writing

can you tell me what direction to take with this?
My essay:
During the last century, the average life span of Americans nearly doubled, from 49 years in 1900 to nearly 80 years in 2000. Increased life expectancy and advances in U.S. healthcare means that Americans now live longer, but with increased chronic illness at the end of life. More than one-third of the population is uninsured, unstably insured, or underinsured. Forgoing preventive or timely care can exacerbate health problems and lead to preventable suffering or even death—and much more expensive treatment down the road. The prolonged and escalating cost of treating illness at the end of life raises an issue that few Americans have been willing to confront: The value of giving expensive new treatments to people whose life expectancy is drastically limited, even with the treatment. Prolonging life in these situations presents a moral and ethical dilemma for the medical profession and the family of the afflicted individual. How is this addressed, and by whom? Gaps in coverage and high out-of-pocket costs hinder patients' access to care. Americans are much more likely than residents of other nations to forgo doctors' visits, fail to fill prescriptions, or skip recommended follow-up care due to cost. Inefficiencies, such as duplication and use of unnecessary services, are costly and compromise the quality of care. There are also significant lapses in safety, with as many as 98,000 Americans dying from medical errors each year.
Innovative ways to improve health care system performance are being explored which include:

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