To improve the first letter of letter set 1, I would entirely remove the third paragraph. The author makes it clear that they are physically struggling in the second paragraph. The third paragraph expands on this point by describing the specific symptoms that he experiences. Although these descriptions do strengthen his claim that his health is failing, they do little to support the overall argument that healthcare reform is necessary. Because there is a limited word count for the letter, I found these extra details unnecessary.  I would replace this paragraph by drawing attention to the prevalence of chronic diseases in the United States:


According to the CDC, 6 in 10 adults in the United States have at least one chronic disease, and 4 in 10 have more than one. Therefore, over half of adults in America have a chronic illness that may affect their ability to get health care. Those who are lucky enough to not have such a disease are likely to know someone who does. It may be tempting to ignore health care reform if you are healthy now, but there’s a high likelihood that you or a loved one will struggle with a chronic illness later in your life. Therefore, health care reform should be an issue that concerns all Americans.

Originally the author told residents of Pennslyvania to “think about [him] and others,” but he didn’t explain how healthcare reform would be personally beneficial to healthy readers. He depicts how he has struggled with disease and healthcare, which does encourage sympathy from the audience. However, the author could have created a more compelling overall argument if he had combined his appeal for sympathy with a logical line of reasoning. This new paragraph makes the logical argument that healthcare reform is an issue that applies to all Americans, and the claim is supported with statistics from the CDC. Rather than just feeling bad for the author of the letter, readers would consider how their own ability to get healthcare would be affected if they were one of the 6 in 10 adults with a chronic disease.