the most daunting and stressful part of the essay process, and is where most students get stuck. Here are some tried-and-tested solutions to common writing problems:

I can’t get started

It’s quite common to want your first sentence to be arresting, paradigm-shifting, to propel your reader headlong into your essay. However, this desire can be paralysing: one of the most stressful feelings in the world is that of staring at a blank page, thinking about the number of words you’ll need to fill it all up. The key to getting started is to just write something . Don’t worry about how good it is – get it down, and move on, and come back and change it when you’re well into your flow.

Writers’ block

Go back to your plan and make sure you know what you’re arguing. If you still can’t get the words out, try and write down what you want to say as simply as possible. Then move on to an easier section of the essay. Alternatively, you can try going for a walk, making a cup of tea or having a break.

It all feels a bit wrong…

Sometimes, in the process of writing, you’ll realise that you entirely disagree with two-days-ago you, and you don’t really believe in the argument you’re trying to make. If it is the case, go back to the drawing board. Don’t plough on regardless – a lack of conviction will show in your essay. Return to your plan, and see if you can use similar material but change the emphasis, and perhaps the odd bit of evidence, to produce a different argument.

Everyone has their own individual writing style: your might be as purple and flowery, or scientific and direct as you like (within reason). However you write, to get top marks, it’s crucial that you learn to be precise .

Style-wise, there are two poles of wrongness: vagueness, and over-complication. Of course, every subject has its particular vocabulary, and learning this will be crucial, and sharpen your analysis; but remember that little words are your friends too! Make sure that you know the exact meaning of each word you use. Crucially, make sure you know exactly what each word you’re using means, and think carefully about whether you’re applying it in the right context – remember that whoever is reading your essay will know better than you the meanings of zeugma, stagflation or symbiosis. Finally, don’t hide behind subject-specific vocabulary: make sure that you’re using terms to contribute to and develop your essay, and nothing of the flow is lost.

The boring stuff

– Get good at conventions like footnoting, and writing bibliographies. Examiners really do check these! – When you’ve finished, leave the essay for a day or two, and then re-read it. If possible, get someone to proofread for you. This way, you’ll avoid making lots of silly mistakes that threaten the clarity and flow of your essay.

Image credits: banner ; runner ; old library ; new library ; pens ; map ; parent ; tapping pencil ; egg . 

• Tips for Reading an Assignment Prompt
• Asking Analytical Questions
• Introductions
• What Do Introductions Across the Disciplines Have in Common?
• Anatomy of a Body Paragraph
• Transitions
• Tips for Organizing Your Essay
• Counterargument
• Conclusions
• Strategies for Essay Writing: Downloadable PDFs
• Brief Guides to Writing in the Disciplines

Ultimate Guide to Writing Your College Essay

Tips for writing an effective college essay.

College admissions essays are an important part of your college application and gives you the chance to show colleges and universities your character and experiences. This guide will give you tips to write an effective college essay.

Want free help with your college essay?

UPchieve connects you with knowledgeable and friendly college advisors—online, 24/7, and completely free. Get 1:1 help brainstorming topics, outlining your essay, revising a draft, or editing grammar.

Writing a strong college admissions essay

Learn about the elements of a solid admissions essay.

Avoiding common admissions essay mistakes

Learn some of the most common mistakes made on college essays

Brainstorming tips for your college essay

Stuck on what to write your college essay about? Here are some exercises to help you get started.

How formal should the tone of your college essay be?

Learn how formal your college essay should be and get tips on how to bring out your natural voice.

Taking your college essay to the next level

Hear an admissions expert discuss the appropriate level of depth necessary in your college essay.

Student Stories

Student Story: Admissions essay about a formative experience

Get the perspective of a current college student on how he approached the admissions essay.

Student Story: Admissions essay about personal identity

Get the perspective of a current college student on how she approached the admissions essay.

Student Story: Admissions essay about community impact

Student story: admissions essay about a past mistake, how to write a college application essay, tips for writing an effective application essay, sample college essay 1 with feedback, sample college essay 2 with feedback.

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Sat / act prep online guides and tips, getting college essay help: important do's and don’ts.

College Essays

If you grow up to be a professional writer, everything you write will first go through an editor before being published. This is because the process of writing is really a process of re-writing —of rethinking and reexamining your work, usually with the help of someone else. So what does this mean for your student writing? And in particular, what does it mean for very important, but nonprofessional writing like your college essay? Should you ask your parents to look at your essay? Pay for an essay service?

If you are wondering what kind of help you can, and should, get with your personal statement, you've come to the right place! In this article, I'll talk about what kind of writing help is useful, ethical, and even expected for your college admission essay . I'll also point out who would make a good editor, what the differences between editing and proofreading are, what to expect from a good editor, and how to spot and stay away from a bad one.

Table of Contents

What Kind of Help for Your Essay Can You Get?

What's Good Editing?

What should an editor do for you, what kind of editing should you avoid, proofreading, what's good proofreading, what kind of proofreading should you avoid.

What Do Colleges Think Of You Getting Help With Your Essay?

Who Can/Should Help You?

Advice for editors.

Should You Pay Money For Essay Editing?

The Bottom Line

What's next, what kind of help with your essay can you get.

Rather than talking in general terms about "help," let's first clarify the two different ways that someone else can improve your writing . There is editing, which is the more intensive kind of assistance that you can use throughout the whole process. And then there's proofreading, which is the last step of really polishing your final product.

Let me go into some more detail about editing and proofreading, and then explain how good editors and proofreaders can help you."

Editing is helping the author (in this case, you) go from a rough draft to a finished work . Editing is the process of asking questions about what you're saying, how you're saying it, and how you're organizing your ideas. But not all editing is good editing . In fact, it's very easy for an editor to cross the line from supportive to overbearing and over-involved.

Ability to clarify assignments. A good editor is usually a good writer, and certainly has to be a good reader. For example, in this case, a good editor should make sure you understand the actual essay prompt you're supposed to be answering.

Open-endedness. Good editing is all about asking questions about your ideas and work, but without providing answers. It's about letting you stick to your story and message, and doesn't alter your point of view.

Think of an editor as a great travel guide. It can show you the many different places your trip could take you. It should explain any parts of the trip that could derail your trip or confuse the traveler. But it never dictates your path, never forces you to go somewhere you don't want to go, and never ignores your interests so that the trip no longer seems like it's your own. So what should good editors do?

Help Brainstorm Topics

Sometimes it's easier to bounce thoughts off of someone else. This doesn't mean that your editor gets to come up with ideas, but they can certainly respond to the various topic options you've come up with. This way, you're less likely to write about the most boring of your ideas, or to write about something that isn't actually important to you.

If you're wondering how to come up with options for your editor to consider, check out our guide to brainstorming topics for your college essay .

Help Revise Your Drafts

Here, your editor can't upset the delicate balance of not intervening too much or too little. It's tricky, but a great way to think about it is to remember: editing is about asking questions, not giving answers .

Revision questions should point out:

• Places where more detail or more description would help the reader connect with your essay
• Places where structure and logic don't flow, losing the reader's attention
• Places where there aren't transitions between paragraphs, confusing the reader
• Moments where your narrative or the arguments you're making are unclear

But pointing to potential problems is not the same as actually rewriting—editors let authors fix the problems themselves.

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Bad editing is usually very heavy-handed editing. Instead of helping you find your best voice and ideas, a bad editor changes your writing into their own vision.

You may be dealing with a bad editor if they:

• Add material (examples, descriptions) that doesn't come from you
• Use a thesaurus to make your college essay sound "more mature"
• Add meaning or insight to the essay that doesn't come from you
• Tell you what to say and how to say it
• Write sentences, phrases, and paragraphs for you
• Change your voice in the essay so it no longer sounds like it was written by a teenager

Colleges can tell the difference between a 17-year-old's writing and a 50-year-old's writing. Not only that, they have access to your SAT or ACT Writing section, so they can compare your essay to something else you wrote. Writing that's a little more polished is great and expected. But a totally different voice and style will raise questions.

Where's the Line Between Helpful Editing and Unethical Over-Editing?

Sometimes it's hard to tell whether your college essay editor is doing the right thing. Here are some guidelines for staying on the ethical side of the line.

• An editor should say that the opening paragraph is kind of boring, and explain what exactly is making it drag. But it's overstepping for an editor to tell you exactly how to change it.
• An editor should point out where your prose is unclear or vague. But it's completely inappropriate for the editor to rewrite that section of your essay.
• An editor should let you know that a section is light on detail or description. But giving you similes and metaphors to beef up that description is a no-go.

Proofreading (also called copy-editing) is checking for errors in the last draft of a written work. It happens at the end of the process and is meant as the final polishing touch. Proofreading is meticulous and detail-oriented, focusing on small corrections. It sands off all the surface rough spots that could alienate the reader.

Because proofreading is usually concerned with making fixes on the word or sentence level, this is the only process where someone else can actually add to or take away things from your essay . This is because what they are adding or taking away tends to be one or two misplaced letters.

Laser focus. Proofreading is all about the tiny details, so the ability to really concentrate on finding small slip-ups is a must.

Excellent grammar and spelling skills. Proofreaders need to dot every "i" and cross every "t." Good proofreaders should correct spelling, punctuation, capitalization, and grammar. They should put foreign words in italics and surround quotations with quotation marks. They should check that you used the correct college's name, and that you adhered to any formatting requirements (name and date at the top of the page, uniform font and size, uniform spacing).

Limited interference. A proofreader needs to make sure that you followed any word limits. But if cuts need to be made to shorten the essay, that's your job and not the proofreader's.

A bad proofreader either tries to turn into an editor, or just lacks the skills and knowledge necessary to do the job.

Some signs that you're working with a bad proofreader are:

• If they suggest making major changes to the final draft of your essay. Proofreading happens when editing is already finished.
• If they aren't particularly good at spelling, or don't know grammar, or aren't detail-oriented enough to find someone else's small mistakes.
• If they start swapping out your words for fancier-sounding synonyms, or changing the voice and sound of your essay in other ways. A proofreader is there to check for errors, not to take the 17-year-old out of your writing.

What Do Colleges Think of Your Getting Help With Your Essay?

Admissions officers agree: light editing and proofreading are good—even required ! But they also want to make sure you're the one doing the work on your essay. They want essays with stories, voice, and themes that come from you. They want to see work that reflects your actual writing ability, and that focuses on what you find important.

On the Importance of Editing

Get feedback. Have a fresh pair of eyes give you some feedback. Don't allow someone else to rewrite your essay, but do take advantage of others' edits and opinions when they seem helpful. ( Bates College )

Read your essay aloud to someone. Reading the essay out loud offers a chance to hear how your essay sounds outside your head. This exercise reveals flaws in the essay's flow, highlights grammatical errors and helps you ensure that you are communicating the exact message you intended. ( Dickinson College )

On the Value of Proofreading

Share your essays with at least one or two people who know you well—such as a parent, teacher, counselor, or friend—and ask for feedback. Remember that you ultimately have control over your essays, and your essays should retain your own voice, but others may be able to catch mistakes that you missed and help suggest areas to cut if you are over the word limit. ( Yale University )

Proofread and then ask someone else to proofread for you. Although we want substance, we also want to be able to see that you can write a paper for our professors and avoid careless mistakes that would drive them crazy. ( Oberlin College )

On Watching Out for Too Much Outside Influence

Limit the number of people who review your essay. Too much input usually means your voice is lost in the writing style. ( Carleton College )

Ask for input (but not too much). Your parents, friends, guidance counselors, coaches, and teachers are great people to bounce ideas off of for your essay. They know how unique and spectacular you are, and they can help you decide how to articulate it. Keep in mind, however, that a 45-year-old lawyer writes quite differently from an 18-year-old student, so if your dad ends up writing the bulk of your essay, we're probably going to notice. ( Vanderbilt University )

Now let's talk about some potential people to approach for your college essay editing and proofreading needs. It's best to start close to home and slowly expand outward. Not only are your family and friends more invested in your success than strangers, but they also have a better handle on your interests and personality. This knowledge is key for judging whether your essay is expressing your true self.

Parents or Close Relatives

Your family may be full of potentially excellent editors! Parents are deeply committed to your well-being, and family members know you and your life well enough to offer details or incidents that can be included in your essay. On the other hand, the rewriting process necessarily involves criticism, which is sometimes hard to hear from someone very close to you.

A parent or close family member is a great choice for an editor if you can answer "yes" to the following questions. Is your parent or close relative a good writer or reader? Do you have a relationship where editing your essay won't create conflict? Are you able to constructively listen to criticism and suggestion from the parent?

One suggestion for defusing face-to-face discussions is to try working on the essay over email. Send your parent a draft, have them write you back some comments, and then you can pick which of their suggestions you want to use and which to discard.

Teachers or Tutors

A humanities teacher that you have a good relationship with is a great choice. I am purposefully saying humanities, and not just English, because teachers of Philosophy, History, Anthropology, and any other classes where you do a lot of writing, are all used to reviewing student work.

Moreover, any teacher or tutor that has been working with you for some time, knows you very well and can vet the essay to make sure it "sounds like you."

If your teacher or tutor has some experience with what college essays are supposed to be like, ask them to be your editor. If not, then ask whether they have time to proofread your final draft.

Guidance or College Counselor at Your School

The best thing about asking your counselor to edit your work is that this is their job. This means that they have a very good sense of what colleges are looking for in an application essay.

At the same time, school counselors tend to have relationships with admissions officers in many colleges, which again gives them insight into what works and which college is focused on what aspect of the application.

Unfortunately, in many schools the guidance counselor tends to be way overextended. If your ratio is 300 students to 1 college counselor, you're unlikely to get that person's undivided attention and focus. It is still useful to ask them for general advice about your potential topics, but don't expect them to be able to stay with your essay from first draft to final version.

Friends, Siblings, or Classmates

Although they most likely don't have much experience with what colleges are hoping to see, your peers are excellent sources for checking that your essay is you .

Friends and siblings are perfect for the read-aloud edit. Read your essay to them so they can listen for words and phrases that are stilted, pompous, or phrases that just don't sound like you.

You can even trade essays and give helpful advice on each other's work.

If your editor hasn't worked with college admissions essays very much, no worries! Any astute and attentive reader can still greatly help with your process. But, as in all things, beginners do better with some preparation.

First, your editor should read our advice about how to write a college essay introduction , how to spot and fix a bad college essay , and get a sense of what other students have written by going through some admissions essays that worked .

Then, as they read your essay, they can work through the following series of questions that will help them to guide you.

Introduction Questions

• Is the first sentence a killer opening line? Why or why not?
• Does the introduction hook the reader? Does it have a colorful, detailed, and interesting narrative? Or does it propose a compelling or surprising idea?
• Can you feel the author's voice in the introduction, or is the tone dry, dull, or overly formal? Show the places where the voice comes through.

Essay Body Questions

• Does the essay have a through-line? Is it built around a central argument, thought, idea, or focus? Can you put this idea into your own words?
• How is the essay organized? By logical progression? Chronologically? Do you feel order when you read it, or are there moments where you are confused or lose the thread of the essay?
• Does the essay have both narratives about the author's life and explanations and insight into what these stories reveal about the author's character, personality, goals, or dreams? If not, which is missing?
• Does the essay flow? Are there smooth transitions/clever links between paragraphs? Between the narrative and moments of insight?

Reader Response Questions

• Does the writer's personality come through? Do we know what the speaker cares about? Do we get a sense of "who he or she is"?
• Where did you feel most connected to the essay? Which parts of the essay gave you a "you are there" sensation by invoking your senses? What moments could you picture in your head well?
• Where are the details and examples vague and not specific enough?
• Did you get an "a-ha!" feeling anywhere in the essay? Is there a moment of insight that connected all the dots for you? Is there a good reveal or "twist" anywhere in the essay?
• What are the strengths of this essay? What needs the most improvement?

Should You Pay Money for Essay Editing?

One alternative to asking someone you know to help you with your college essay is the paid editor route. There are two different ways to pay for essay help: a private essay coach or a less personal editing service , like the many proliferating on the internet.

My advice is to think of these options as a last resort rather than your go-to first choice. I'll first go through the reasons why. Then, if you do decide to go with a paid editor, I'll help you decide between a coach and a service.

When to Consider a Paid Editor

In general, I think hiring someone to work on your essay makes a lot of sense if none of the people I discussed above are a possibility for you.

If you can't ask your parents. For example, if your parents aren't good writers, or if English isn't their first language. Or if you think getting your parents to help is going create unnecessary extra conflict in your relationship with them (applying to college is stressful as it is!)

If you can't ask your teacher or tutor. Maybe you don't have a trusted teacher or tutor that has time to look over your essay with focus. Or, for instance, your favorite humanities teacher has very limited experience with college essays and so won't know what admissions officers want to see.

If you can't ask your guidance counselor. This could be because your guidance counselor is way overwhelmed with other students.

If you can't share your essay with those who know you. It might be that your essay is on a very personal topic that you're unwilling to share with parents, teachers, or peers. Just make sure it doesn't fall into one of the bad-idea topics in our article on bad college essays .

If the cost isn't a consideration. Many of these services are quite expensive, and private coaches even more so. If you have finite resources, I'd say that hiring an SAT or ACT tutor (whether it's PrepScholar or someone else) is better way to spend your money . This is because there's no guarantee that a slightly better essay will sufficiently elevate the rest of your application, but a significantly higher SAT score will definitely raise your applicant profile much more.

Should You Hire an Essay Coach?

On the plus side, essay coaches have read dozens or even hundreds of college essays, so they have experience with the format. Also, because you'll be working closely with a specific person, it's more personal than sending your essay to a service, which will know even less about you.

But, on the minus side, you'll still be bouncing ideas off of someone who doesn't know that much about you . In general, if you can adequately get the help from someone you know, there is no advantage to paying someone to help you.

If you do decide to hire a coach, ask your school counselor, or older students that have used the service for recommendations. If you can't afford the coach's fees, ask whether they can work on a sliding scale —many do. And finally, beware those who guarantee admission to your school of choice—essay coaches don't have any special magic that can back up those promises.

Should You Send Your Essay to a Service?

On the plus side, essay editing services provide a similar product to essay coaches, and they cost significantly less . If you have some assurance that you'll be working with a good editor, the lack of face-to-face interaction won't prevent great results.

On the minus side, however, it can be difficult to gauge the quality of the service before working with them . If they are churning through many application essays without getting to know the students they are helping, you could end up with an over-edited essay that sounds just like everyone else's. In the worst case scenario, an unscrupulous service could send you back a plagiarized essay.

Getting recommendations from friends or a school counselor for reputable services is key to avoiding heavy-handed editing that writes essays for you or does too much to change your essay. Including a badly-edited essay like this in your application could cause problems if there are inconsistencies. For example, in interviews it might be clear you didn't write the essay, or the skill of the essay might not be reflected in your schoolwork and test scores.

Should You Buy an Essay Written by Someone Else?

Let me elaborate. There are super sketchy places on the internet where you can simply buy a pre-written essay. Don't do this!

For one thing, you'll be lying on an official, signed document. All college applications make you sign a statement saying something like this:

I certify that all information submitted in the admission process—including the application, the personal essay, any supplements, and any other supporting materials—is my own work, factually true, and honestly presented... I understand that I may be subject to a range of possible disciplinary actions, including admission revocation, expulsion, or revocation of course credit, grades, and degree, should the information I have certified be false. (From the Common Application )

For another thing, if your academic record doesn't match the essay's quality, the admissions officer will start thinking your whole application is riddled with lies.

Admission officers have full access to your writing portion of the SAT or ACT so that they can compare work that was done in proctored conditions with that done at home. They can tell if these were written by different people. Not only that, but there are now a number of search engines that faculty and admission officers can use to see if an essay contains strings of words that have appeared in other essays—you have no guarantee that the essay you bought wasn't also bought by 50 other students.

• You should get college essay help with both editing and proofreading
• A good editor will ask questions about your idea, logic, and structure, and will point out places where clarity is needed
• A good editor will absolutely not answer these questions, give you their own ideas, or write the essay or parts of the essay for you
• A good proofreader will find typos and check your formatting
• All of them agree that getting light editing and proofreading is necessary
• Parents, teachers, guidance or college counselor, and peers or siblings
• If you can't ask any of those, you can pay for college essay help, but watch out for services or coaches who over-edit you work
• Don't buy a pre-written essay! Colleges can tell, and it'll make your whole application sound false.

Ready to start working on your essay? Check out our explanation of the point of the personal essay and the role it plays on your applications and then explore our step-by-step guide to writing a great college essay .

Using the Common Application for your college applications? We have an excellent guide to the Common App essay prompts and useful advice on how to pick the Common App prompt that's right for you . Wondering how other people tackled these prompts? Then work through our roundup of over 130 real college essay examples published by colleges .

Stressed about whether to take the SAT again before submitting your application? Let us help you decide how many times to take this test . If you choose to go for it, we have the ultimate guide to studying for the SAT to give you the ins and outs of the best ways to study.

Want to improve your SAT score by 160 points or your ACT score by 4 points? We've written a guide for each test about the top 5 strategies you must be using to have a shot at improving your score. Download it for free now:

Anna scored in the 99th percentile on her SATs in high school, and went on to major in English at Princeton and to get her doctorate in English Literature at Columbia. She is passionate about improving student access to higher education.

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Atlas Shrugged Essay Contest

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What is Atlas Shrugged?

The astounding story of a man who said that he would stop the motor of the world—and did.

Tremendous in scope, breathtaking in its suspense, Atlas Shrugged is unlike any other book you have ever read. It is a mystery story, not about the murder of a man’s body, but about the murder—and rebirth—of man’s spirit.

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Every three months there is a new seasonal entry round, with its own unique essay prompt. You may compete in any or all of these entry rounds.

The top three essays from each season will be awarded a cash prize. The first-place essay from each season will advance to compete for the annual grand prize.

The first-place essay from each season will be eligible to contend for the annual first-place title, with the opportunity to secure a grand prize of $25,000.

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Each entry round features a unique topic designed to provoke a deeper understanding of the book’s central themes and characters.

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Atlas Shrugged  is a mystery novel like no other. You enter a world where scientists, entrepreneurs, artists, and inventors are inexplicably vanishing—where the world is crumbling.

And what you discover, by the end, is an uplifting vision of life, an inspiring cast of heroes, and a challenging new way to think about life’s most important issues.

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Understanding Childhood Trauma Can Help Us Be More Resilient

I n 2022, the World Health Organization estimated that 1 billion children were maltreated each year around the globe. Maltreatment such as neglect and abuse are types of adverse childhood experiences, or ACEs . But they often say little about how children respond, which can either be traumatic or resilient. Now, revolutionary new findings in the sciences help us understand how different dimensions of adversity can leave different signatures of trauma and how we can use this knowledge to help children recover and build resilience against future harms.

Consider Ethan and Kevin (their names are pseudonyms to protect their privacy), two children that I worked with as an educator and researcher of trauma in schools. Ethan was abandoned by his mother at birth and placed in an orphanage in Eastern Europe, his home for the next six years. He was deprived of the fundamental needs of safety, nutrition, and human contact. He had books, but there was no one to read to him. He had caretakers, but they rarely comforted him when he was upset.

Kevin, on the other hand, witnessed his father physically and emotionally abusing his mother for the first ten years of his life. Around his sixth birthday, Kevin directly experienced his father's abuse. For entertainment, and to teach him that life is tough, Dad put Kevin and his older sister Joani into the outdoor dog cage, threw food in, and forced them to compete for their nightly dinner. If they refused, he beat them until they entered the dinner arena.

Ethan and Kevin were both traumatized by their maltreatment, but that doesn't capture what was happening inside of them. Ethan had no motivation, was numb to rewards, struggled with school and couldn't maintain social relationships. Kevin was an emotional maelstrom, frightened, hypervigilant, running away from unfamiliar men and hurting himself when he heard noises. Ethan and Kevin presented different traumatic responses or “signatures”—unique identifiers of the mental distortions created by their adverse experiences. Identifying these traumatic signatures enables caretakers, teachers, doctors, and counselors to sculpt a path to resilience that is specific to the child's harms and needs and gives them the best hope for recovery, whether in childhood or later in life.

Read More: How Traumatized Children See the World, According to Their Drawings

The idea of traumatic signatures is only a few years old , but the scientific evidence leading to it is not. We have known for decades that different environmental experiences shape development, including how and when our emotions, thoughts, and actions mature. When the environment is harsh and unpredictable, threatening survival, the timing of development tends to speed up, leading to individuals who mature quickly—recognizing and responding appropriately to danger as youngsters. In contrast, when the environment is impoverished, with individuals deprived of essential experiences and resources, development tends to slow down, resulting in delays in the attainment of independence, dedicated social roles, and sexual behavior.

Ethan and Kevin, like millions of other children, experienced two of the core types of ACEs — deprivation and abuse, respectively — during different time periods of development. These differences in experience shaped their traumatic signatures.

Deprivation is typified by a delay in the development of the brain’s executive functions —attention, short-term working memory, self-regulation, and planning. The executive functions form the bedrock to all learning and decision-making, but they are also essential in supporting more specialized cognitive functions such as language, social thinking, math, music, and morality. Children with weak executive functions fare poorly in school, and are socially and physically unhealthy. Such was Ethan’s traumatic response.

Abuse is characterized by warp speed development of a nervous system that detects threats, accompanied by hypervigilance, emotional turbulence, and out of control behavior. The root cause is a hyperactive amygdala, a brain region that plays an essential role in emotional processing, and its connection to a frontal lobe region that controls our feelings, thoughts, and actions. This constellation of changes to the nervous system leaves the child in a heightened state of fear, either fleeing or fighting to cope with an unsafe world . Such was Kevin's traumatic response.

The signatures penned by these types of adversity are further modified by their timing. In studies of orphans living in austere, institutionalized settings — such as the orphanage that Ethan grew up in—those deprived of essential experiences for more than the first few years of life showed deficits in executive functioning, social relationships, and attachment. In contrast, orphans who were placed in foster care by their second birthday, largely recovered from their deprivation in the years that followed. Children who are abused earlier in life , typically before puberty—such as Kevin—show greater emotional dysregulation, weaker control over their thoughts and actions, and more rapid biological aging.

Read More: How Childhood Trauma Can Cause Premature Aging

Different types of adversity, including different combinations, pen different signatures. But ultimately, they also define how we help children recover and sculpt their resilience. Each child's genetic architecture positions them somewhere on a spectrum of responses to adversity that runs from vulnerable to resilient . Those who land on the resilient end are handed greater immunity to adversity because of stronger executive functions that tamp down emotions and maintain focused attention. Those who land on the vulnerable end are handed greater sensitivity to adversity, dominated by emotional turbulence and inflamed autoimmune systems that heighten illness . Environmental experiences can displace individuals onto different sections of this spectrum, either enhancing their resilience or magnifying their vulnerability.

At age six, Ethan's tenure of deprivation ended and a rich life of loving care started with Julie, his adoring adoptive mother. At age 10, Kevin's father was incarcerated and his parents divorced, thereby ending his tenure of exposure to abuse and starting a more promising life with his mother Kate who desperately tried to provide for him despite her own struggles with mental health. Ethan and Kevin were both on Individualized Education Plans (IEPs) that documented their disabilities and guided the work carried out in their schools. Both of their schools were trauma-informed, meaning that they adhered to the 4Rs : r ealizing that traumatic experiences are common, r ecognizing that traumatic experiences are associated with specific symptoms or signatures, r esponding to a child's trauma by integrating knowledge of what happened with what can be done to help, and r esisting re-traumatizing both students and staff. Both schools were also aware of Ethan's and Kevin's life experiences and recognized that they would require different approaches for aiding recovery and building resilience.

Ethan, like other children who have been deprived of essential experiences in the early years of their lives, required an approach that reassured him of receiving unwavering, predictable care while providing strategies to enhance his ability to learn and develop healthy relationships. His care included access to a visual schedule that showed the timing of activities, including when meals and snacks were provided. Predictable access to meals and snacks, both at home and in school, rapidly helped reduce his obsession and hoarding of food. The unwavering support provided by Julie as well as the school staff, eventually melted away Ethan's distrust of others, enabling healthy relationships to grow. The visual schedule helped reduce the load on his short- term working memory, while helping him prepare and plan for transitions between activities. Stubbornly resistant to change, however, was Ethan’s capacity to associate or link actions with consequences. For Ethan, as for other children who have been severely deprived of experiences early in life, associative learning was heavily compromised, awaiting the addition of new tools to the trauma-informed toolkit.

Kevin’s signature of abuse was initially treated by a psychiatrist with Tenex—a medication for aggression, impulsivity, and hyperactivity—along with cognitive behavioral therapy to help him find alternative ways of thinking about and coping with his trauma. His teachers intervened further, providing him with frequent breaks to manage his frustration and burn off some energy. These approaches reduced Kevin’s outbursts and violent attacks on peers and staff, but he was still highly impulsive and fidgety. Kevin’s team decided to start him on neurofeedback , a method that enabled him to consciously modify the pattern of brain activation, shifting toward greater calm, focus, and control over his emotions. Eventually, Kevin developed good friends, healthy relationships with teachers, and an after-school job where he was learning to be a car mechanic. He also learned to trust other men, including me, one of his teachers, who deeply cared about him and cheered on his successes.

Ethan and Kevin walked off their landscapes of harm and onto paths of hope, equipped with skills to manage future adversity. Both lucked out with relatively resilient genetic architectures that were joined by nurturing environments, ones filled with people who cared for them. Many other children, perhaps the majority of the 1 billion who are maltreated each year, are less fortunate, more vulnerable by nature and nurture. While it is highly unlikely that we will ever flatten the landscape of harm, we can do far more to nurture recovery and build resilience if we recognize how traumatic signatures unfold—and how to create action plans to work through them.

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Mental health care is hard to find, especially for people with Medicare or Medicaid

Rhitu Chatterjee

With rates of suicide and opioid deaths rising in the past decade and children's mental health declared a national emergency , the United States faces an unprecedented mental health crisis. But access to mental health care for a significant portion of Americans — including some of the most vulnerable populations — is extremely limited, according to a new government report released Wednesday.

The report, from the Department of Health and Human Services' Office of Inspector General, finds that Medicare and Medicaid have a dire shortage of mental health care providers.

The report looked at 20 counties with people on Medicaid, traditional Medicare and Medicare Advantage plans, which together serve more than 130 million enrollees — more than 40% of the U.S. population, says Meridith Seife , the deputy regional inspector general and the lead author of the report.

Medicaid serves people on low incomes, and Medicare is mainly for people 65 years or older and those who are younger with chronic disabilities.

The report found fewer than five active mental health care providers for every 1,000 enrollees. On average, Medicare Advantage has 4.7 providers per 1,000 enrollees, whereas traditional Medicare has 2.9 providers and Medicaid has 3.1 providers for the same number of enrollees. Some counties fare even worse, with not even a single provider for every 1,000 enrollees.

"When you have so few providers available to see this many enrollees, patients start running into significant problems finding care," says Seife.

The findings are especially troubling given the level of need for mental health care in this population, she says.

"On Medicare, you have 1 in 4 Medicare enrollees who are living with a mental illness," she says. "Yet less than half of those people are receiving treatment."

Among people on Medicaid, 1 in 3 have a mental illness, and 1 in 5 have a substance use disorder. "So the need is tremendous."

The results are "scary" but "not very surprising," says Deborah Steinberg , senior health policy attorney at the nonprofit Legal Action Center. "We know that people in Medicare and Medicaid are often underserved populations, and this is especially true for mental health and substance use disorder care."

Among those individuals able to find and connect with a provider, many see their provider several times a year, according to the report. And many have to drive a long way for their appointments.

"We have roughly 1 in 4 patients that had to travel more than an hour to their appointments, and 1 in 10 had to travel more than an hour and a half each way," notes Seife. Some patients traveled two hours each way for mental health care, she says.

Mental illnesses and substance use disorders are chronic conditions that people need ongoing care for, says Steinberg. "And when they have to travel an hour, more than an hour, for an appointment throughout the year, that becomes unreasonable. It becomes untenable."

"We know that behavioral health workforce shortages are widespread," says Heather Saunders , a senior research manager on the Medicaid team at KFF, the health policy research organization. "This is across all payers, all populations, with about half of the U.S. population living in a workforce shortage."

But as the report found, that's not the whole story for Medicare and Medicaid. Only about a third of mental health care providers in the counties studied see Medicare and Medicaid patients. That means a majority of the workforce doesn't participate in these programs.

This has been well documented in Medicaid, notes Saunders. "Only a fraction" of providers in provider directories see Medicaid patients, she says. "And when they do see Medicaid patients, they often only see a few."

Lower reimbursement rates and a high administrative burden prevent more providers from participating in Medicaid and Medicare, the report notes.

"In the Medicare program, they set a physician fee rate," explains Steinberg. "Then for certain providers, which includes clinical social workers, mental health counselors and marriage and family therapists, they get reimbursed at 75% of that rate."

Medicaid reimbursements for psychiatric services are even lower when compared with Medicare , says Ellen Weber , senior vice president for health initiatives at the Legal Action Center.

"They're baking in those discriminatory standards when they are setting those rates," says Steinberg.

The new report recommends that the Centers for Medicare & Medicaid Services (CMS) take steps to increase payments to providers and lower administrative requirements. In a statement, CMS said it has responded to those recommendations within the report.

According to research by Saunders and her colleagues at KFF, many states have already started to take action on these fronts to improve participation in Medicaid.

Several have upped their payments to mental health providers. "But the scale of those increases ranged widely across states," says Saunders, "with some states limiting the increase to one provider type or one type of service, but other states having rate increases that were more across the board."

Some states have also tried to simplify and streamline paperwork, she adds. "Making it less complex, making it easier to understand," says Saunders.

But it's too soon to know whether those efforts have made a significant impact on improving access to providers.

CMS has also taken steps to address provider shortages, says Steinberg.

"CMS has tried to increase some of the reimbursement rates without actually fixing that structural problem," says Steinberg. "Trying to add a little bit here and there, but it's not enough, especially when they're only adding a percent to the total rate. It's a really small increase."

The agency has also started covering treatments and providers it didn't use to cover before.

"In 2020, Medicare started covering opioid treatment programs, which is where a lot of folks can go to get medications for their substance use disorder," says Steinberg.

And starting this year, Medicare also covers "mental health counselors, which includes addiction counselors, as well as marriage and family therapists," she adds.

While noteworthy and important, a lot more needs to be done, says Steinberg. "For example, in the substance use disorder space, a lot of addiction counselors do not have a master's degree. And that's one of their requirements to be a counselor in the Medicare program right now."

Removing those stringent requirements and adding other kinds of providers, like peer support specialists, is key to improving access. And the cost of not accessing care is high, she adds.

"Over the past two decades, [in] the older adult population, the number of overdose deaths has increased fourfold — quadrupled," says Steinberg. "So this is affecting people. It is causing deaths. It is causing people to go to the hospital. It increases [health care] costs."

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The Case for Marrying an Older Man

A woman’s life is all work and little rest. an age gap relationship can help..

In the summer, in the south of France, my husband and I like to play, rather badly, the lottery. We take long, scorching walks to the village — gratuitous beauty, gratuitous heat — kicking up dust and languid debates over how we’d spend such an influx. I purchase scratch-offs, jackpot tickets, scraping the former with euro coins in restaurants too fine for that. I never cash them in, nor do I check the winning numbers. For I already won something like the lotto, with its gifts and its curses, when he married me.

He is ten years older than I am. I chose him on purpose, not by chance. As far as life decisions go, on balance, I recommend it.

When I was 20 and a junior at Harvard College, a series of great ironies began to mock me. I could study all I wanted, prove myself as exceptional as I liked, and still my fiercest advantage remained so universal it deflated my other plans. My youth. The newness of my face and body. Compellingly effortless; cruelly fleeting. I shared it with the average, idle young woman shrugging down the street. The thought, when it descended on me, jolted my perspective, the way a falling leaf can make you look up: I could diligently craft an ideal existence, over years and years of sleepless nights and industry. Or I could just marry it early.

So naturally I began to lug a heavy suitcase of books each Saturday to the Harvard Business School to work on my Nabokov paper. In one cavernous, well-appointed room sat approximately 50 of the planet’s most suitable bachelors. I had high breasts, most of my eggs, plausible deniability when it came to purity, a flush ponytail, a pep in my step that had yet to run out. Apologies to Progress, but older men still desired those things.

I could not understand why my female classmates did not join me, given their intelligence. Each time I reconsidered the project, it struck me as more reasonable. Why ignore our youth when it amounted to a superpower? Why assume the burdens of womanhood, its too-quick-to-vanish upper hand, but not its brief benefits at least? Perhaps it came easier to avoid the topic wholesale than to accept that women really do have a tragically short window of power, and reason enough to take advantage of that fact while they can. As for me, I liked history, Victorian novels, knew of imminent female pitfalls from all the books I’d read: vampiric boyfriends; labor, at the office and in the hospital, expected simultaneously; a decline in status as we aged, like a looming eclipse. I’d have disliked being called calculating, but I had, like all women, a calculator in my head. I thought it silly to ignore its answers when they pointed to an unfairness for which we really ought to have been preparing.

I was competitive by nature, an English-literature student with all the corresponding major ambitions and minor prospects (Great American novel; email job). A little Bovarist , frantic for new places and ideas; to travel here, to travel there, to be in the room where things happened. I resented the callow boys in my class, who lusted after a particular, socially sanctioned type on campus: thin and sexless, emotionally detached and socially connected, the opposite of me. Restless one Saturday night, I slipped on a red dress and snuck into a graduate-school event, coiling an HDMI cord around my wrist as proof of some technical duty. I danced. I drank for free, until one of the organizers asked me to leave. I called and climbed into an Uber. Then I promptly climbed out of it. For there he was, emerging from the revolving doors. Brown eyes, curved lips, immaculate jacket. I went to him, asked him for a cigarette. A date, days later. A second one, where I discovered he was a person, potentially my favorite kind: funny, clear-eyed, brilliant, on intimate terms with the universe.

I used to love men like men love women — that is, not very well, and with a hunger driven only by my own inadequacies. Not him. In those early days, I spoke fondly of my family, stocked the fridge with his favorite pasta, folded his clothes more neatly than I ever have since. I wrote his mother a thank-you note for hosting me in his native France, something befitting a daughter-in-law. It worked; I meant it. After graduation and my fellowship at Oxford, I stayed in Europe for his career and married him at 23.

Of course I just fell in love. Romances have a setting; I had only intervened to place myself well. Mainly, I spotted the precise trouble of being a woman ahead of time, tried to surf it instead of letting it drown me on principle. I had grown bored of discussions of fair and unfair, equal or unequal , and preferred instead to consider a thing called ease.

The reception of a particular age-gap relationship depends on its obviousness. The greater and more visible the difference in years and status between a man and a woman, the more it strikes others as transactional. Transactional thinking in relationships is both as American as it gets and the least kosher subject in the American romantic lexicon. When a 50-year-old man and a 25-year-old woman walk down the street, the questions form themselves inside of you; they make you feel cynical and obscene: How good of a deal is that? Which party is getting the better one? Would I take it? He is older. Income rises with age, so we assume he has money, at least relative to her; at minimum, more connections and experience. She has supple skin. Energy. Sex. Maybe she gets a Birkin. Maybe he gets a baby long after his prime. The sight of their entwined hands throws a lucid light on the calculations each of us makes, in love, to varying degrees of denial. You could get married in the most romantic place in the world, like I did, and you would still have to sign a contract.

Twenty and 30 is not like 30 and 40; some freshness to my features back then, some clumsiness in my bearing, warped our decade, in the eyes of others, to an uncrossable gulf. Perhaps this explains the anger we felt directed at us at the start of our relationship. People seemed to take us very, very personally. I recall a hellish car ride with a friend of his who began to castigate me in the backseat, in tones so low that only I could hear him. He told me, You wanted a rich boyfriend. You chased and snuck into parties . He spared me the insult of gold digger, but he drew, with other words, the outline for it. Most offended were the single older women, my husband’s classmates. They discussed me in the bathroom at parties when I was in the stall. What does he see in her? What do they talk about? They were concerned about me. They wielded their concern like a bludgeon. They paraphrased without meaning to my favorite line from Nabokov’s Lolita : “You took advantage of my disadvantage,” suspecting me of some weakness he in turn mined. It did not disturb them, so much, to consider that all relationships were trades. The trouble was the trade I’d made struck them as a bad one.

The truth is you can fall in love with someone for all sorts of reasons, tiny transactions, pluses and minuses, whose sum is your affection for each other, your loyalty, your commitment. The way someone picks up your favorite croissant. Their habit of listening hard. What they do for you on your anniversary and your reciprocal gesture, wrapped thoughtfully. The serenity they inspire; your happiness, enlivening it. When someone says they feel unappreciated, what they really mean is you’re in debt to them.

When I think of same-age, same-stage relationships, what I tend to picture is a woman who is doing too much for too little.

I’m 27 now, and most women my age have “partners.” These days, girls become partners quite young. A partner is supposed to be a modern answer to the oppression of marriage, the terrible feeling of someone looming over you, head of a household to which you can only ever be the neck. Necks are vulnerable. The problem with a partner, however, is if you’re equal in all things, you compromise in all things. And men are too skilled at taking .

There is a boy out there who knows how to floss because my friend taught him. Now he kisses college girls with fresh breath. A boy married to my friend who doesn’t know how to pack his own suitcase. She “likes to do it for him.” A million boys who know how to touch a woman, who go to therapy because they were pushed, who learned fidelity, boundaries, decency, manners, to use a top sheet and act humanely beneath it, to call their mothers, match colors, bring flowers to a funeral and inhale, exhale in the face of rage, because some girl, some girl we know, some girl they probably don’t speak to and will never, ever credit, took the time to teach him. All while she was working, raising herself, clawing up the cliff-face of adulthood. Hauling him at her own expense.

I find a post on Reddit where five thousand men try to define “ a woman’s touch .” They describe raised flower beds, blankets, photographs of their loved ones, not hers, sprouting on the mantel overnight. Candles, coasters, side tables. Someone remembering to take lint out of the dryer. To give compliments. I wonder what these women are getting back. I imagine them like Cinderella’s mice, scurrying around, their sole proof of life their contributions to a more central character. On occasion I meet a nice couple, who grew up together. They know each other with a fraternalism tender and alien to me.  But I think of all my friends who failed at this, were failed at this, and I think, No, absolutely not, too risky . Riskier, sometimes, than an age gap.

My younger brother is in his early 20s, handsome, successful, but in many ways: an endearing disaster. By his age, I had long since wisened up. He leaves his clothes in the dryer, takes out a single shirt, steams it for three minutes. His towel on the floor, for someone else to retrieve. His lovely, same-age girlfriend is aching to fix these tendencies, among others. She is capable beyond words. Statistically, they will not end up together. He moved into his first place recently, and she, the girlfriend, supplied him with a long, detailed list of things he needed for his apartment: sheets, towels, hangers, a colander, which made me laugh. She picked out his couch. I will bet you anything she will fix his laundry habits, and if so, they will impress the next girl. If they break up, she will never see that couch again, and he will forget its story. I tell her when I visit because I like her, though I get in trouble for it: You shouldn’t do so much for him, not for someone who is not stuck with you, not for any boy, not even for my wonderful brother.

Too much work had left my husband, by 30, jaded and uninspired. He’d burned out — but I could reenchant things. I danced at restaurants when they played a song I liked. I turned grocery shopping into an adventure, pleased by what I provided. Ambitious, hungry, he needed someone smart enough to sustain his interest, but flexible enough in her habits to build them around his hours. I could. I do: read myself occupied, make myself free, materialize beside him when he calls for me. In exchange, I left a lucrative but deadening spreadsheet job to write full-time, without having to live like a writer. I learned to cook, a little, and decorate, somewhat poorly. Mostly I get to read, to walk central London and Miami and think in delicious circles, to work hard, when necessary, for free, and write stories for far less than minimum wage when I tally all the hours I take to write them.

At 20, I had felt daunted by the project of becoming my ideal self, couldn’t imagine doing it in tandem with someone, two raw lumps of clay trying to mold one another and only sullying things worse. I’d go on dates with boys my age and leave with the impression they were telling me not about themselves but some person who didn’t exist yet and on whom I was meant to bet regardless. My husband struck me instead as so finished, formed. Analyzable for compatibility. He bore the traces of other women who’d improved him, small but crucial basics like use a coaster ; listen, don’t give advice. Young egos mellow into patience and generosity.

My husband isn’t my partner. He’s my mentor, my lover, and, only in certain contexts, my friend. I’ll never forget it, how he showed me around our first place like he was introducing me to myself: This is the wine you’ll drink, where you’ll keep your clothes, we vacation here, this is the other language we’ll speak, you’ll learn it, and I did. Adulthood seemed a series of exhausting obligations. But his logistics ran so smoothly that he simply tacked mine on. I moved into his flat, onto his level, drag and drop, cleaner thrice a week, bills automatic. By opting out of partnership in my 20s, I granted myself a kind of compartmentalized, liberating selfishness none of my friends have managed. I am the work in progress, the party we worry about, a surprising dominance. When I searched for my first job, at 21, we combined our efforts, for my sake. He had wisdom to impart, contacts with whom he arranged coffees; we spent an afternoon, laughing, drawing up earnest lists of my pros and cons (highly sociable; sloppy math). Meanwhile, I took calls from a dear friend who had a boyfriend her age. Both savagely ambitious, hyperclose and entwined in each other’s projects. If each was a start-up , the other was the first hire, an intense dedication I found riveting. Yet every time she called me, I hung up with the distinct feeling that too much was happening at the same time: both learning to please a boss; to forge more adult relationships with their families; to pay bills and taxes and hang prints on the wall. Neither had any advice to give and certainly no stability. I pictured a three-legged race, two people tied together and hobbling toward every milestone.

I don’t fool myself. My marriage has its cons. There are only so many times one can say “thank you” — for splendid scenes, fine dinners — before the phrase starts to grate. I live in an apartment whose rent he pays and that shapes the freedom with which I can ever be angry with him. He doesn’t have to hold it over my head. It just floats there, complicating usual shorthands to explain dissatisfaction like, You aren’t being supportive lately . It’s a Frenchism to say, “Take a decision,” and from time to time I joke: from whom? Occasionally I find myself in some fabulous country at some fabulous party and I think what a long way I have traveled, like a lucky cloud, and it is frightening to think of oneself as vapor.

Mostly I worry that if he ever betrayed me and I had to move on, I would survive, but would find in my humor, preferences, the way I make coffee or the bed nothing that he did not teach, change, mold, recompose, stamp with his initials, the way Renaissance painters hid in their paintings their faces among a crowd. I wonder if when they looked at their paintings, they saw their own faces first. But this is the wrong question, if our aim is happiness. Like the other question on which I’m expected to dwell: Who is in charge, the man who drives or the woman who put him there so she could enjoy herself? I sit in the car, in the painting it would have taken me a corporate job and 20 years to paint alone, and my concern over who has the upper hand becomes as distant as the horizon, the one he and I made so wide for me.

To be a woman is to race against the clock, in several ways, until there is nothing left to be but run ragged.

We try to put it off, but it will hit us at some point: that we live in a world in which our power has a different shape from that of men, a different distribution of advantage, ours a funnel and theirs an expanding cone. A woman at 20 rarely has to earn her welcome; a boy at 20 will be turned away at the door. A woman at 30 may find a younger woman has taken her seat; a man at 30 will have invited her. I think back to the women in the bathroom, my husband’s classmates. What was my relationship if not an inconvertible sign of this unfairness? What was I doing, in marrying older, if not endorsing it? I had taken advantage of their disadvantage. I had preempted my own. After all, principled women are meant to defy unfairness, to show some integrity or denial, not plan around it, like I had. These were driven women, successful, beautiful, capable. I merely possessed the one thing they had already lost. In getting ahead of the problem, had I pushed them down? If I hadn’t, would it really have made any difference?

When we decided we wanted to be equal to men, we got on men’s time. We worked when they worked, retired when they retired, had to squeeze pregnancy, children, menopause somewhere impossibly in the margins. I have a friend, in her late 20s, who wears a mood ring; these days it is often red, flickering in the air like a siren when she explains her predicament to me. She has raised her fair share of same-age boyfriends. She has put her head down, worked laboriously alongside them, too. At last she is beginning to reap the dividends, earning the income to finally enjoy herself. But it is now, exactly at this precipice of freedom and pleasure, that a time problem comes closing in. If she would like to have children before 35, she must begin her next profession, motherhood, rather soon, compromising inevitably her original one. The same-age partner, equally unsettled in his career, will take only the minimum time off, she guesses, or else pay some cost which will come back to bite her. Everything unfailingly does. If she freezes her eggs to buy time, the decision and its logistics will burden her singly — and perhaps it will not work. Overlay the years a woman is supposed to establish herself in her career and her fertility window and it’s a perfect, miserable circle. By midlife women report feeling invisible, undervalued; it is a telling cliché, that after all this, some husbands leave for a younger girl. So when is her time, exactly? For leisure, ease, liberty? There is no brand of feminism which achieved female rest. If women’s problem in the ’50s was a paralyzing malaise, now it is that they are too active, too capable, never permitted a vacation they didn’t plan. It’s not that our efforts to have it all were fated for failure. They simply weren’t imaginative enough.

For me, my relationship, with its age gap, has alleviated this rush , permitted me to massage the clock, shift its hands to my benefit. Very soon, we will decide to have children, and I don’t panic over last gasps of fun, because I took so many big breaths of it early: on the holidays of someone who had worked a decade longer than I had, in beautiful places when I was young and beautiful, a symmetry I recommend. If such a thing as maternal energy exists, mine was never depleted. I spent the last nearly seven years supported more than I support and I am still not as old as my husband was when he met me. When I have a child, I will expect more help from him than I would if he were younger, for what does professional tenure earn you if not the right to set more limits on work demands — or, if not, to secure some child care, at the very least? When I return to work after maternal upheaval, he will aid me, as he’s always had, with his ability to put himself aside, as younger men are rarely able.

Above all, the great gift of my marriage is flexibility. A chance to live my life before I become responsible for someone else’s — a lover’s, or a child’s. A chance to write. A chance at a destiny that doesn’t adhere rigidly to the routines and timelines of men, but lends itself instead to roomy accommodation, to the very fluidity Betty Friedan dreamed of in 1963 in The Feminine Mystique , but we’ve largely forgotten: some career or style of life that “permits year-to-year variation — a full-time paid job in one community, part-time in another, exercise of the professional skill in serious volunteer work or a period of study during pregnancy or early motherhood when a full-time job is not feasible.” Some things are just not feasible in our current structures. Somewhere along the way we stopped admitting that, and all we did was make women feel like personal failures. I dream of new structures, a world in which women have entry-level jobs in their 30s; alternate avenues for promotion; corporate ladders with balconies on which they can stand still, have a smoke, take a break, make a baby, enjoy themselves, before they keep climbing. Perhaps men long for this in their own way. Actually I am sure of that.

Once, when we first fell in love, I put my head in his lap on a long car ride; I remember his hands on my face, the sun, the twisting turns of a mountain road, surprising and not surprising us like our romance, and his voice, telling me that it was his biggest regret that I was so young, he feared he would lose me. Last week, we looked back at old photos and agreed we’d given each other our respective best years. Sometimes real equality is not so obvious, sometimes it takes turns, sometimes it takes almost a decade to reveal itself.

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Guest Essay

Let People Sell Their Kidneys. It Will Save Lives.

By Dylan Walsh

Mr. Walsh is a freelance journalist who focuses on science and the criminal justice system.

I owe the past 25 years of my life to my father, who dozed under general anesthesia as a surgeon cut eight inches from stomach to spine, removed one of his kidneys, placed it on ice and sent it to a nearby operating room, where it was fitted into my abdomen. My brother had a kidney transplant the same week, six days before I did. His new kidney came from a man we never knew who had died in a car accident in the mountains.

We were teenagers, afflicted with a congenital kidney disease. But we were lucky.

There are 100,000 people in the United States waiting for a kidney. More than half a million are on dialysis, which from my experience I know to be more of a means of survival than a form of living. About 4,000 people die each year while waiting for a kidney. Another 4,000 become too sick to undergo surgery — a gentler way of saying that they, too, die. The National Kidney Foundation estimates that without more investment in preventing diabetes and other ailments, more than one million people will be suffering from kidney failure by 2030, up from over 800,000 now .

These numbers illuminate a story of largely preventable suffering. Hundreds of millions of healthy people walk the streets quietly carrying two kidneys. They need only one. The head-scratcher is how to get kidneys from the people who have one to spare into the people who need one. Getting them from genetically modified pigs , as was recently found possible, won’t be a widespread solution for a very long time.

There’s a simpler and long overdue answer: Pay people for their kidneys.

Creating a market for kidneys is not a new concept, but it’s historically been met with disgust: Sell what? To be fair, some of the ways to structure such a market would be irresponsible, coercive and deserving of that disgust.

But others are more thoughtful and prudent. One approach is to make the federal government the sole purchaser of kidneys. Donor and recipient would never meet. Compensation would be fixed, haggling impossible. After the kidney is acquired, the transplant process would unfold in the typical manner.

This idea fits nicely within today’s health economics. Through a quirk of a 50-year-old law , Medicare is the primary insurer for anyone of any age in need of dialysis or a transplant. This has extended the lives of hundreds of thousands of people. It has also been costly, with end-stage renal disease patients accounting for about 7 percent of Medicare’s spending, despite constituting 1 percent of its users. Because transplants are ultimately cheaper than dialysis, if Medicare started paying people to donate kidneys, fewer people would need to survive on dialysis, and Medicare would need less taxpayer money to cover it.

Federal law presents the first and most significant hurdle to a market for kidneys. The 1984 National Organ Transplant Act, NOTA for short, makes it unlawful “to knowingly acquire, receive or otherwise transfer any human organ for valuable consideration for use in human transplantation.” Though markets exist for human tissue, bone, amniotic stem cells and blood plasma and for the use of a woman’s womb and her eggs, organs cannot legally be bought and sold.

For several decades, efforts to persuade people to become kidney donors haven’t increased the number of volunteers. There were roughly 6,000 living kidney donors in 2000; there were roughly 6,000 in 2023. The only way to get more donors is to change the law.

One organization, the Coalition to Modify NOTA, hopes to legalize compensation and then pass a federal law it has titled the End Kidney Deaths Act . As it’s written, it would award living donors $50,000 over five years — $10,000 per year — through refundable tax credits. The coalition says it has held meetings with nearly 100 legislators from both parties and has been encouraged by the level of support for its idea (though the bill still has not been brought to the floor of Congress).

Other proposals meant to solve kidney donation shortages abound. Several bills have recently been introduced to Congress, including one that would prohibit life and disability insurance companies from denying coverage to or increasing premiums for donors, and another that would reimburse donors for expenses they incur during donation. Two Colorado state representatives, one Democratic and one Republican, have drafted their own proposal for a statewide tax credit of up to $40,000 for organ donors; a representative in New Hampshire is trying to create an open market for organs in his state.

Some people who are opposed to the idea of selling organs argue that we should instead improve the process of capturing organs from people who have died. But even a flawlessly functioning system that recovered and transplanted 100 percent of available organs would not meet demand. And deceased-donor kidneys don’t last as long as those from living donors.

One of the most consistent and vociferous objections to a kidney market centers on the fear of coercion or exploitation: If you pay people to do something, particularly if you pay them a lot, then you will drive those who are most desperate and socially precarious to take steps they later will regret.

Ned Brooks, a co-founder of the Coalition to Modify NOTA, told me there are ways to mitigate “the concern that someone is going to donate a kidney because they have a gambling debt or they are losing their house to foreclosure or you name it.” His organization’s proposal, for example, would split the $50,000 payment into installments arriving only around tax season to weaken donation as a get-rich-quick scheme. Even now, donation requires a weeks- to monthslong process of physical and psychological evaluation .

Compensating donors could also go a long way to reducing current inequities. Black patients are more than three times as likely to develop kidney failure as white patients. And under today’s system, white patients are about four times as likely as Black patients (and approximately two times as likely as Asian and Hispanic patients) to receive a living kidney donation within two years of needing one . While there are many reasons for this imbalance, one critical factor is that white people generally possess social networks saturated with volunteers who are able to make the kinds of accommodations needed for major surgery. Compensation would broaden the pool of available kidneys for those who lack these social networks.

Alongside the flurry of political activity surrounding organ donation, a shift in attitudes among the public seems to be underway, making this moment particularly ripe for legislative change. A 2019 study found that roughly 60 percent of Americans would favor compensation through a public agency — and this number, depending on the form of compensation, would increase to 70 percent to 80 percent if such a system eliminated kidney shortages. This is a rare nonpartisan idea at a highly polarized moment and could save the dozen people who die every day waiting for a kidney.

My kidney has been ticking along since August 1998, far longer than the average transplantation. It will give out sometime, maybe before my children graduate from high school. It will almost certainly fail before any children they may have are born. Still, I’ve lived 25 years I would not have had otherwise. I hope for a world in which others — many others — are given such an exquisite gift.

Dylan Walsh is a freelance journalist in Chicago who focuses on science and the criminal justice system.

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