Universidad Nacional de Hurlingham

CPI Pre-intermediate
Blas Bigatti – Cecilia Lértora

Unit 4: Health systems

 Learning points:  Vocabulary:  Recycling:

-Present perfect -Time phrases -Past simple
-Skimming and scanning -Health care -Present simple
-Comparing and contrasting information -Newspaper articles -Present continuous
-Definite and indefinite articles -TV programmes and films -First conditional
-Comparative and superlative adjectives
-Zero conditional
-Writing reviews

A) Go through the texts quickly and answer the following questions:

a) What type of texts are they? Where were they extracted from?
b) What is their common topic?
c) What countries are mentioned in each of the texts?
d) What nationality were the intended readers for each text?

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 Universidad Nacional de Hurlingham
CPI Pre-intermediate
Blas Bigatti – Cecilia Lértora
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a.1) Think about reading strategies: You weren’t supposed to read the full texts in order to answer the pre-
vious questions. In fact, you were supposed to apply two different fast-reading strategies: skimming and scanning.
Which one did you use to answer each question?

Skimming refers to looking only for the general or main ideas.

Scanning refers to looking only for a specific fact or piece of information without reading everything.

a.1.1) Reflect: What specific tactics did you apply to carry out each strategy?

a.2) Now read the texts carefully and answer:

a) What government or organisation has been in charge of Operation Miracle and of The Alma Train?
b) What medical services do Operation Miracle and The Alma Train offer?
c) Where do volunteer doctors for each program come from?
d) For how long has each program been active by the time the articles were published?

Need vocabulary to contrast? Check Appendix 1.

a.3) Think about grammar: Reread Text 1, underline the verbs and identify the paragraphs written…
a) in the past simple
b) in the present perfect (have+participial)

a.3.1) Discuss:

a) Why are the different tenses used in each case? What time relation do they express?
b) What time phrases accompany them?

a.3.2) Work on your book: pg. 31, activitie 4, 5 and 6.

a.3.3) Back to Text 2: Underline verbs and time phrases, identify tenses and discuss why they
are used in each case.

B) Medical vocabulary: read the vocabulary on pg. 108, V1, and group the words in the chart

Health professionals Health ystem Health problems Medical treatments

b.1) Write: Go over the words in the ‘Health system’ column. Choose as many of them as you need
and write a short paragraph describing the healthcare system in Argentina.

Recycling: Use at least three phrases from Unit 3: Appendix 5. 

b.2) Check the film poster and answer the questions: a) What type of film do you think this will be?
b) What will be the topic of the film?
c) What information can we get about the author?
d) Circle the adjectives used to describe the film. What
idea do they convey?

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 Universidad Nacional de Hurlingham
CPI Pre-intermediate
Blas Bigatti – Cecilia Lértora

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 b.3) Video: Now watch Fragment A from the film ‘Sicko’ and complete the transcript with the words:
Video edited from: Michael Moore (2007) Sicko.

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health insurance cancer  copays and deductibles 
heart attack good jobs  accident they’re driving 
This is Adam. He had an ____________. He’s one of nearly 50 million Americans with no ________________…

It’s moving day for Larry and Donna Smith, and _________________ to Denver, Colorado. To their new home in
their daughter’s storage room. They both had ______________. She was a newspaper editor. And he was a union
machinist. But Larry had a ________________. And then another one... And then another one. And then Donna
got _____________. And even though they had health insurance, the _____________________ soon added up to
the point where they could no longer afford to keep their home.

b.3.1) Write: in pairs, write two or three sentences comparing the American health system as de-
scribed in Sicko and the Argentine one.

b.3.2) Think about grammar: Which of the bold words in the text does each definition refer to?
Definite article (‘specific’): It is used when the noun is already known to our
listener, or when it can be considered as part of the common ground that we
share. ____________

Indefinite article (‘not specific’): It is used when the noun is unknown to our
listener or when it is not part of our common ground. It is most often used to
introduce new information. ____________

b.3.3) Back to the book: Go on working on articles on pg.33, activities 6a, 6c and 7. If
any doubt, help yourself with the grammar rules on pg. 108, G3.

Still not sure about the zero article?

More practice in Appendix 2.

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 Universidad Nacional de Hurlingham
CPI Pre-intermediate
Blas Bigatti – Cecilia Lértora

 b.4) Video: Now watch the first part of Fragment B from the film ‘Sicko’ without sound. Then answer the
questions with your partners:

a) What country is Michael Moore visiting?

b) Is it possible that he likes this country? Why?
c) What do you think will be his opinion about the health care system of this country?

b.4.1) Before watching the video again: Order the dialogue:

“Everything, yes.”
“Thank you, very much. Thank you.”
“Excuse me, we’re looking for a doctor. Is there a doctor here in Cuba?”
“All on this one block?”
“There’s a doctor around the corner. There’s a hospital over there. There’s a pharmacy right here.”

 b.4.2) Video: Now watch Fragment B with sound and check your previous answers.
b.4.3) Answer about the video:

a) What type of health care system do Cubans have?

b) What’s the medical relationship between Cuba and other third-world countries?
c) Which country spends more in healthcare, Cuba or the US?
d) Which country has a better healthcare system, Cuba or the US?
e) What’s Cuba’s ‘sin’ according to Moore?

b.5) Think about grammar: Read the transcript from Fragment B and complete the chart below with the
underlined phrases.

Okay, okay… I know what you’re thinking… The worst place on Earth! The most evil nation ever created!
How do we know that? ‘Cos that’s what we’ve been told for over 45 years.

Now, after all these years, the one thing that Cubans do have is free, universal health care. They’ve be-
come known around the world as having not only one of the best healthcare systems, but as being one of
the most generous countries in providing doctors and medical equipment to third-world countries. In the
US, healthcare cost round nealy 6,000 dollars per person, but in Cuba they spend only 251 dollars, and
yet the Cubans are able to have a lower infant mortality rate than in the United States, a longer average
life span than in the United States… Their only sin, when it comes to health care, seems to be that they
don’t do it for profit.

You know, when we see a good idea from another country, we grab it. If they build a better car, we drive
it. If they make a better wine, we drink it. So if they’ve come up with a better way to treat the sick, to
simply be good to each other, then what’s our problem? Why can’t we do that?

Adjective Comparative Superlative

 good 
 bad

 low

 long
evil
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generous
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Don’t remember much about comparisons? Check your book, pg110, G1.
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 Universidad Nacional de Hurlingham
CPI Pre-intermediate
Blas Bigatti – Cecilia Lértora

b.5.1) Write comparisons about the countries:

Argentina Cuba United States United Kingdom
Infant mortality rate 10,1 4,5 5,8 4,3
Life expectancy 76 79 78 80
Healthcare expenditure US$ 1,300 US$ 816 US$ 9,500 US$ 4,100
Doctors every 1,000 people 4 7,5 2,5 3
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 What adjectives may help in this activity? Some ideas:
low – high – cheap – expensive – much - little 
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b.5.2) Consider the phrases in bold in the text: Draw a timeline for each phrase following the example
from pg. 31 in your book.

b.5.3) What type of sentences are the following? What difference can you find between these sen-
tences and those studied in Unit 3?

If they build a better car, we drive it. If they make a better wine, we drink it.

Remember from Unit 3:

“If you want to challenge power, you’ll be pushed to the margins.”
Compare both conditional sentences in Appendix 3.
-Complete the conditional sentences: zero or first?

a) If people eat too much, __________________________.

b) If you touch the fire, _________________________.
c) If it rains tomorrow, __________________________.
d) If you don’t have a health insurance in the US, ___________________________.
e) If a Cuban citizen gets sick, ___________________________.
f) If I save enough money this year, __________________________.

C) Go over the following text quickly and discuss:

a) What type of text is this?

b) Is the author’s opinion on the film positive or negative?
c) What other film by Moore is mentioned in the article?
d) What countries beside the US are mentioned?

'Sicko': a tonic, even with flaws

By Tom Charity
Special to CNN

America's most polarizing filmmaker, Michael Moore, returns with his first movie since Fahrenheit 9/11 challenged
George W. Bush. This time, with Sicko, Moore has set his sights on a more powerful target: the health care indus-
try.

In a nutshell, Moore's argument comes down to this: the insurance companies are making a killing at their custom-
ers' expense. And in this industry, that term is all too literal. Many of the people in the film are in desperately dire
straits: sick, bereaved, or just plain broke.

Moore adopts a low profile in the film's first half. But when he eventually slouches on screen, it's to play the inno-
cent abroad, surprised by the wonders of socialized medicine in Canada, the UK and France. True, this will be an
eye-opener for many. But having "enjoyed" first-hand experience of these health systems, I can certify that they're
not quite as idyllic as Mr. Moore paints them. Except in comparison with the U.S. system, of course, and that's the
point. Moore hits the target more often than not. It only hurts when we laugh.

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 Universidad Nacional de Hurlingham
CPI Pre-intermediate
Blas Bigatti – Cecilia Lértora

If Moore missteps, it's in Cuba. Moore is easily diverted into a silly commercial for Cuban socialist medicine. But
all is fair in love and Moore, and the American health system is sick, no question.

The prospect of universal care seems a distant hope. However, it's not impossible that this bitterly funny, bitterly
sad film could put reform back on the political agenda. For that reason alone, you owe it to yourself to see this
movie.
Edited from: Tom Charity (2007) Review: 'Sicko' a tonic, even with
flaws [on line] http://edition.cnn.com/2007/SHOWBIZ/Movies/06/28/
review.sicko/index.html (accessed May 1, 2018)

c.1) Write the bold words next to their closest synonym:

-controversial: -err: -victim:

-deviate: -painfully: -visibility:
-emergency: -possibility:

c.2) Match to the closest meaning:

-Insurance companies are making a killing at their costumers’ expense.

-In the second part of the film, Moore plays the innocent abroad.
-The French health system is not quite as idyllic as Mr. Moore paints it.
-Moore hits the target more often than not.
-All is fair in love and Moore.
-Moore’s film could put reform back on the political agenda.

a) Moore pretends to be what he’s not.

b) Moore succeeds the majority of times.
c) Moore has the power to change discussions in the media and in Congress.
d) Moore describes an inhuman excess of profit.
e) Moore exaggerates.
f) Moore follows no rules.

c.3) Match the different types of information in the box to their corresponding paragraphs:

Paragraph 1: ___________________________________ -film relevance

Paragraph 2: ___________________________________ -author, film and topic
-recommendation
Paragraph 3: ___________________________________ -author’s style
Paragraph 4: ___________________________________ -film flaws
-message and content
Paragraph 5: ___________________________________

c.4) Go on working on reviews:

a) Work on your book: pg. 29, activities 9a-c.

b) Complete with the type of information given in each paragraph in the ‘Borgen’ review:

Paragraph 1: ___________________________________________
Paragraph 2: ___________________________________________
Paragraph 3: ___________________________________________
Paragraph 4: ___________________________________________
Paragraph 5: ___________________________________________
c) Compare: What similarities and differences in content can you find the ‘Sicko’ and the ‘Borgen’ re-
views? Enumerate them.

Similarities: ………………………………………………………….………………………………………

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 Universidad Nacional de Hurlingham
CPI Pre-intermediate
Blas Bigatti – Cecilia Lértora

…………………………………………………………………………………….………………………….
……………………………………………………………………………………………….……………….
Differences: …………………………………………………………………………………………………
…………………………………………………………………………………….………………………….
……………………………………………………………………………………………….……………….

d) Back to the book: pg. 29, activities 10c and 11.

D) Write a review: Choose a film, a TV programme, a series or a book and write a review. Try to follow these
steps:

-Step 1: Write a list of the important information you’d like to consider in your review (title, year, author,
actors/actresses, topic, style, soundtrack, setting, etc).
-Step 2: Write a layout to organise your information (what information will you include in paragraph 1, 2,
etc.?)
-Step 3: Write the first draft of your review. Once that you finish it, leave it aside for one or two days.
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 Need more words to describe books or films?
Get some ideas from Appendix 4.
-Step 4: After a couple of days, get back to your review. Reread it, underlined the mistakes you find or the
things you don’t like and start editing it. The result should be your second draft.
-Step 5: Share your second draft with your classmates for a pair review: Is everything clear for them or
are there some confusing sentences or ideas? Take down note of their opinions.
-Step 6: If necessary, after the pair review, write your final draft and hand it in to your teacher.

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 APPENDIX 1: Contrast vocabulary
Vocabulary Sample Sentence Frames
while -Dentists take care of our teeth, while oftalmologists take care of our eyes.

but -Nurses take care of patients, but they don’t operate on them.

different from -Doctors are different from nurses in that they cure patients (while nurses take care of them).

differ -Doctors differ from nurses in that they cure patients (while nurses take care of them).

However / -Many Argentine doctors travel as volunteers to other countries. However, not many foreign doctors
On the contrary / come as volunteers to Argentina.
Conversely

by comparison There are many dentists in Argentina. By comparison, there aren’t so many brain surgeons.

unlike Unlike nurses, surgeons can operate on patients.

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 Universidad Nacional de Hurlingham
CPI Pre-intermediate
Blas Bigatti – Cecilia Lértora
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 APPENDIX 2: Zero article

Source: iSLCollective (2013) [on line] https://en.islcollective.com/resources/printables/worksheets_doc_docx/

test_on_articles_definite_and_indefinite_editable_and_with_keys/articles-article-preintermediate/42407
(accessed May 6, 2018)

 APPENDIX 3: Zero and first conditional

Zero conditional: Zero conditional sentences take two present simple verbs (one in the 'if clause' and one in the
'main clause'). The implication of this conditional is that, given the condition, the result will always happen. The
zero conditional is used to express general facts, or cases that are considered by the speaker to be general.

If + present simple, .... present simple.

Examples:
-If water reaches 100 degrees, it always boils. (It's a general fact)
-If Americans see a good idea from another country, they grab it. (A general fact in Moore’s opinion)

First conditional: The first conditional takes a present simple verb in the 'if clause', and a ‘will+verb’ in the main
clause. The implication is that, given the condition, the result is highly possible to happen. This conditional is used
to express something believed to be true in a particular case.

if + present simple, ... will + infinitive

Examples:

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 Universidad Nacional de Hurlingham
CPI Pre-intermediate
Blas Bigatti – Cecilia Lértora

-If you forget the kettle on the fire, the water will boil. (a particular case)
-If Americans see a new idea this year, they’ll grab it.

 APPENDIX 4: Useful vocabulary for reviews

Positive Adjectives:

-It’s a very readable account of the history of this great city.

-It’s probably not his best movie but it’s very watchable.
-It’s not a great novel but it’s fairly entertaining.
-I really liked her last novel – I found it very absorbing.
-The movie was completely engrossing from start to finish.
-I found the storyline so intriguing – I had absolutely no idea what was going to happen next.
-This is a series with great characters and a gripping storyline.
-You’ll love the novel – it’s riveting stuff.
-His latest book is compulsive reading. (you can’t stop reading it)
-I found the whole series very compelling.

More positive adjectives:

-an action-packed weekend -she was very impressive in the interview.

-atmospheric music -a deeply moving experience.
-the acting is very convincing -outstanding performance.
-enthusiastic and vivid descriptions of the -powerful acting
scenery -gave a stunning performance.
-the novel provides a fascinating/ valua- -credible
ble/revealing insight into the customs in -innovative
Mexico. -memorable
-her performance was mesmerizing.

Negative adjectives:

-a clichéd view of upper-class life.

-There are two versions of this excruciating film.
-excruciatingly boring.
-a rather implausible story.
-Promoters grossly overhyped the movie.
-a slushy/sentimental love story
-That’s the cheesiest chat-up line I’ve ever heard.
-a drippy love song.
-a very long and tedious film.
-I find the characters in the book very unconvincing.
-I found the plot rather predictable/disappointing.

Expressions to compare and contrast:

-Her latest novel, a tale of unrequited love, bears a close/a striking/a strong/a slight/little/no resemblance to
her earlier, more philosophical work.
-There are several obvious/striking similarities between the two films.
-There is a world of difference between the two films.
-What sets the film apart from others of the same genre is its ability to make us laugh.
-a considerable/huge/marked/slight difference
-a close/remarkable/striking similarity
-is unlike another film
-has a great deal/little/nothing in common with

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 Universidad Nacional de Hurlingham
CPI Pre-intermediate
Blas Bigatti – Cecilia Lértora

Other expressions:

-I would highly recommend it to anyone who is interested in the human mind.

-One particular strength/weakness of the film is…
-The design/production is second to none (the best).
-The characterization is not its best feature.
-I would strongly advise you (not) to go out and buy/see it.
-Do not be put off by the title/critics/cover.
-It will have you roaring with laughter (laugh very loudly).
-I would definitely give it a miss (decide not to do sth.)

Edited from: Tomeu Aloy (2010) ‘Ready for CAE p 76. Reviews. Vocabulary’ [on line]
http://englishadvanced2.blogspot.com.ar/2011/02/ready-for-cae-p-76-reviews-vocabulary.html
(accessed May 6, 2018)

BONUS TRACK

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