Modern Management 5_ITC

Let’s look at the challenges of providing motivation, the managers at Bristol-Myers Face.   The company has several over-the-counter brands and cosmetic products and its sales throughout the World exceed $ 18 billion.   Jack Cooper is the frontline manager of the company and has adopted an effective internet strategy to market the company’s products.   He finds this strategy very difficult has it may be hard to motivate the staff members.   Internet strategy would mean implementing several projects simultaneously.   The managers have to allocate the adequate resources, set targets and control the budgets of implementation. Motivation of the staff is very difficult as the managers have to convince the staff that their internet strategy would be effective and successful.   Frequently, the staff members perceive that the internet strategy would fail.   In case of any adversity, the managers should be able to step in and create solutions so that the strategy would work.   Cooper also feels that the technical issues should be appropriately sorted out by the managers along with solving the human resources problems (especially with motivation). The behavior of the staff should be appropriately altered to enable proper development of the internet strategy.   Motivation levels of the staff members need to be high for creative and efficient outputs.   Studies have been seen that if the staff members are not properly motivated, the creative expressions and the efficiency would suffer.   Motivation should be considered as an instrument required as a resource to enable a strong digital strategy.   Five specific principles about motivation should be kept in mind.   These include:- 1.  Ã‚  Ã‚  Ã‚  Ã‚   If a need is felt by a person, behavior would be brought about to reduce the need. 2.  Ã‚  Ã‚  Ã‚  Ã‚   The person’s feeling of the value of the outcome of conducting a particular behavior and the felt chances that the behavior would be successful, helps to bring a desire to perform a particular behavior. 3.  Ã‚  Ã‚  Ã‚  Ã‚   The value of reward for generating a particular behavior depends on certain internal and external factors that create satisfaction when the behavior is demonstrated. 4.  Ã‚  Ã‚  Ã‚  Ã‚   Only if the individual understands that the task is possible and he/she has the skills and know-how to perform a particular activity, would he/she be effective in completing the activity successfully. 5.  Ã‚  Ã‚  Ã‚  Ã‚   When the reward is received, the fairness instituted in this process, helps to generate satisfaction. Feedback is a set of responses generated by one person to another so that the quality and effectiveness of the work (or output generated) could improve in the future.   It includes corrections, approvals, additions, positive remarks, negative remarks, etc.   It may be given by the manager, but can also be given by other individuals.   The feedback provided by the manager should be highly specific and relate to the particular situation it should be utilized in.   Feedback should enable a particular behavior and not on attacking a particular individual or his/her objectives.   Feedback should be administered sincerely and honestly, so that the staff member feels that he is being helped in difficulty. The individual receiving feedback should have trust in the person giving feedback.   The individual should give permission to the manager to give the feedback.   The individual receiving the feedback should be capable of utilizing the feedback or using it for improving his/her efficiency.   Feedback also includes giving out data and observations, and not only giving advice.   The feedback should be given out only in an appropriate situation.   The person being provided the feedback should understand each and every piece of data that is being communicated.   The manager should be able to demonstrate the manner in which the work has to be done effectively whist providing feedback.   It is preferable to communicate feedback on a regular basis, rather than irregular. References: Cresto, S. C. and Cresto, S. T. (2006). Chapter 5: Motivation, Modern Management, (10th ed), New Jersey: Upper Saddle River. Cresto, S. C. and Cresto, S. T. (2006). Chapter 17: Group, Teams and Corporate Culture, Modern Management, (10th ed), New Jersey: Upper Saddle River.

Interest in Rainwater Essay

The article entitled â€Å"Interest in Rainwater Harvesting Grows in Colorado† written by Paul Day was about a proposal of Brad Lancaster, a rainwater virtuoso and initiator. His entire idea according to the news was that he wanted to use the rainwater for needs of the people and environment just like in Arizona and New Mexico. But the Executive Director of Colorado Waterwise, Paul Lander, prohibited his willingness to pursue this project because according to him it might result in breaking the rights of the people to that water. Lancaster insisted and he even showed two concrete project proposals for this. First, it would legalize the conception in countrysides that were not served by municipal water supplies. Lastly, it would instruct for conducting projects to study whether rainwater harvesting can be used without harming water rights. It interests me a lot because if we’re going to use the water from the sky in some ways, we can get lot of benefits out of it. I consider this as a biological issue because it discusses the precipitation process. This is very important because this is an exact example of learning how to utilize the nature for our advantage. The steps of scientific process: a. The usage of the rainwater purposefully though Colorado water law forbids it? b. Other places like Arizona and New Mexico can do it, why can’t we. c. They show the proposals using diagrams of storage tanks for collecting rainwater that runs off the rooftops home homes and businesses. d. The people who witness the presentation of the project agree that we can get a lot out of it. Scientific Terms: rainwater – water that comes form the sky project proposals – the entire flow or plan of the project and the things that they wanted to do precipitation process – the continuous cycle of water â€Å"Does Diabetes Make the Mind Go to Pieces† written by Mary Brophy Marcus is the second article. It imparted us about the risk of having Alzheimer’s disease and the effects of it are as follows: a. more prone to cognitive decline b. the mind’s ability to evaluate problems and the speed of processing information might suffer because of high rate of insulin or abnormal blood glucose. The experimentation by the researchers from the University of Alberta in Canada verified the people with diabetes and non – diabetic were prone to mental decline according to the American Psychological Association’s January issue of Neuropsychology but the executive function – complex, analytical thinking and speed processing were directed to the diabetic ones. In the journal Neuron published in December found out that if the brain didn’t get enough sugar it produced Alzheimer’s plaques but improving the brain’s blood flow might prevent or cured Alzheimer’s according to Robert Vassar, a professor of cell and molecular biology at Northwestern University’s Feinberg School of Medicine and he recommended that doing some exercise, minimizing cholesterol intake and taking care of the hypertension could help a lot. On the contrary, according to Nir Barzilai, director of the Institute for Aging Research at Albert Einstein College of Medicine in New York that insulin worked in the nerves that went to the liver and it declared stoppage glucose production and healed diabetes but not in the blood. I found it fascinating because it conveyed awareness on how to take good care of our body. I considered this biological issue because it dealt with the health of an individual. The steps of the scientific process: a: Treating Alzheimer’s disease? b. the insulin is a great help c. they observe people with diabetes and non – diabetic individuals d. proper maintenance of insulin/glucose in our body and the habitual exercise and taking care of the body will prevent diseases. Scientific Terms: glucose – a crystalline sugar insulin – secreted by islets of Langerhans for carbohydrate’s metabolism and glucose regulation in the blood and produced diabetes mellitus when insufficient. Alzheimer’s disease – progressive memory loss, impaired thinking, and changes in mood. The last article entitled â€Å"The Big Green Giveaway† by Tony Milney wanted to share about Mr. Miliband’s willingess to save the planet and our benefit out of it. The objective of putting up the household carbon emissions close to zero by 2050, the government decided to plan an environmental makeover. Establishing ground or air-source heat pumps, solar heating, solid wall insulation, or to join a community heating scheme are the suggested ways to lessen the average ? 300 a year of the wasted energy that needed an action or prevention. Based from the principles of this proposal, all the privileges were given to the homeowners to be able to fulfill the energy saving measures in our home. Not only this, but also the 90,000 solar water-heating systems in Britain. Another offer was the installation wind turbines, wood-pellet stoves, ground-source heat pumps and other eco kit by the Energy Saving Trust. And it even mentioned here the different gadgets used to save energy at home. This article caught my attention because it gave us information and ideas on how to save energy and at the same having advantage of it. I considered this as a biological issue because it discussed the environment that we had and the energy that we consumed. It is important because it helped the people saved energy without damaging the ecosystem. The steps of the scientific process: a. How can we avoid wasted energy? b. the misused of the energy and environment can cause this kind of problem c. they mentioned the different ways on how to save energy and the invented gadgets that could be of great help to the people d. there will be no wasted energy if the people would learn how to save energy wisely. Scientific Terms: energy – dynamic exertion of power carbon – a nonmetallic primarily tetravalent element found native gadgets – an often small automatic or electronic device with a sensible use but often thought of as a novelty. Works Cited Day, Paul. â€Å"Interest in Rainwater Harvesting Grows in Colorado. † CBS4Denver. com (Feb 12, 2009): http://cbs4denver. com/local/Rainwater. Harvesting. illegal. 2. 934360. html Marcus, Mary Brophy. â€Å"Does Diabetes Make the Mind Go to Pieces? † USA TODAY (Jan. 28, 2009): http://www. usatoday. com/news/health/2009-01-28-diabetes-alzheimers_n. htm Milne, Tony â€Å"The Big Green Giveaway. † The Sunday Times (February 15, 2009): http://www. timesonline. co. uk/tol/news/environment/article5732920. ece

British American Tobacco Essay Example | Topics and Well Written Essays - 3500 words

British American Tobacco - Essay Example It is documented that the company was formed in 1902 by joining Imperial Tobacco Company of United Kingdom with American Tobacco Company of USA. The resulting company was then referred to as the British-American Tobacco Company Ltd. The name later changed to British American Tobacco plc which immediately began earnest diversification in countries all over the world except the United Kingdom and USA, the parent countries. This essay attempts to present a critical appraisal of the strategies adopted by BAT since 2003, an analysis of its environment of operation as well as an evaluation of its potential to remain a major player in the global tobacco business. There is also a brief conclusion given at the end of the essay. Since the year 2003, British American Tobacco Company put in place significant strategic initiatives which saw it grow from a regional company to a global conglomerate. To attain its current status, BAT employed a myriad of strategies. At the outset, the tobacco company decided to grow organically by increasing its market share in existing markets and also through entering new markets. This strategy required BAT to increase its market penetration in the tobacco industry while at the same time observing cost efficiency. Interestingly enough, organic growth was reportedly very successful though with enormous cost implications. To this effect, BAT managed to increase organic sales volumes of its four main brands namely Dunhill, Kent, Pall Mall and Lucky Strike (as cited in Lee and Collin, 2006). Additionally, these top brands are reported to have seen an increase of 8% in volumes in 2003 as indicated in Lee and Collin (2006) with further expectations of even better performance in 2005. This projection in growth by volume was indicative of some organic growth especially in the face of difficult situations in some key markets (Lee and Collin, 2006). On the other hand, to enhance its diversification programme, British American Tobacco went into partnership with R. J. Reynolds Tobacco Company on 11 June 2006 to manufacture Camel brand of cigarettes in Sweden. This marked part of the company's strategy of growth through careful acquisitions as well as some organic growth and share exchanges in the long term to realise high single figure earnings (Glantz, 2000). For this reason financially attractive mergers and acquisitions were concluded in close succession to provide BAT with growth opportunities. A land mark acquisition came in 2003 when BAT acquired Ente Tabacchi Italiani, Italy's state tobacco company, thereby elevating BAT to the number two slot in Italy. This acquisition had come on the heels of an earlier one of Rothmans International in 1999 which had some presence in Burma (Glantz, 2000). Finally, in 2008 BAT acquired Turkey's state-owned cigarette maker Tekel (as cited in Glantz, 2000). In my commends about organic growt h for BAT, its veracious appetite for market penetration raised a lot of criticism from human rights groups particularly with the Rothmans International hence forcing BAT to sell its share of the factory in 2003 purportedly after an exceptional request from the British government (Mackey, Mackey and Barney, 2007). Advertising and promotion also marked another strategy employed by BAT since 2003. This strategy was

Why the Renaissance has been called the birth of modernity Essay

Why the Renaissance has been called the birth of modernity - Essay Example Renaissance was a powerful humanistic and cultural movement, which was featured with bright and cheerful expectations from the future. It was the time when people finally believed in own powers, so they had no insurmountable obstacles to the historical ascent to freedom, happiness and justice.Thus, as the Renaissance, the Modernism got its reputation of being the age of rebirth of exploration and learning. In contrast to the eclecticism with its interest to the reliability of the playback of national and historic art individual parts Modernism tried to revive the spirit of stylistic unity of artistic organisms. It was inherent to medieval or folk art, as well as to the Renaissance art. Abandoning from attempts to "reanimate" outdated academic standards by copying the styles of the past, modernist artists came to the new principles by shaping styling features of various eras and styles art. Through the understanding of the new designs and materials and as well as through using the ric h ornamentation of natural motifs, modern art brought not only ornamental beginning but also unprecedented rhythms, especially the mobility of nervous lines and shapes, and that incorporated all kinds of art of this period.So, as you can see, the effects of the European Renaissance were felt during the Modernity, as well as it is prevalent in contemporary society, when the cyber revolution is well underway following Machiavelli’s tenet of acceptance any means for achievement of desired purpose.

Metformin Essay Example | Topics and Well Written Essays - 750 words

Metformin - Essay Example Metformin needs not be used during surgery.Intake of metformin needs to be avoided before or after any surgery,e.g. Dental surgery. Doctor who is about to carry out the surgery should be provided with the knowledge of patient`s consumption of metformin.. Around 48 hours are prescribed by the doctor to wait for the medical procedure to start again. If any of the following symptoms is experienced by the patient after taking metformin then the doctor should be contacted immediately. Extreme tiredness, stomach ache, dizziness, fast or slow heartbeat, weakness, nausea, vomiting, deep and rapid breathing or shortness of breath; dizziness, lightheadedness, flushing of the skin; muscle pain or feeling cold. Consumption of alcohol needs to be mentioned too. The patient need not carry out heavy drinking. Use of alcohol may lead to development of lactic acidosis or may result in a rapid decrease in blood sugar.A geriatric patient is requested not to take metformin without the doctor`s prescript ion. The adult`s medical history is extremely important as the use of the metformin may lead to several unfortunate consequences, worsening the patient`s condition. Adults aging over 80 years old may develop a chance of life-threatening condition called lactic acidosis. If the geriatric patient has experienced stroke, diabetic ketoacidosis, or coma, heart, liver and kidney diseases.  If the following symptoms are experienced during the consumption of metformin, then the doctor should be visited soon.

Long Term Care Essay Example | Topics and Well Written Essays - 500 words

Long Term Care - Essay Example t is not that easy to get a long-term –care insurance so late, because the cost of insurance may be quite huge or insurers will reject applicant at age 60 for health reasons. Therefore, the best age to buy a long- term –care insurance is mid 50s. One of the reasons is that the price for insurance keeps growing from 3 to 4% each year. For example, a price for the long –term care insurance annually for a 55 year old man nowadays is approximately 1,032$. But, if he will wait until his 65s he will purchase insurance that will cost 2,770$ as it grows 5% per year. The other benefit of buying a long-term – care insurance at age 50s is that with time the risk of health problems increases. The insurers are quite strictly in writing their policies. The statistics from the American Association for Long Term Care Insurance shows that 25% of applicants at age of 60 to 69 were not offered an insurance cause of their health worsened. (American Association for Long-Term C are Insurance, 2014) Inflation protection. All long-term-care insurance must include a 5% compound per year to protect from the inflation. This is a quite important option as it helps to insure all benefits of insurance with the rising cost of living. Alternative plan of care benefits. This option allowed insuring of all additional requirements of the patient. This feature helps for patients receiving alternative supplies or services that were not included in benefits booklet. Benefit period. Accordingly, to the statistic from the US Department of Health and Human Services a person spends approximately 2.4 years in the nursing home. Therefore, patients are able to choose the duration of the benefit period accordingly to their health. 1. American Association for Long-Term Care Insurance.(2014). Whats The Best Age To Buy Long Term Care Insurance. American Association for Long-Term Care Insurance Online. Retrieved from

Technology and Interpersonal Relationships Essay

Technology and Interpersonal Relationships - Essay Example The fast-paced life of people today keeps human relationships on a standstill most of the time. The many things that occupy our time – family, school, building a career at work, etc., have made rushing from one place to another and always lacking time for everything common features in most people’s lifestyles. However, the human need to be connected to others is always present, and so people have turned to technology, specifically the internet, or mobile phones to fulfil this need. Family and friends have become more accessible and available in just a click of a button. The internet also offers a myriad of opportunities for meeting more people, relaxing with online games, sharing pictures and videos and an outlet to express innermost thoughts and feelings to share with others. The question of how technology affects interpersonal relationships is becoming a popular issue nowadays. The generation gap between the older people and the younger generation is broadening. Older people are accustomed to candid conversations with eye contact and are usually adept at reading body language and nonverbal gestures. The young people of today are very much into technological communication via texting, internet chatting, tweeting, etc. and are engaged with their mobile phones, Ipods, Ipads and other gadgets. When brought together, the older people may complain that the younger ones are lacking manners because they do not know how to give due attention to their companions. It is as if they live in their own worlds, with their gadgets as their gateway to reach their friends. Michael Bugeja’s book on the Interpersonal Divide meticulously describes how the technological age has affected humankind, most especially its humaneness in interacting with others. What prevail right now in terms of technology are computers, the internet, mobile phones, television, radio and other media paraphernalia. These things physically separate people from each other but provide a way for them to connect using technology. In Chapter 3, Bugeja explains how the proliferation of computer-mediated communication affects our views, expectations and interpersonal relationships. In computer-mediated communication, so many of our personhood becomes filtered that the communication lacks social cues. It then prevents the establishment of strong interpersonal collaboration and trust especially in cyber environments where invisibility is an option. Thus, when people chat online or send text messages, a lot of miscommunication may take place when the received messages are interpreted differently from how the sender meant it. This is because the text do not show people’s tone of voice, facial expression or non-verbal gestures which contribute to the clarity of the message sent. Media and technology saturate the lives of people with so many tasks they can do simultaneously and that makes them feel productive at a faster rate. When they log-out from the virtual world a nd re-join the real world, they may find it difficult to be accustomed to it for some time. The real world has three dimensions- up, down and breadth. It also offers intricate human sensations experienced in person. Bugeja also explains that interpersonal skills become the result of physical formats in the real world such as touch, eye contact, smell,

Case about International Commercial Arbitration Essay

Case about International Commercial Arbitration - Essay Example In the case of CalCo and IndCo, while disputes arose between them, CalCo filed a request for arbitration with ICC claiming various defaults and damages due to breaching contracts before attempting to resolve disputes inter alia. When IndCo filed suit in Mumbai High Court seeking inter alia with CalCo before the arbitration proceeding to be done and argued the contract was invalid or incapable of being performed the claimant filed a claim with California Federal Court to compel arbitration proceedings. IndCo responded saying that American court should wait until Mumbai court decides on the case and the contract has violated US antitrust laws. IndCo was still on the argument that the case is not arbitrable. According to the ‘arbitrational clause’ that both IndCo and CalCo agreed upon, each party has to appoint one arbitrator and the third one shall be appointed by Indian Chamber of Commerce, but this was not considered by ICC. Even though ICC tribunal decided that the case has close connection with Indian law and hence the contract is valid and awarded the claimant $ 2,000,000, the primary claims of IndCo that it is not arbitrable as according to their clause that an arbitration can be done only when both parties are unable to solve by negotiation, and secondly the appointment of arbitrators is not according to what both parties had agreed upon can be considered to be valid but this was not so considered by ICC. According to Article 10 of ICC (2008), â€Å"In the absence of such a joint nomination and where all parties are unable to agree to a method for the constitution of the Arbitral Tribunal, the Court may appoint each member of the Arbitral Tribunal and shall designate one of them to act as chairman. In such case, the Court shall be at liberty to choose any person it regards as suitable to act as arbitrator, applying Article 9 when it considers this appropriate† (p. 9).

Bordeaux Wine Region Essay Example for Free

Bordeaux Wine Region Essay Romans †¢ In the mid-1st century, they introduced wine to the Bordeaux Region to provide wine for local consumption, and wine production has been continuous in the region since then. †¢ the popularity of Bordeaux wines in England increased dramatically following the marriage of Henry Plantagenet and Eleanor of Aquitaine. The marriage made the province of Aquitaine English territory, and thenceforth the majority of Bordeaux was exported. †¢ Grave; Clairet †¢ Dutch traders drained the swampy ground of the Medoc in order that it could be planted with vines, and this gradually surpassed Graves as the most prestigious region of Bordeaux. Malbec was dominant grape here, until the early 19th century, when it was replaced by Cabernet Sauvignon. 12th century 17th century 1855 †¢ the chateaux of Bordeaux were classified; this classification remains widely used today. 18751892 †¢ almost all Bordeaux vineyards were ruined by Phylloxera infestations. The regions wine industry was rescued by grafting native vines on to pest-resistant American rootstock and all Bordeaux vines that survive to this day are a product of this action. This is not to say that all contemporary Bordeaux wines are truly American wines, as rootstock does not affect the production of grapes. 1936 †¢ the government responded to the appeals from the winemakers and stated that all regions in France had to name their wines by the place in which they had been produced. Labeled with the AOC approved stamp, products were officially confirmed to be from the region that it stated. Terminologies †¢ The Bordeaux Wine Official Classification of 1855 resulted from the 1855 Exposition Universelle de Paris, when Emperor Napoleon III requested a classification system for Frances best Bordeaux wines which were to be on display for visitors from around the world. Brokers from the wine industry ranked the wines according to a chateaus reputation and trading price, which at that time was directly related to quality. †¢ Cremant are produced using the traditional method, and have to fulfill strict production criteria. †¢ Grafting – or graftage, is a horticultural technique whereby tissues from one plant are inserted into those of another so that the two sets of vascular tissues may join together. †¢ Rootstock – is a plant, and sometimes just the stump, which already has an established, healthy root system, used for grafting a cutting or budding from another plant. †¢ Phylloxera is a pest of commercial grapevines worldwide, originally native to eastern North America. These almost microscopic, pale yellow sapsucking insects, related to aphids, feed on the roots and leaves of grapevines (depending on the phylloxera genetic strain). It gradually cutting off the flow of nutrients and water to the vine. Bordeaux Wine †¢ The major reason for the success of winemaking in the Bordeaux region is the excellent environment for growing vines. The geological foundation of the region is limestone, leading to a soil structure that is heavy in calcium. †¢ These rivers define the main geographical subdivisions of the region: ? The right bank, situated on the right bank of Dordogne, in the northern parts of the region, around the city of Libourne. ? Entre-deux-mers, French for between two seas, the area between the rivers Dordogne and Garonne, in the centre of the region. ? The left bank, situated on the left bank of Garonne, in the west and south of the region, around the city of Bordeaux itself. The left bank is further subdivided into: o Graves, the area upstream of the city Bordeaux. o Medoc, the area downstream of the city Bordeaux, situated on a peninsula between Gironde and the Atlantic. Climate and geography Red Grapes †¢ MERLOT Early-ripening Merlot is the most widelyplanted grape variety in Bordeaux. It expresses its full potential on cool soils, producing smooth wines with a great deal of color, roasted aromas, and flavors reminiscent of red fruit (such as plums) and figs after ageing in bottle for several years. Red Grapes †¢ CABERNET SAUVIGNON Cabernet Sauvignon is a traditional late-ripening local variety. The gravely soil of the Left Bank provides the necessary warmth for optimum ripening. This grape variety contributes structure to the wines as well as hearty tannins and a flavor profile including liquorice, black fruit (such as blackcurrant), and elegant aromas of forest floor with age. Red Grapes †¢ CABERNET FRANC Cabernet Franc ripens earlier than Cabernet Sauvignon. It is an excellent complementary grape variety that rarely makes up the majority of the final blend. It adds freshness, finesse, and aromatic complexity as well as hints of raspberry and violet. White Grapes †¢ SAUVIGNON BLANC Sauvignon Blanc, except in rare instances, is the most important variety for dry white wines. It provides the wines with the necessary acidity as well as minerality, aromatic freshness, and varietal aromas, such as citrus, boxwood, and fig leaves. White Grapes †¢ SEMILLON Semillon is the main grape variety for semi-sweet and sweet white wines and is almost always a component of dry white wines as well. It contributes roundness, richness, and apricot and honey aromas. When affected by  «noble rot », it develops an inimitable bouquet. White Grapes †¢ MUSCADELLE Muscadelle, which plays a secondary role in the blend for both dry and sweet white wines (generally no more than 10%), is a fragile but very interesting variety with musky floral overtones. Viticulture †¢ Bordeaux is a relatively humid region. Thus it is a place rife with diseases and other problems that afflict vines, compared with many of the worlds other wine regions, such as dry Chile or Australia. †¢ In Bordeaux, the pruning of the vine happens almost always as cane-pruning (as opposed to spur-pruning). There are two types of cane-pruning: guyot simple and guyot double. †¢ The use of chemicals and fertilizers has dropped in the recent decades in Bordeaux. Instead, the *lutte raisonnee method is gaining ground. †¢ When harvest time approaches the Bordeaux wine producers start getting anxious. Unlike many other wine regions, weather in Bordeaux is relatively unstable and sudden changes in weather can delay a harvest, force a harvest in bad weather (diluting the wine) or severely damage the harvest. †¢ In Bordeaux, hand picking is now common among the more prestigious chateaux. But while hand-picking is foremost, some classified chateaux still harvest by machine. Viticulture Hand-Picking †¢ the delicate and selective process of harvesting by hand is still the best way to secure a maximum quality harvest. †¢ One problem with manual harvesting is the sheer size of vineyards in Bordeaux (not to mention the labor cost of hand-picking), with tens of thousands of hectares needing harvesting within a few weeks. Mechanical harvesting †¢ flexibility: it makes possible harvesting at night, which is preferable during hot weather. †¢ The flatter geography of Bordeaux also allows for mechanical harvesting, whereas the steep slopes of wine-producing areas such as *Cote-Rotie make machine harvesting nearly impossible. Winemaking †¢ In Bordeaux, almost all wines are blended. Only a few producers make single-variety or varietal wines, though the lack of naming grape varieties on labels masks the fact. The typical blend consists of Merlot and Cabernet Sauvignon (and/or Cabernet Franc), with small additions of Petit Verdot and Malbec. Wine classification. †¢ There are four different classifications of Bordeaux, covering different parts of the region: ? The Bordeaux Wine Official Classification of 1855, covering (with one exception) red wines of Medoc, and sweet wines of Sauternes-Barsac. ? The 1955 Official Classification of St. -Emilion, which is updated approximately once every ten years, and last in 2006. ? The 1959 Official Classification of Graves, initially classified in 1953 and revised in 1959. ? The Cru Bourgeois Classification, which began as an unofficial classification, but came to enjoy official status and was last updated in 2003. However, after various legal turns, the classification was annulled in 2007. As of 2007, plans exist to revive it as an unofficial classification. Wine styles †¢ The Bordeaux wine region is divided into subregions including Saint-Emilion, Pomerol, Medoc, and Graves. The 60 Bordeaux appellations and the wine styles they represent are usually categorized into six main families, four red based on the subregions and two white based on sweetness: ? Red Bordeaux and Red Bordeaux Superieur ? Red Cotes de Bordeaux ? Red Libourne, or Right Bank wines ? Red Graves and Medoc or Left Bank wines ? Dry white wines ? Sweet white wines †¢ The name of estate -(Image example: Chateau HautBatailley) †¢ The estates classification -(Image example: Grand Cru Classe en 1855) This can be in reference to the 1855 Bordeaux classification or one of the Cru Bourgeois. †¢ The appellation -(Image example: Pauillac) Appellation dorigine controlee laws dictate that all grapes must be harvested from a particular appellation in order for that appellation to appear on the label. The appellation is a key indicator of the type of wine in the bottle. With the image example, Pauillac wines are always red, and usually Cabernet Sauvignon is the dominant grape variety. †¢ Whether or not the wine is bottled at the chateau (Image example: Mis en Bouteille au Chateau) or assembled by a Negociant. †¢ The vintage -(Image example: 2000). †¢ Alcohol content (Image example: 13% vol) Wine label †¢ http://en. wikipedia. org/wiki/Bordeaux_wine Credits †¢ http://www. bordeaux. com/us †¢ http://www. bordeaux-fete-levin. com/uk/programme/index2012uk. html THANK YOU! ?

Personal Ethics Essay Example for Free

Personal Ethics Essay Personal ethics comes from inside and are influenced by our everyday life and people around us. The directions we obtain as a child helps to form and begin our awareness of ethics. My upbringing memoirs and experiences instilled a well-built belief in family structure and significance of family in general. I was fortunate to be born and brought up in India in a traditional Roman Catholic family. My father was a doctor and he died of heart attack when I was ten years old. My mother was a registered nurse and I have three older brothers and one younger sister. My mother went to the Middle East to work as a nurse and had to leave us in a boarding school. I missed my mother a lot while I was in the boarding school. That was when I decided what I wanted to do. My only ambition was to become a nurse to be with my mother. I always used to watch my parents caring sick people. My parents constantly reminded me to live in Christian faith. They led us by example all the time, providing precious lessons vital to my development. My parents taught me to treat others as we would want them to treat us. I also learned from my parents that every person is important and we should love and respect them. I strive to live by those set of laws, though it is not always easy. My faith also influences my philosophy. I believe in God and God has a plan and purpose for every one of us. This is the basis of my ethical practices. Each individual cultivates different cultural, spiritual and personal values from their own life experiences which add to their worldview and philosophy of nursing in their practice. To me ethics is my own personal belief structure. Knowing our own personal values is critical to every person. My moral compass in nursing offers highest priority for the wellbeing of patients. My moral courage helps me to speak up, stand up for my personal belief and moral values and bring about change in my work place. The persona l and professional values, my relationship and behaviors to others and my morals help me succeed in my personal and professional life. Our conscience acts as a judge for each one of us. We are responsible for our actions. I believe that God is using me as a tool to care for the needy by providing me the knowledge and ability to promote healing. I also believe in the power of prayer. My patients used to tell me I am always smiling. I believe that it is the gift of God and being a nurse is, a calling not just a career. World view is a personal insight about meaning and reality. It helps the person to interprets, through his or her own eyes, a personal belief about the world. My personal worldview is shaped by my Christian religion, origin as an Indian, circumstances, experiences, and education and philosophy. I accept God as the center of the universe. I believe that I am a good mother for my three kids, faithful wife to my husband and an excellent nurse. I also believe in afterlife. I take pride in my profession. My nursing philosophy comes from my desire to care for others. I consider that nursing care is based on c oncrete evidence that is provided within a respectful framework. I always treat my patients the way I wanted to be treated if I am in that situation. Nurses are honored to interact with patients and families at some of the most vulnerable points in their lives. Being considerate of that vulnerability is important. Being respectful of my health care team is also important, as I consider that each of us play a fundamental role in the care of patients and families that we provide. I believe that God is using me as a tool to care for the needy by providing me the knowledge and ability to promote healing. It is essential for the nurses to understand their own selves so that they are able to take care of their patients better. I believe that spirituality plays an important role in the nursing profession. I think that the care of the soul is the beauty of the art of caring in nursing. The values such as integrity, responsibility, trust, reliability, and honesty are some of the personal values, which will determine how we face the world. Reliability and responsibility are very important to ones professional and personal life. Culture is something that a person learns from his family and surroundings, and is not inbuilt in him from birth. My upbringing as a Christian in Southern part of India, active participation in church activities and catholic schooling have helped me to value human dignity and assist me to take right decision in my personal and professional life. Awareness of different rules about how their members coexist with each other and interact with each other. Some cultures believe that discussing death, making a living will can invite death to the person who is ill. Looking at the life in different ways should be respected always (Runzheimer Larsen, 2011). Cultural diversity and differences in personal values can direct our relations with patients, family, and co-workers. Cultural competence is the ability to provide effective care for patients and families and our co- workers who come from different cultures. To understand different cultural beliefs and practices requires flexibility and a respect for others viewpoints . Ethical issues occur in everyday practices. An ethical dilemma is described as a type of situation that involves being in between two correct courses of action that leads the person to choose the right move and still be wrong at the same time (Purtillo, 2011). This can cause a lot of distress as it encompasses both ethical conflict and conduct. The ethical decision what we make should respect the patient and family desires, physician’s belief and concepts on life and death in our own view. Many situations arise in the critical care where nurses and doctors are obligated to make ethical decisions in a short period of time. Few years back I came across a situation in our ICU. A 90 year old woman from nursing home got admitted with history of multiple strokes with weakness on her right side, emphysema and difficulty in swallowing. She was demented also. Her admission diagnosis was aspiration pneumonia. She had two children and her son was the health care proxy who was living in C alifornia and he couldn’t come to visit her mother because of some personal situation. Patient’s daughter who was living locally was taking care of her. The daughter wanted to place the feeding tube and treat for every problem. We respected the daughter’s decision. We started her on antibiotics. We placed the feeding tube and and started feeding her. Day by day her respiratory status started deteriorating. The attending physician contacted the patient’s son over the phone and explained the patient’s condition in detail. Apparently, we found out from him that the patient had a living will that stated she did not want any feeding tube or even antibiotics in a situation where her quality of life was poor. Fortunately patient’s son came with her living will and our hospital ethics committee had a talk with her family especially the daughter. Because the patient’s wishes were clearly stated in the living will, she was made comfortable and transferred her to a private room to allow the family to be with her all the time and she died peacefully after one day. In this situation, the daughter wanted to treat her mother even though she knew about her wishes and she did not tell us anything about the patient’s living will. She was acting unrealistic in this situation. The decision was tough for the daughter in this situation. In my view the physician made the right choice to contact her son that put an end to her sufferings. Nurses can make satisfactory solutions to the different ethical problems through creative and knowledge based approach. Each nurse has the responsibility to optimize the caring response and reduce damage to the patient. .â€Å" Nurses are leaders and vigilant advocates for the delivery of dignified and humane care. Nurses actively participate in assessing and assuring the responsible and appropriate use of intervention in order to minimize unwarranted or unwanted treatment and patient suffering† (American Nurses Association, 2001). The significant impact we make in the lives of our patients and their families in their vulnerable situations and the positive encouragement I get from my nurse manager, co-workers, patients and families keeps me moving in my profession. References American Nurses Association (2001). Code of ethics for nurses with interpretive statements. Washington, DC. Retrieved from http://www.sfcc.edu/files/SFCC NursingStudentHandbook Purtilo, R., Doherty, R. (2011). Ethical dimensions in the health professions. (5th ed.). P (5-10) St.Louis, Missouri: Elsevier Saunders. Role of the Registered professional nurse. June 8, 2005. Retrieved on June 6, 2012 from http://www.nysna.org/practice/positions/position6.htm Runzheimer, J., Larsen, L. (2011). Medical ethics for dummies. (p. 113). NJ: WileyPublishing.

Theory of Deontology Analysis

Theory of Deontology Analysis Malik Jones This paper will argue why deontology is the most plausible ethical theory in my opinion. I will deliberate how should we live, how should we interpret the human condition, the most serious objections to this ethical theory, and how should one who holds this ethical theory respond to these objections. According to deontology, we should never inflict wrong onto anyone, or thing because no matter the circumstances, it will always be wrong. It does not matter if you are trying to save a trolley full of people hurtling down towards a group of workers by sacrificing one person, or if you are trying to steal two dollars from someone who has one million dollars, no matter the circumstance you shall never inflict damage to anyone no matter how big or small the matter, or the circumstances. In deontology, no matter what wrong you do, no matter the circumstance, whatever you do that inflicts damage to others or anything, it is immoral and you should feel deprived about the situation. People who have faith in deontology, or deontologist, think that morality is a matter of duty. People have moral responsibilities to do things that are right and moral duties not to do things that are immoral. Whether something is correct or incorrect doesnt depend on its penalties or magnitude. Rather, a deed is right or wrong in itself. The only thing that should drive human beings is the desire to do the right thing. Not money, power, material things, or even possibly doing things to achieve some sort of eternal life, but we should do the right thing, for no other reason, besides the fact that doing the right way is the right way or the only way. Kants claim is that the moral standing of our behavior is determined exclusively on the basis of the rightness and wrongness of the action itself. This means that it is unconditionally wrong too, for instance, self-defense, in all conditions, regardless of the consequences. For example, say there has been a case of armed robberies around your community by a group of ruthless criminals. Law enforcement also believes that this group of individuals have been bouncing from city to city and maybe even have had jobs in several other states, but they were not harming anyone who let them come in, take what they want, then leave.   Then one day, a group of people comes to your house late at night, while all of your family is asleep. The thieves came this late in the night expecting no one in the house to be awake. Little do they know that you are wide awake in your house a reach away from a twelve-gauge shotgun that can inflict enough damage with one or two shells to ensure that your family will remain safe and that no other family will have to suffer the wrath of these men. The only question left in the mind of a deontologist is that will you save your family and yourself or will you inflict damage to others, and if you let them just come and take whatever they want, then your family will be left with none of the means that you once had to survive on that you spent your life working on. This is one serious objection to deontology that pushes many people away from it, because most people will acknowledge that it is right to do the right time all the time for the sole sake of doing right, but they dont appreciate the fact that deontology requires no matter what you must always do the right thing no matter the circumstances because most people will want to save their family for the greater good if at all possible in this scenario for example. Just like in any great debate, though, ever objection can get counteracted which is certainly the case with even the most severe examples such as the one stated before. One might argue that if the father had time to hear and know they were coming, he had time to react without inflicting harm to the home invaders. He could have got his family and left the house before the invaders broke into the house. When the news hit that this group of people were now currently in their area, they should have come up with a signal to let everyone in the house know that the invaders were there and came up with a plan to evacuate and meet up somewhere to call the appropriate authorities. Or if evacuating wasnt an option, then contact the authorities and have faith that they will do their job to either stop the thieves in the act or catch them in a timely manner to restore your family to the way it was before they broke in. You also never know the circumstances that made them start to burglarize you, to begin with. Lets say that it is revealed that the group of individuals are all family members, and they have no health insurance, but their mother is terribly sick with cancer and they cant afford to get her the treatments that she drastically needs without committing these acts. If you kill them instead of giving them what they want, not only are you killing people that had no intention to kill you unless necessary, but you would also be killing a person who was in no way shape or form related to the crime that the guys were committing because she was completely unaware of what her family was doing to pay for her treatments. Deontology, while not perfect, gives the best explanation of the human condition and is the most plausible ethical theory out of all the lessons that we were taught in class. To me, while it may not be realistic in every single case, if society would look at life from a deontologist point of view, the world would be a much better place.

The Crown Of Diamond: Overview :: essays research papers

1. Author? Sir Arthur Conan Doil. 2. Setting? Baker Street, Threadneedle street, and Streathham in London England. 3. Identify the theme of your book? The theme is to never misjudge people until proven guilty. 4. Story? One morning, a well-known gentleman went into a bank in London, and was received immediately by Mr. Alexander Holder, head of the bank. He asked for a loan of fifty thousand Pounds. Mr. Holder asked him to present collateral to cover that large sum of money; the man showed him a crown that belongs to the country. Knowing the risk, Mr. Holder agreed to lend the gentleman that large sum of money if he pays it back in a few days. After the gentleman left Mr. Holder decided to keep the crown all the time near by him, so he took the crown to his home in Streatham. There he lived with his only son Arthur and his niece Mary who was an orphan. He told them about his story with the crown of diamonds. When the father was going to sleep, Arthur asked for two hundred pounds. He refused to give him thinking his son was spoiled by his rich friends who had nothing to do except watch horses. Before going to sleep, he went to check that all windows and doors were locked. He saw Mary at a side window at the hall. She closed it quickly, and Holder noticed that she looked anxious. After he went to sleep, he heard some noise that woke him up; he waited until he heard it again coming from his sitting room. He jumped out of his bed and saw his son holding the crown broken from the side and three diamonds were missing. In grief, he accused Arthur of being a thief and a liar. Meanwhile Mary came in and seeing the crown fainted. Arthur asked if he could leave for five minutes but Holder refused and called the police to take his only beloved son to jail. The police searched the house but could not find anything and advised Holder to get the help of Mr. Holmes the famous detective. Mr. Holder went to Mr. Holmes in a hysterical manner. He was calmed down and started to tell him his mystery. Then Holmes asked him whether any one visits them, no one replied Holder except for Arthur’s friend George Burnwell. He added that Mary does not go out of the house, which seemed strange for a young lady but her uncle thought of her as a pleasant and quite girl, and thought of his son of being guilty.

black holes :: essays research papers

The Search for Black Holes: Both as a Concept and An Understanding for age’s people have been determined to explicate on everything. Our search for explanation rests only when there is a lack of questions. Our skies hold infinite quandaries, so the quest for answers will, as a result, also be infinite. Since, its interception, Astronomy as a science speculated heavily upon discovery, and only came to concrete conclusions later with closer inspection. Aspects of the skies which at one time seemed like reasonable explanations are now laughed at as egotistical ventures. Time has shown that as better instrumentation was developed, more accurate understanding was attained. Now it seems, as we advance on scientific frontiers, the new quest of the heavens is to find and explain the phenomenon known as a black hole. The goal of this paper is to explain how the concept of a black hole came about, and give some insight on how black holes are formed and might be tracked down in our more technologically advanced future. Gaining an understanding of a black hole allows for a greater understanding of the concept of space time and maybe gives us a grasp of both science fiction and science fact. Hopefully, all the clarification will come by the close of this essay. A black hole is probably one of the most misunderstood ideas among people outside of the astronomical and physical communities. Before an understanding of how it is formed can take place, a bit of an introduction to stars is necessary. This will shed light on the black hole philosophy.   Ã‚  Ã‚  Ã‚  Ã‚  A star is an enormous fire ball, fueled by a nuclear reaction at its core which produces massive amounts of heat and pressure. It is formed when two or more enormous gaseous clouds come together which forms the core, and as an aftereffect the conversation, due to that impact, of huge amounts of energy from the two clouds. The clouds come together with a great enough force, which a nuclear reaction ensues. This type of energy is created by fusion wherein the atoms are forced together to form a new one. In turn, heat in excess of millions of degrees Fahrenheit is produced. This activity goes on for eons until the point at which the nuclear fuel is exhausted. Here is where things get interesting. For the entire life of the stars, the nuclear reaction at its core produced an enormous outward force.

Hcs/455 Health Care Policy; the Past and the Future Hiv Aid in Women

HIV/AIDS in Women HCS/455 HIV/AIDS in Women HIV and AIDS medically known as Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) are spreading within the United States among women and young girls at an astounding rate. It is imperative that women and girls comprehend the issues, data, and trends associated with living with these diagnoses. December 2010, one in four individuals living with a medical diagnosis of the HIV infection within the United States was women (CDC, 2013).The percentage of HIV cases in 1985 was at 8%, and rose to 25% by the end of 2010 (CDC, 2013) HIV/AIDS diagnosis in women represent over half of all adults living in the United States with one of these medical conditions (Kaiser Family Foundation, 2007). Transmission of HIV/AIDS in Women The epidemic and rate of transmission of HIV/AIDS is continually growing within the United States and the impact it has on women is profound. The main source of transmission of HIV/AIDS in women is t hrough heterosexual intercourse.According to the statistics from the Kaiser Family Foundation HIV/AIDS transmission has increased to 31% in 2005 from 3% in 1985 (Kaiser Family Foundation, 2007). Women between the ages of 13 to 19 are 50% more likely to acquire the diagnosis of HIV/AIDS. The increased number of young women diagnosed with HIV has resulted in more women with the diagnosis of AIDS between the ages of 24 and 44. This means most women received her HIV diagnosis at a very young age (Kaiser Family Foundation, 2007).African American women with HIV/AIDS The numbers have increased at a very high rate in African American women diagnosed with HIV/AIDS. The diagnosis of HIV/AIDS elevated in women of African American decent dwelling in the United States (Kaiser Family Foundation, 2007). However, the Centers for Disease Control and Prevention (CDC) estimated the year ending in 2010, that women of color diagnosed with HIV/AIDS decreased (CDC, 2013). There was a time that HIV infecti on was one of the prominent causes of demise among African American omen between the ages of 25 to 34 and third with African American woman aged 34 to 44 residing in the United States. . The African American women diagnosed in 2005 were 20 times more than White women (Rose, Sharpe, Raleigh, Reid, Foley, and Cleveland, 2008). The health care industry is attempting to obtain a solution to the increased incidents of HIV/AIDS in women of color as well as the lack of medical care. Policy Recommendations by the CDC to revamp guidelines associated with HIV testing to promote this as a product of routine health care prevention (CDC, 2013).The CDC recommends that every woman receive routine HIV screenings no matter the age, and every pregnant woman within her third trimester (Kaiser Family Foundation, 2007). Signing the Affordable Care Act by President Obama affords HIV/AIDS patients to obtain early treatment and preventative care. Another positive attribute of the Affordable Care Act is tha t health insurance companies cannot deny care to patients for any pre-existing condition, so women will obtain treatment even though the condition is pre-existing (Sharp, Khaylis, Kamen, Lee & Gore-Felton, 2010). ConclusionThe women and young girls who live with HIV and AIDS (AIDS) spread at an astounding rate within the United States. It is imperative that women and girls understood the issues, data, and trends associated with living with those diagnoses. By December 2010, one in four individuals was living with a medical diagnosis of the HIV within the United States was women (CDC, 2013). The percentage of HIV cases in 1985 was at 8%, and rose to 25% by the end of 2010 (CDC, 2013) HIV/AIDS diagnosis in women represented over half of all adults living in the United States with one of these medical conditions (Kaiser Family Foundation, 2007).References CDC. (2013). Centers of Disease Control and Prevention. HIV Among Women http://www. cdc. gov/hiv/topics/women/ Kaiser Family Foundat ion. (2007). Women and HIV/AIDS in the United States. Retrieved from http://www. kaiseredu. org/Tutorials-and-Presentations/Women-and-HIV-in-the-US. aspx Rose, M. , Sharpe, T. , Raliegh, K. , Reid, L. , Foley, M. , & Cleveland, J. (2008). An HIV/AIDS crisis among African American women: a summary for prevention and care in the 21st century.Journal of Women's Health (15409996), 17(3), 321-324. Retrieved from EBSCOhost. Sharp, S. , Khaylis, A. , Kamen, C. , Lee, S. , ; Gore-Felton, C. (2010). A Review of Psychosocial Factors that Facilitate HIV Infection among Women Living in Canada ; the United States: Implications for Public Health Policy. Women's Health & Urban Life, 9(2), 63-79. Retrieved from EBSCOhost.

The importance of the meaning and measurement of “affordable” in the Affordable Care Act Essay

Affordable Care Act Introduction   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The purpose of this paper is to research about the general health care condition of the United States citizens. The paper also argues about the advantages of individual payment of health insurance as opposed to compulsory insurance. Financial benefits of obamacare affordable care Act are also illustrated throughout the paper. The paper also illustrates about the rising costs of health care in United States where the US has the highest healthcare expenditure globally. The U.S healthcare system is also compared with other systems adopted by other developed countries to show the pros and cons of the United States system. The paper describes also about PPACA and how it solves many serious challenges which are faced by the small business owners such as lack of affordable coverage, rising health insurance costs, limited choice of health plans and escalating costs of health care.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Affordable care Act refers to the healthcare reform law in the United States. It is aimed at making health insurance and healthcare to be more available and more affordable to more American citizens. The act does this by new regulations, new rules and consumer protections the industry of healthcare, through establishing a marketplace purposed for insurance which is subsidized and also by expanding and reforming public programs on healthcare programs such as Medicaid and Medicare. Affordable care Act also incorporates measures which are aimed at reducing healthcare spending in United States. Many American citizens are unaware that since 2010 when the Affordable care Act became into law after being signed they have been enjoying from the protections, rights and benefits of obamacare (Faria, 2012). Before this Affordable care Act many small businesses and low and middle income earning American citizens found it challenging to afford healthcar e for their families and also for themselves (Burkhauser & Lyons, 2011). In the past the many sick people were denied health treatment or coverage with diminutive right for appealing. Insurance companies charged individuals more on basis of their health status where women were required to pay higher rates. Affordable care Act entails provisions which are aimed at solving all these challenges. Obamacare gives rise to clear financial benefits for all stakeholders: the government, the individual and the insurance companies. BODY Macroeconomic angle Non –return on high healthcare expenditure America’s high healthcare expenditure   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   United States expenditure on health care is very high becoming a great concern however it is the medical expenditure growth rate and not its level which determines the financial security of United States. United States expenditure exceeds one -sixth of the economy of the country and the percentage keep rising every year. Unfortunately, this system does not deliver value to match the annual health care expenditure totaling to approximately 2.7 trillion dollars. Experts claims that approximately 20% to 30% of that spending which totals to about 800 billion dollars annually is spent on care that is inefficient, redundant and wasteful (Miller, 2001). This rise in healthcare expenditure harms the country in many ways. For seniors and families, the increasing medical care cost means increased expenses making them to make hard choices regarding to rent, needed care and balanced food. For the local, state and federal governments, increasing health costs result to higher Medicaid and Medicare costs, and decreased funding on key priorities like education, public safety and infrastructure (Oberlander, 2012). For the fortune 500 employers and small businesses these costs makes it challenging for them to add new workers, maintain retiree coverage becomes a great challenge for them and they are unable to compete in world economy. The net outcomes of increasing health care costs are ominous and far –reaching: increased costs for health insurance, erosion of global competitiveness, fraying of nation’s safety net and fiscal insolvency which is long-standing. Although health reform law has made important steps in spreading out coverage, more efforts should also be directed to reducing the increasing healthcare cost (Sade, 2012). Comparison with other developed nations   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   U.S health care expenditure is the highest compared to other nations yet the American citizens experiences more illnesses and die sooner compared to citizens from other developed countries. United States is ranked 37th position out of 191 nations according to the world health organization (WHO) health care systems rankings. This means that despite the fact that the united states citizens spends a lot of money on healthcare and the cost is still increasing however they are offered product which is ranked 37th position in quality. When comparing United States with other nations which are developed, it is evident that America performs poorly on infant mortality and life expectancy. Also United States tops list of deaths which are perceived to be preventable when diagnosed early and adequate early care is administered. Typical American citizen has very few doctor appointments annually compared to citizens from other nations but yet spends more for this privilege. When U.S citizen is admitted one day in a hospital, it would 5.6 times more when compared to what it would cost a Japan citizen. Also United States top all other developed nations in healthcare cost where it spends 8,233 dollars more per individual annually than other developed nations, although 47 million of those U.S citizens are still uninsured ( Hodge, Arias and Ordell, 2011).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The figure $8,233 per citizen annually spent by united states is over two and a half times more compared to what other developed countries spend per citizen annually globally including Europeans nations which are relatively rich such as united kingdom, Sweden and France. On an advanced global scale, it is clear that health care costs of United States represents 17.6% of the nation’s GDP.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   According to reports from OECD (organization for Economic Co-operation and Development) which is an international economic group which consists of 34 member countries, American citizens are not getting what they expect.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   United States has fewer physicians per individual compared to most other OECD nations. For example United States had 2.4 physicians per 1000 citizens in 2010 which is below 3.1 which is OECD average. In 2009, the hospital beds number in United States was 2.6 per 1,000 individuals which is lower than 3.4 beds which is OECD average.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Between 1960 and 2010, Life expectancy in the U.S increased by approximately nine years however those years were few compared to Japan where there was an increase of 15 years and also it was below 11 years which the average in OECD nations. Also, in 2010 the average U.S citizen lived 78.7 years which is below 79.8 years which is the average.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   However, United States tops globally in the cancer treatment and health care research, for example. The breast cancer survival rate is very high in United States compared to other OECD nations and also U.S is among the best in survival from colorectal cancer. The poor general health condition of American citizens   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   United States citizens spend a lot of money on healthcare and the cost is still increasing however they are offered product which is ranked 37th position in quality. This means that Americans are offered poor general health care. U.S healthcare system does not deliver value to match the annual health care expenditure totaling to approximately 2.7 trillion dollars. Experts claims that approximately 20% to 30% of that spending which totals to about 800 billion dollars annually is spent on care that is inefficient, redundant and wasteful. Also United States tops list of deaths which are perceived to be preventable when diagnosed early and adequate early care is properly administered.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The leading cause of disability and death in United States is the chronic diseases. They lead to 7 out of 10 deaths annually. Stroke, cancer and heart disease leads to more than 50% of all deaths annually.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Out of 107 million American citizens approximately 1 out of every 2 adults aged 18 or much older had at least 1 of 6 reported chronic ailments which includes asthma, arthritis, diabetes, cancer, cardiovascular disease and chronic obstructive pulmonary disease. Typical American citizen has very few doctor appointments annually compared to citizens from other nations but yet spends more for this privilege. When U.S citizen is admitted one day in a hospital, it would 5.6 times more when compared to what it would cost a citizen from other nations. When comparing United States with other nations which are developed, it is evident that America performs poorly on infant mortality and life expectancy. United States has fewer physicians per individual compared to most other OECD nations. In 2009, the hospital beds number in United States was 2.6 per 1,000 individuals which is lower than 3.4 beds which is OECD average. These facts from various resea rches shows that American citizens experiences poor general health condition despite the fact that they spend the highest amount on healthcare but they end up getting poor quality compared to other developed countries. Therefore, it is evident that despite the fact that although America is among wealthiest countries globally however, it is far from becoming the healthiest nation (Sage, 2011). The nine health domains studied by Committee on Population, and Board on Population Health and Public Health Practice. When United States is compare with peer nations which are average America is ranked poorly in the following nine health domains. Adverse birth results: For many years America has experience huge infant mortality rate of high income nations and also ranked poorly on other birth results, like low birth weight. Kids in America are unlikely to live to age 5 compared to kids in other nations with high incomes. Injuries and homicides: Violence, deaths emanating from motor vehicle accidents and injuries which are not related to transportation occur at much more commonly in U.S than in other nations and are a primary cause of deaths in kids, young adults and adolescents. Since 1950s, Young adults and adolescents in United States have died at an alarming rate from homicide and traffic accidents than in other nations. Sexually transmitted infections and Adolescent pregnancy: since 1990’s , among all the developed nations the united states adolescents have had high chances of acquiring infections which are sexually transmitted and also have the highest number of pregnancies. HIV and AIDS: America is the second leading nation among 17 peer nations with high pervasiveness of HIV infection. Drug-related mortality: united states lose more life years to alcohol and also other drugs compared to individuals from peer nations, even after excluding deaths emanating from drunk driving. Diabetes and Obesity: For many years America has experienced the highest rates of obesity among the developed nations. High occurrence rates for obesity are experienced in United States kids and also in every age group subsequently. From 20 years onward the adults in America have among the highest occurrence rates of diabetes among peer nations. Heart disease: Death rate in America emanating from ischemic heart disease is second leading among the 17 peer nations. Citizens from united states attain age 50 with less favorable cardiovascular risk profile compared with their peers in Europe and also adults aged over 50 years have higher chances of developing and dying from cardiovascular disease compared to older adults in developed nations. Chronic lung disease: Lung disease are more common and linked with high mortality rates in America compared to UK and other European nations. Disability: older adults in United States depicts higher occurrence of activity limitations and arthritis compared to their counterparts in Japan, UK and other European nations (Sade, 2012). Comparison with other developed nations   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   For many years, Violence, deaths emanating from motor vehicle accidents and injuries which are not related to transportation occur at much more commonly in U.S than in other nations and are a primary cause of deaths in kids, young adults and adolescents. Since 1950s, Young adults and adolescents in United States have died at an alarming rate from homicide and traffic accidents than in other nations.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   America has experience huge infant mortality rate of high income nations and also ranked poorly on other birth results, like low birth weight. Kids in America are unlikely to live to age 5 compared to kids in other nations with high incomes (Majette, 2011).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   since 1990’s , among all the developed nations the united states adolescents have had high chances of acquiring infections which are sexually transmitted and also have the highest number of pregnancies.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   America is the second leading nation among 17 peer nations with high pervasiveness of HIV infection. united states lose more life years to alcohol and also other drugs compared to individuals from peer nations, even after excluding deaths emanating from drunk driving.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   For many years America has experienced the highest rates of obesity among the developed nations. High occurrence rates for obesity are experienced in United States kids and also in every age group subsequently. From 20 years onward the adults in America have among the highest occurrence rates of diabetes among peer nations.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Death rate in America emanating from ischemic heart disease is second leading among the 17 peer nations. Citizens from united states attain age 50 with less favorable cardiovascular risk profile compared with their peers in Europe and also adults aged over 50 years have higher chances of developing and dying from cardiovascular disease compared to older adults in developed nations.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Lung disease is more common and linked with high mortality rates in America compared to UK and other European nations.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Older adults in United States depicts higher occurrence of activity limitations and arthritis compared to their counterparts in Japan, UK and other European nations (Sade, 2012). Financial justification for system overhaul   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   United States healthcare system in not universal, where some people benefits more from the system compared to others. This system does not deliver value to match the annual health care expenditure totaling to approximately 2.7 trillion dollars. The Experts claims that approximately 20% to 30% of that spending which totals to about 800 billion dollars annually is spent on care that is inefficient, redundant and wasteful. United States top all other developed nations in healthcare cost where it spends 8,233 dollars more per individual annually than other developed nations, although 47 million of those U.S citizens are still uninsured. This necessitates an overhaul of the entire healthcare system which is both complex and gigantic. When comparing America healthcare system to Dutch system there are many improvements that are required in order for the US system to be successful. Some of these improvements should be trying to make it transparent and simpler for consumers to purchase health insurance easily through aggressive regulation of the insurance marketplace in such a manner that the products are universal.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Obamacare has four types of fundamental insurance packages which includes platinum, gold, silver and bronze. Dutch system has just one type of package for fundamental insurance. The system should not discriminate some applicants by charging them higher premiums depending on their age, health status, gender and just like Dutch system they should charge all the applicants the same price. Under the obamacare system the older applicants are supposed to pay three times as much in terms of premiums than the young ones. This means in obamacare system an applicant is supposed to input and then verify their age in order for their charge to be determined.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The system in US should be modified to be transparent where consumers should be allowed to compare prices and buy insurance through private sector portal websites instead of government run website. This will led to an aggressive way of restructuring and regulating the private sector industry as consumers will be able to compare the prices and decide which insurance to buy thus reducing consumer exploitation and increasing transparency. In this way the government will be able to reduce the rising healthcare costs and the number of the insured citizens will increase (Pipe, 2013). Microeconomic angle: Opposing views and rebuttals The individual’s point of view The individual mandate: compulsory insurance Opposing view: compulsory insurance places financial burden on citizens   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Universal healthcare system where compulsory insurance is introduced to everyone would do more harm to the citizens due to the financial burden it would implicate to the citizens. This would give the insurance companies a chance to increase the premiums since government will not be able to cover everyone where some people will be coerced to purchase insurance from the private sector insurance companies since it is a compulsory insurance. The poor and low income earners would be required to dig deep into their pockets and purchase the insurance despite the fact that insurance premiums are rising. During presidential campaign in 2008, president Barrack obama who was then a Democrat senator assured American citizens to improve the health care where he claimed that 47 million American citizens were not in a financial position to afford health insurance. He instead advocated for creation of government run, federally administered health care sys tem where people would pay individually for their health care and insurance instead of compulsory insurance which overburdened the poor. He also explained that people could be offered subsidized government coverage making insurance affordable to many. Requiring for citizens to buy mandatory health care insurance from private companies at any price they decide to charge will be directly overburdening the citizens while promoting the insurance industry. This is because insurance premiums rise faster than income thus reducing the disposable income of the citizens.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   For the poor and those who earn low incomes they will be forced to choose low premium plans which have high deductibles and co-payments. This is because they cannot afford the best plans due to high premiums. Therefore many poor citizens will be left with healthcare insurance which is unaffordable to use but they are mandated to purchase such insurance anyway         Compulsory insurance is extremely regressive and in some cases the mandated insurance plus the co-payments can add up to almost a third of the income which is a great financial burden to the citizensRebuttal 1: The ‘health promotion’ theory of insurance   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Health promotion refers to the approach of allowing people to increase power over the health determinants thus improving their health. It is the most sustainable, efficient, effective and ethical approach to attaining good health.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   PPACA invests in research to identify relative value of healthcare procedures.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   PPACA solves many serious challenges which are faced by the small business owners such as lack of affordable coverage, rising health insurance costs, limited choice of health plans and escalating costs of health care. PPACA is highly popular as the most fundamental health care legislation since establishment of Medicaid and Medicare about 10 years ago. The act was enacted in 2010 and it was aimed at taking effect in phases in a period of 8 years and incorporates reforms like expansion of Medicaid eligibility, subsidizing of insurance premiums, providing businesses with incentives to offer health care benefits and prohibiting the insurers from denying some applicants coverage for the pre-existing conditions. It persuades states to introduce exchanges of health care where small businesses and adults who are uninsured can purchase insurance from a variety of the private insurers. One element of PPACA is promoting comparative effectiveness res earch. This is aimed at comparing treatment options which are available. The core benefit of PPACA is to reduce the number of the uninsured individuals and providing them with high value healthcare (Gray & Sullivan, 2011). It uses a mixture of subsidies, tax credits and mandates in encouraging people and corporations on buying coverage and also it protects applicants who are hard to insure including those who possess conditions which are pre-existing. Other elements of legislation will be aimed at encouraging evidence based decision making and improving healthcare practices. United States tops globally in the cancer treatment and health care research by PPACA, for example. The breast cancer survival rate is very high in United States compared to other OECD nations and also U.S is among the best in survival from colorectal cancer thus ensuring high value healthcare. The comparative effectiveness research (CER) involves a board which lowers overall expenditure through determining whic h procedures, treatments and medicines which are most perfect, their price tags and identifying those who ignore justifying identifying the evidence based health benefits. Through PPACA as the acknowledgement Medicare has been successful in rewarding certain health coverage providers and punishes some providers on basis of value of care. Through PPACA Medicare is required to measure performance and change payments of providers on basis of scoring system in its current value based purchasing program (Skocpol, & Williamson, 2011). PPACA promotes consumption of ‘high value’ healthcare.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The core benefit of PPACA is to reduce the number of the uninsured individuals and providing them with high value healthcare. It uses a mixture of subsidies, tax credits and mandates in encouraging people and corporations on buying coverage and also it protects applicants who are hard to insure including those who possess conditions which are pre-existing. Other elements of legislation will be aimed at encouraging evidence based decision making and improving healthcare practices. Through PPACA as the acknowledgement Medicare has been successful in rewarding certain healthcare providers and punishes some providers on basis of value of care. PPACA solves many serious challenges which are faced by the small business owners such as lack of affordable coverage, rising health insurance costs, limited choice of health plans and escalating costs of health care. Through PPACA Medicare is required to measure performance and change payments of provid ers on basis of scoring system in its current value based purchasing program. PPACA is highly popular as the most fundamental health care legislation since establishment of Medicaid and Medicare about 10 years ago. The act was enacted in 2010 and it was aimed at taking effect in phases in a period of 8 years and incorporates reforms like expansion of Medicaid eligibility, subsidizing of insurance premiums, providing businesses with incentives to offer health care benefits and prohibiting the insurers from denying some applicants coverage for the pre-existing conditions. It persuades states to introduce exchanges of health care where small businesses and adults who are uninsured can purchase insurance from a variety of the private insurers. One element of PPACA is promoting comparative effectiveness research. This is aimed at comparing treatment options which are available. The comparative effectiveness research (CER) involves a board which lowers overall expenditure through determin ing which procedures, treatments and medicines which are most ideal, their price tags and identifying those who ignore justifying identifying the evidence based health benefits. United States tops globally in the cancer treatment and health care research by PPACA, for example. The breast cancer survival rate is very high in United States compared to other OECD nations and also U.S is among the best in survival from colorectal cancer thus ensuring high value healthcare (Kotlikoff, 2007). Rebuttal 2: The ‘financial security’ model of health insurance   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Individual’s financial risk due to unforeseen illness   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Insurance companies play a great role in managing the risk of individuals. These companies enable individuals to share their liability through pooling the personal risk and assist them through reducing chances of facing financial desolation. Due to many risks that individuals faces on a daily basis, these insurance companies have advanced over the years to meet the needs of the average human beings and have come up with different products and policies which covers almost entire risks. These companies normally provide financial coverage of loss that a certain person is expected to suffer as a result of unforeseen events thus reducing the effects of a certain event. They compensate the financial damage and people whose peril can be pooled. An individual who want to be insured is expected to pay a premium which is dependent on the probability of the event occurring where high probabilities will lead to high premiums. In a case of health insur ance the insurance is able to insure individuals through pooling the risk of illness. The health care cost is easily balanced in the pool since some individuals go through life devoid of catching a cold whereas others have to spend many dollars for treatment. The act of pooling the peril with other individuals is a prudent decision since no individual is able to predict what their health will be, and also how much they will have to pay in order to be treated. It is therefore advisable for individuals to pay for their individual health insurance to avoid financial challenges that may face them in case of unforeseen illness (Woolf & Aron, 2013)   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The escalating costs of health insurance prior to PPACA.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   PPACA solves many serious challenges which are faced by the small business owners such as lack of affordable coverage, rising health insurance costs, limited choice of health plans and escalating costs of health care. The core benefit of PPACA is to reduce the number of the uninsured individuals and providing them with high value healthcare. It uses a mixture of subsidies, tax credits and mandates in encouraging people and corporations on buying coverage and also it protects applicants who are hard to insure including those who possess conditions which are pre-existing. Other elements of legislation will be aimed at encouraging evidence based decision making and improving healthcare practices. Before PPACA the health insurance costs were very high and still escalating year after year. This was as a result of requiring citizens to buy mandatory health care insurance from private companies at any price they decide to charge which directly ov erburdening the citizens while promoting the insurance industry. This made insurance premiums to rise faster than income thus reducing the disposable income of the citizens. The number of uninsured Americans was very high where 47 million American citizens were not in a financial position to afford health insurance. President obama was against this and he launched PPACA aimed at reducing the escalating health insurance costs. He also advocated for creation of government run, federally administered health care system where people would pay individually for their health care and insurance instead of compulsory insurance which overburdened the poor. He offered subsidized government coverage making insurance affordable to many. PPACA reduced the rising costs of health insurance which resulted to increased number of people who were insured (Hofer, Abraham, & Moscovice, 2011). Cost-sharing requirements under older health insurance regime.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   There was a universal insurance regime where every person was supposed to be responsible for his or her health insurance. This regime required citizens to buy mandatory health care insurance from private companies at any price they decide to charge which directly overburdening the citizens while promoting the insurance industry. This made insurance premiums to rise faster than income thus reducing the disposable income of the citizens. The number of uninsured Americans was very high where 47 million American citizens were not in a financial position to afford health insurance. The insurance market place was not controlled by government which gave the insurance companies a chance to raise the premiums. Every individual was required to be covered where those who did not have a cover were faced by financial fines. Non-insurance or under-insurance as result of the above   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   This healthcare coverage approach made many people who were unable to pay the good plans to opt for the buying covers that were not helpful to them just because they wanted to fulfill the requirement. Many other people were unable to purchase any cover as a result of increased premiums as a result of uncontrolled insurance marketplaces. Also, most of the people were under insured due to financial constraints. This made many people in reality to be non -insured since the covers they purchased could not be used to compensate them during an event of illness. Also those who were under insured were not able to get fully compensation in an event of illness. Therefore, this led to poor general healthcare situation for many citizens (Hoffman, 2011).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   PPACA places reasonable limits on financial insecurity due to health hazards   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   PPACA is aimed at reducing the number of the uninsured individuals and providing them with high value healthcare. It uses a mixture of subsidies, tax credits and mandates in encouraging people and corporations on buying coverage and also it protects applicants who are hard to insure including those who possess conditions which are pre-existing. Other elements of legislation will be aimed at encouraging evidence based decision making and improving healthcare practices. Through PPACA as the acknowledgement Medicare has been successful in rewarding certain healthcare providers and punishes some providers on basis of value of care. PPACA solves many serious challenges which are faced by the small business owners such as lack of affordable coverage, rising health insurance costs, limited choice of health plans and escalating costs of health care. Through PPACA Medicare is required to measure performance and change payments of providers on basis of scoring system in its current value based purchasing program. PPACA is highly popular as the most fundamental health care legislation since establishment of Medicaid and Medicare about 10 years ago. The act was enacted in 2010 and it was aimed at taking effect in phases in a period of 8 years and incorporates reforms like expansion of Medicaid eligibility, subsidizing of insurance premiums, providing businesses with incentives to offer health care benefits and prohibiting the insurers from denying some applicants coverage for the pre-existing conditions. It persuades states to introduce exchanges of health care where small businesses and adults who are uninsured can purchase insurance from a variety of the private insurers (Hoffman, 2011).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The comparative effectiveness research (CER) involves a board which lowers overall expenditure through determining which procedures, treatments and medicines which are most ideal, their price tags and identifying those who ignore justifying identifying the evidence based health benefits. United States tops globally in the cancer treatment and health care research by PPACA, for example. The breast cancer survival rate is very high in United States compared to other OECD nations and also U.S is among the best in survival from colorectal cancer thus ensuring high value healthcare. One element of PPACA is promoting comparative effectiveness research. This is aimed at comparing treatment options which are available (Sade, 2012). Financial relief to the individual   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Insurance companies enable individuals to share their liability through pooling the personal risk and assist them through reducing chances of facing financial desolation. They play a great role in managing the risk of individuals and providing financial relief to individuals who are faced by a calamity which they had insured. These Due to many risks that individuals faces on a daily basis, these insurance companies have advanced over the years to meet the needs of the average human beings and have come up with different products and policies which covers almost entire risks. These companies normally provide financial coverage of loss that a certain person is expected to suffer as a result of unforeseen events thus reducing the effects of a certain event. They compensate the financial damage and people whose peril can be pooled. An individual who want to be insured is expected to pay a premium which is dependent on the probability of the ev ent occurring where high probabilities will lead to high premiums. In a case of health insurance the insurance is able to insure individuals through pooling the risk of illness. The health care cost is easily balanced in the pool since some individuals go through life devoid of catching a cold whereas others have to spend many dollars for treatment. The act of pooling the peril with other individuals is a prudent decision since no individual is able to predict what their health will be, and also how much they will have to pay in order to be treated. It is therefore advisable for individuals to pay for their individual coverage to avoid financial challenges that may face them in case of unforeseen event. Rebuttal 3: The ‘brute luck’ theory of health insurance   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Underwriting; Insurers’ discrimination on the basis of unavoidable risk factors, resulting in high insurance costs   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The insurance companies look at many determinants when determining the premiums to be paid by the applicant for them to be covered for a certain risk. Some applicants are supposed to pay higher premiums due to their health status, gender, race, religion, national origin, age among other factor. For instance, older adults are asked to pay higher premiums by health insurance providers than the premiums expected for young adults and kids. In this regard the insurers charge different premiums depending with groups on basis of their risk. These health coverage providers categorize their insureds into different risk pools on basis of their differences in their risk probabilities (Hoffman, 2011). PPACA prohibits above-mentioned discrimination   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   PPACA is against these discriminatory laws and requires the coverage providers to stop this discrimination and charge the applicants fairly without considering their pre-conditions. It protects applicants who are hard to insure including those who possess conditions which are pre-existing from this discrimination. This is aimed at ensuring that no one is penalized for their propensities and genetics or for factors and events which are beyond their control (Hoffman, 2011). Financial relief to the ‘unlucky’ individual   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Insurance companies play a great role in managing the risk of individuals and providing financial relief to unlucky individuals who are faced by a calamity which they had insured. This is because they enable individuals to share their liability through pooling the personal risk and assist them through reducing chances of facing financial desolation. As a result of many risks that individuals faces on a daily basis, these insurance companies have advanced over the years to meet the needs of the average human beings and have come up with different products and policies which covers almost entire risks. These companies normally provide financial coverage of loss that a certain person is expected to suffer as a result of unforeseen events thus reducing the effects of a certain event. They compensate the financial damage and people whose peril can be pooled. An individual who want to be insured is expected to pay a premium which is dependent on the probability of the event occurring where high probabilities will lead to high premiums. In a case of health insurance the insurance is able to insure individuals through pooling the risk of illness. The health care cost is easily balanced in the pool since some individuals go through life devoid of catching a cold whereas others have to spend many dollars for treatment. The act of pooling the peril with other individuals is a prudent decision since no individual is able to predict what their health will be, and also how much they will have to pay in order to be treated. It is therefore advisable for individuals to pay for their individual coverage to avoid financial challenges that may face them in case of unforeseen event. This is because if they are unlucky they will be provided with financial relief by their health insurance providers (Hoffman, 2011).. The insurers’ point of view Opposing views & rebuttals Objection 1 & rebuttal Objection: Insurance companies’ bottom lines hurt through limitations on deductibles, co-insurance and co-payments, and prohibition on underwriting.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Employee expenses on cost sharing include coinsurance, deductibles and co-payments. Insurers companies are experiencing unfavorable impact due to the limitations on co-payments, coinsurance, deductable and prohibition on underwriting as they increases the risks therefore increasing the amounts paid as compensation thus reducing their returns. Rebuttal 1: Insurers’ losses from reduced profit margins mitigated through broadened customer base   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Insurers’ losses from reduced margins can be reduced by increasing their customer base. This is because insurance use the pooling of risks approach where broadened customer base will result to high returns. This is because more customers will lead to more funds in funding pool of risks while the amount paid out to the unlucky individuals as compensation will be low than the premiums paid therefore leading to increased profit margins. Also, increased broadened customer base also serves as a way of diversifying the risks. Rebuttal 2: View disproved by financial statements and stock market movements   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Such a view which is refuted by stock market movement and financial statements should not be used and should be regarded as void. Stock movements are un predictable and an insurance company should not be forced to compensate an unlucky individual who loses unless such a claim is validated. Objection 2 & rebuttal Objection: Compulsory acceptance of foreseeable risks unfair burden on insurers   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   PPAC protects the applicants from the insurer’s discrimination where the insurance companies are forced to accept foreseeable risks thus reducing the profit margins. This mandatory acceptance of these foreseeable risks will lead to increased expenses which are paid to the unlucky individuals as compensation which eventually leads to reduced returns. This act is unfair to the insurers since they should be given an opportunity to consider whether to accept or reject insuring individuals with foreseeable risks. This is because increase in amounts paid for these foreseeable risks as compensations will reduce the profits margins to an extent of making losses which may lead to such companies deciding to exit the industry due to constant loss making.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Rebuttal: Insurers allowed to underwrite avoidable risks and discriminate on the basis of lifestyle choices   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Insurers should be allowed to discriminate based on lifestyle choices and underwrite avoidable risks. This is because the individual to be covered should be responsible. The fear that individuals may have that they may not be compensated if the risk was avoidable would prevent them from making choices which are reckless thus protecting the insurance companies from paying unfair amounts as compensation. Also individuals should be responsible and they should put necessary measures or efforts to ensure that the risk doesn’t occur, so as not to overburden the insurance provider with expenses which are avoidable. In this regard individuals should be ready to bear the responsibilities for the consequences of their freely made decisions. Summing up & Conclusion   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Affordable care Act also incorporates measures which are aimed at reducing healthcare spending in United States. Many American citizens are unaware that since 2010 when the Affordable care Act became into law after being signed they have been enjoying from the protections, rights and benefits of obamacare. Before this Affordable care Act many small businesses and low and middle income earning American citizens found it challenging to afford healthcare for their families and also for themselves. In the past the many sick people were denied health treatment or coverage with diminutive right for appealing. Insurance companies charged individuals more on basis of their health status where women were required to pay higher rates. Affordable care Act entails provisions which are aimed at solving all these challenges.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The cost of health care in United States keeps rising year after year at an alarming rate. This rise in healthcare expenditure harms the country in many ways. For seniors and families, the increasing medical care cost means increased expenses making them to make hard choices regarding to rent, needed care and balanced food. For the local, state and federal governments, increasing health costs result to higher Medicaid and Medicare costs, and decreased funding on key priorities like education, public safety and infrastructure.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   For many years America has experienced the highest rates of obesity among the developed nations. High occurrence rates for obesity are experienced in United States kids and also in every age group subsequently. From 20 years onward the adults in America have among the highest occurrence rates of diabetes among peer nations. However, United States tops globally in the cancer treatment and health care research, for example. The breast cancer survival rate is very high in United States compared to other OECD nations and also U.S is among the best in survival from colorectal cancer thus ensuring high value healthcare.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In conclusion, although obama care has been faced by many challenges however it has resulted to many benefits than costs. Before this Affordable care Act many small businesses and low and middle income earning American citizens found it challenging to afford healthcare for their families and also for themselves. In the past the many sick people were denied health treatment or coverage with diminutive right for appealing. Insurance companies charged individuals more on basis of their health status where women were required to pay higher rates. Affordable care Act entails provisions which are aimed at solving all these challenges. 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