Rules of the Proximity Agreement in English Grammar

The Federal Aviation Administration Is The Governing Force...

Introduction Discrimination is the process of excluding a person based on a multitude of factors not limited to just age, sex or ethnicity. Just about 200 years ago, in 1808, The Congress banned the importation of slaves from Africa and they were given voting rights in 1870 with the Fifteenth Amendment [1]. Less than 100 years ago, the 19th Amendment to the U.S. Constitution gave women the right to vote in 1920 [2]. Even more recently, the Age Discrimination Act was introduced in 1967 by the Department of Labour to protect the aging population on the basis of employment [3]. Although our society has made vast progress by enacting equal opportunity laws, a lot of improvement is yet to be made before employment diversity increases, particularly in the aviation industry. The Federal Aviation Administration is the governing force of Aviation, dealing with all aspects of safety, innovation and aviation related regulations. They proudly advertise on their employment opportunity site by saying â€Å"our inclusive culture is defined by our values and we continuously seek employees from all backgrounds with distinctive ideas, perspectives†¦.and talents† [4]. There are numerous employee programs designed for minority groups such as FAA GLOBE- Gay, Lesbian or Bisexual Employees, NBCFAE- National Black Coalition of Federal Aviation Employees with Disabilities and PWC- Professional Women Controllers. They strive to provide the resources necessary for the minority groups to facilitate theirShow MoreRelatedThe Federal Aviation Administration Is The Governing Force Of Aviation Essay1630 Words   |  7 PagesAlthough our society has made vast progress by enacting equal opportunity laws, a lot of improvement is yet to be made before employment diversit y increases, particularly in the aviation industry. 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Research shows that various internationalRead MoreThe National Transportation Safety Board860 Words   |  4 Pagesfailure of the lap joint a S-10L and the separation of the fuselage upper lobe† (National Transportation Safety Board, 1989). There were other contributing factors, for example, failure of management to supervise properly its maintenance force and the failure of governing officials to ensure that all directives and inspections were complied with by the FAA (National Transportation Safety Board, 1989). 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IMO describes fatigue as a â€Å"State of feeling tired, weary, or sleepy that results from prolonged mental or physical work, exposure to harsh environment, or loss of sleep which can lead to the impairment of performanceRead MoreModern Federal, State, And Local Governments1298 Words   |  6 PagesModern federal, state, and local governments must deal with changes in technology and chang es in society and culture. One emerging technology is the proliferation of drone technology in the hands of private citizens. Christ Pritchard, writing in Journal Of The Australian New Zealand Institute Of Insurance Finance, suggests that â€Å"[c]urrent usage patterns show it’s a safe bet that drones are destined to play an increasingly important role in business relationships† (Pritchard, 2015). Once solelyRead MoreIndustrial Safety Differences in Unmanned Aerial Systems3260 Words   |  13 PagesIndustrial Safety Differences in Unmanned Aerial Systems Although they tend to be smaller than manned aircraft including most small general aviation types, UAVs are indeed aircraft and all of the industrial safety measures that apply in other forms of aviation also apply here. At this point it is appropriate to define a few terms; Remotely Piloted Vehicle/Aircraft (RPV/Aircraft) refers to an aircraft or vehicle piloted from the ground. Unmanned Aerial Vehicles (UAV) may be piloted from the groundRead MoreForeign Policy : An Overview Of Major Trends Essay1242 Words   |  5 PagesMorocco was the first Muslim country to formally deals with the United States as represented by the Moroccan – American treaty of friendship in 1786†. Now the foreign policy of Barack Obama has been the policy of the United States since the Obama administration was inauguration in January of 2009. Since then Congress and President Obama are working on the shared power of foreign policy. The role of the President and Congress in foreign policy: The United States Constitution divided the power of foreign

Pharmacoeconomics and Outcomes Research †MyAssignmenthelp.com

Question: Discuss about the Pharmacoeconomics and Outcomes Research. Answer: Introduction The Pharmaceutical Benefits Scheme (PBS) is a program through which the Australian government subsidises prescription drugs to Australians. The introduction of the scheme can be traced back to 1944 but in which it had failed to sail through. The successful reintroduction was attained in 1948 with a limit to offering free drugs for pensioners, while the rest of Australians were eligible to a total of 139 free drugs which were considered as life-saving and disease preventing (Grove, 2016). It wasnt until 1960 that the program attained maturity and was then able to provide access to a wide range of drugs. PBS stands out as an integral part of Australias National Medicines Policy (NMP) whose aim is to foster favourable health outcomes for Australians by improving accessibility to, and the rational use of drugs (Department of Health (DoH), 2014). The Pharmaceutical Benefits Scheme is founded by provisions of the National Health Act 1953 (Grove, 2016). The 2014/15 annual report by the Department of Health (DoH) put the cost of PBS at $9.1 billion following over two hundred million prescriptions having been subsidised during the same duration (DoH, 2015). This PBS cost accounted for 21% of the funds that were administered by the department of health during the same duration (Grove, 2016). The expenditure on the scheme is uncapped and as a result, it increases in relation to increase in demand and the introduction of new drugs. Between 2005/6 and 2013/14, the total expenditure on the scheme grew at about 4.9%, which however was not the case for the duration between 2013/14 and 2014/15, in which the expenditure fell slightly by 0.5% (Grove, 2016). Regardless of the marginal decrease, analysis of the projected government spending on pharmaceutical shows a gradual increase. Evidenced by the fact that the expenditure has more than doubled in the last ten years, the same is projected to continue, making this expenditure one of the fastest growing areas of Australian governments expenditure. It has been established that the scheme pays an excess of at least $1.3 billion for prescription drugs. Therefore, this report seeks to describe the scheme, investigate the costs and causes of medicine consumption in the country, the types of medicines consumed, characterise the problems with the scheme, and lastly make recommendations for cost reduction and lower consumption. Decision Makers in the Structure of Australias Pharmaceutical Benefits Scheme The PBS is undoubtedly an integral component of Australias health system that enables consumers timely access to affordable medicines (close to 800 in number as of June 2015). For a medicine to be subsidised, it has to undergo a hierarchical process that ends with the minister who assents for inclusion in the schedule as shown in figure 1 below. Before a medicine is listed on the PBS, it has to be approved by the Therapeutic Goods Administration (TGA). TGA reviews evidence on the safety and effectiveness of the medication for the proposed uses. Pharmaceutical manufacturers make submissions for listing on the PBS schedule for medicines that are TGA-registered or are in the process of registration by TGA (Turkstra, Comans, Gordon, Scuffham, 2015). For a medicine to be listed on the PBS, it has to be recommended by the Pharmaceutical Benefits Advisory Committee (PBAC) after consideration of factors such as safety, cost, and effectiveness compared with others (Wonder, Blackhouse, Sulli van, 2012). PBAC also makes recommendations to the minister on medicines for specific palliative listing. The Health Technology Assessment Section (HTAS) looks after and provides secretariat support for PBAC, Economics Sub-committee(ESC), and the Drug Utilisation Sub-Committee (DUSC) (Wonder, Blackhouse, Sullivan, 2012). The ESC has the mandate of reviewing submissions from sponsors and the commentaries from the evaluation groups, while the DUSC provides advice pertaining to expected drug utilisation prior to PBS listing and also monitors the use post-listing. Consumers pay a co-payment for each medicine purchased with a PBS subsidy. For concessional access, consumers pay $6.00 whereas for general access, $36.90, and the government pays the rest (The Pharmaceutical Benefits Scheme, 2017). Pharmacies which serve as the primary outlet for dispensing prescription medicines are paid by the government a dispensed price (approximately $6.63) for every PBS medicine they dispense. Compared to its counterpart, New Zealands Pharmaceutical Management Agency (PHARMAC) structure has more bottlenecks. This translates to a characteristic reduced access to new medicines in New Zealanders compared to Australians. This can be supported by New Zealand Medical Associations observation that the access to new medicines in New Zealand is considerably slower than in Australia (Milne Wonder, 2012). Australia has a considerably expanded government-subsidy program, with a diverse listing, with comes along with a significant price tag. The expanded access comes along with a monetary opportunity cost and a steady increase through time compared to PHARMAC which has been able to contain the budget of subsidised medicines whereas widening access to other medicines (Milne Wonder, 2012). The Costs of the Pharmaceutical Benefits Scheme The growth in pharmaceutical benefits expenditure in Australia has been evidenced to be on the rise since its inception. An exponential increase has been documented since the beginning with a staggering 80% rise between 2004 and 2014. Precisely, between 1994/95 and 2004/5, the expenditure on PBS grew by about 13% each year (DoH, 2017). This was followed by a drop in its annual growth rate for the duration 2005/6 to 2013/14 by about 4.86%. In 2014-15, the expenditure on PBS stood at $9.1 billion, followed by a 19.5% increase for the following year (2015-2016) to stand at $10.8 billion. Notably, this is regardless of a drop in the total volume of PBS prescriptions by 1.9% for the same duration (DoH, 2016). According to the Parliamentary Budget Office, the expenditure on PBS is bound to level out at 0.3% per annum in the medium level ( Parliamentary Budget Office, 2014), but at 4-5% annually in the longer term (Senate Community Affairs Legislation Committee, 2014) one of the possible explanations for the reduction can be partially attributed to the effect of various policies on pricing and changes to arrangements in co-payments and the safety net as introduced around the same time (2005) (Department of Health and Ageing (DoHA) and Medicines Australia (MA), 2013). Take note of the exponential growth in government expenditure on PBS through the years. The rising trend is projected to rise due to its capacity to hit the targeted groups (pensioners, healthcare card holders, and those who have hit safety net), who are bound to rise with time accompanied with Australias demographic change, the increase in the incidence of chronic conditions, and the increase in new PBS medicine listings and changes in technology. Drug prices in Australia have been described as being unacceptably high, as evidenced by some drugs costing up to 3.7 times the international prices (Duckett, 2013). Compared to other countries such as New Zealand, France, and Spain, the cost of generic drugs is particularly high. As of 2011-12, Australians spend more than $18 billion annually on medications (Australian Institute of Health and Welfare (AIHW), 2014). It is the fifth most expensive expenditure following hospital and primary health care expenditure. Data from OECD shows that Australia pays more for pharmaceuticals compared to other countries (ONeill, Puig-Peir, Mestre-Ferrandiz, Sussex, 2012).some of the possible explanations to this scenario is that while some countries strived to contain the growth in prices, Australia must have missed out, especially after a 2005 study that concluded Australian prices were substantially lower (Duckett, 2013). There is also the likelihood that there is a limited number of suppliers a nd tightly regulated prices which can cause some companies maintaining the prices that high. In addition, drug prices are not the only factor that contributes to high pharmaceutical expenditures, rather other factors such as demographics, clinical choices and also comes into play. Types of Medicines Consumed The five major classes in Australia include ACE inhibitors, calcium channel blockers, proton pump inhibitors, statins, selective serotonin reuptake inhibitors (Statistica, 2015). ACE inhibitors are the most, with 15 drug types and a total of 242 products. Atorvastatin is the most commonly administered calcium channel blocker (table 3), accounting for over $300 million each year. The high expenditure on medications under the PBS scheme produces a financial pain meaning that the government is not making savings like other countries. For instance, New Zealand spends far less on the same drug compared to the same in Australia. The government is also unable to make any returns upon the expiry of pharmaceutical patents. These two challenges result in high out of pocket expenditure on medicines and also a high cost of generic medicines. Private expenditure on prescription pharmaceuticals is also reported. Generally, the PBS was designed to generate savings, and also make medicines affordable to both consumers and the government, and this has not been the case. Recommendations The ministry of health should undertake regular revising of the Pricing Authoritys recommendations to the minister pertaining to drug pricing. The ministry of health should undertake regular international benchmarking of Australias mark-ups on drug pricing. The government should advocate for cost-effective choices such as the cheapest and most-effective drug from each group should be used instead of the most expensive one. The PBS should be governed by a more independent governance with minimal political interference regarding decision making on elements such as pricing and access decisions, which should be based on clinical value, and this ought to be done by experts. The government should establish an independent authority whose mandate will be to oversee the management of the subsidised medicines. References Parliamentary Budget Office. (2014). Projections of government spending over the medium term. 2014: Parliamentary Budget Office. Australian Institute of Health and Welfare (AIHW). (2014). Australia's health 2014. Canberra: AIHW. Department of Health (DoH). (2014, November 6). National Medicines Policy. Retrieved from The Department of Health: https://www.health.gov.au/nationalmedicinespolicy Department of Health and Ageing (DoHA) and Medicines Australia (MA). (2013). Trends in and drivers of Pharmaceutical Benefits Scheme expenditure report, Report for the Access to Medicines Working Group. Sydney: Department of Health and Ageing (DoHA). DoH. (2015). Annual Report 2014-2015. Canberra: Commonwealth of Australia. DoH. (2016). Expenditure and Prescriptions Twlve Months to 30 June 2016. Canberra: PBS Information Management Section Pharmaceutical Policy Branch . DoH. (2017, July 18). About the PBS. Retrieved from The Pharamaceutical Benefits Scheme: https://www.pbs.gov.au/info/about-the-pbs#Managing_the_cost_of_the_scheme DoH. (2017, November 1). PBS Publications. Retrieved from The Pharmaceutical Benefits Scheme: https://www.pbs.gov.au/browse/publications DoH. (2017, October 23). PBS Statistics. Retrieved from The Pharmaceutical Benefits Scheme: https://www.pbs.gov.au/info/browse/statistics Duckett, S. (2013). Australia's bad drug deal: High pharmaceutical prices. Melbourne: Grattan Institute . Grove, A. (2016). The Pharmaceutical Benefits Scheme: a quick guide. Canberra: Parliament of Australia. Milne, R., Wonder, M. (2012). Access to new medicines in New Zealand compared to Australia. New Zealand Medical Journal. ONeill, P., Puig-Peir, R., Mestre-Ferrandiz, J., Sussex, J. (2012). International Comparisons of Medicine Prices 2011 Indices Methodology and Results. London: OHE Consulting. Senate Community Affairs Legislation Committee. (2014). Official committee Hansard. Canberra: Senate Community Affairs Legislation Committee. Statistica. (2015). Breakdown of the number of under co-payment prescriptions in Australia in 2015, by ATC group (in millions). Retrieved from Number of non-subsidized prescriptions by ATC group in Australia 2015: https://www.statista.com/statistics/693905/australia-number-of-non-subsidized-prescriptions-by-groups/ The Pharmaceutical Benefits Scheme. (2017, July 1). Pharmaceutical Benefits: Fees, Patient Contributions and Safety Net Thresholds. Retrieved from The Pharmaceutical Benefits Scheme: https://www.pbs.gov.au/info/healthpro/explanatory-notes/front/fee Turkstra, E., Comans, T., Gordon, L., Scuffham, P. (2015). Australia - Pharmaceutical. Sydney: International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Wonder, M., Blackhouse, M., sullivan, S. (2012). Australian Managed Entry Scheme: A New Manageable Process for the Reimbursement of New Medicines? ScienceDirect, 586-590.

Three Great Religion Essays - Chinese Communists, Mao Zedong

Three Great Religion Two years after the death of Mao Zedong in 1976, it became apparent to many of China's leaders that economic reform was necessary. During his tenure as China's premier, Mao had encouraged social movements such as the Great Leap Forward and the Cultural Revolution, which had as their bases ideologies such as serving the people and maintaining the class struggle. By 1978 Chinese leaders were searching for a solution to serious economic problems produced by Hua Guofeng, the man who had succeeded Mao Zedong as CCP leader after Mao's death (Shirk 35). Hua had demonstrated a desire to continue the ideologically based movements of Mao. Unfortunately, these movements had left China in a state where agriculture was stagnant, industrial production was low, and the people's living standards had not increased in twenty years (Nathan 200). This last area was particularly troubling. While the gross output value of industry and agriculture increased by 810 percent and national income grew by 420 pe rcent [between 1952 and 1980] ... average individual income increased by only 100 percent (Ma Hong quoted in Shirk 28). However, attempts at economic reform in China were introduced not only due to some kind of generosity on the part of the Chinese Communist Party to increase the populace's living standards. It had become clear to members of the CCP that economic reform would fulfill a political purpose as well since the party felt, properly it would seem, that it had suffered a loss of support. As Susan L. Shirk describes the situation in The Political Logic of Economic Reform in China, restoring the CCP's prestige required improving economic performance and raising living standards. The traumatic experience of the Cultural Revolution had eroded popular trust in the moral and political virtue of the CCP. The party's leaders decided to shift the base of party legitimacy from virtue to competence, and to do that they had to demonstrate that they could deliver the goods. (23) This movement from virtue to competence seemed to mark a serious departure from orthodox Chinese political theory. Confucius himself had posited in the fifth century BCE that those individuals who best demonstrated what he referred to as moral force should lead the nation. Using this principle as a guide, China had for centuries attempted to choose at least its bureaucratic leaders by administering a test to determine their moral force. After the Communist takeover of the country, Mao continued this emphasis on moral force by demanding that Chinese citizens demonstrate what he referred to as correct consciousness. This correct consciousness could be exhibited, Mao believed, by the way people lived. Needless to say, that which constituted correct consciousness was often determined and assessed by Mao. Nevertheless, the ideal of moral force was still a potent one in China even after the Communist takeover. It is noteworthy that Shirk feels that the Chinese Communist Party leaders saw economic reform as a way to regain their and their party's moral virtue even after Mao's death. Thus, paradoxically, by demonstrating their expertise in a more practical area of competence, the leaders of the CCP felt they could demonstrate how they were serving the people. To be sure, the move toward economic reform came about as a result of a changed domestic and international environment, which altered the leadership's perception of the factors that affect China's national security and social stability (Xu 247). But Shirk feels that, in those pre-Tienenmen days, such a move came about also as a result of an attempt by CCP leaders to demonstrate, in a more practical and thus less obviously ideological manner than Mao had done, their moral force. This is not to say that the idea of economic reform was embraced enthusiastically by all members of the leadership of the Chinese Communist Party in 1978. To a g reat extent, the issue of economic reform became politicized as the issue was used as a means by Deng Xiaoping to attain the leadership of the Chinese Communist Party. Mao's successor, Hua Guofeng, had tried to prove himself a worthy successor to Mao by draping himself in the mantle of Maoist tradition. His approach to economic development was orthodox Maoism with an up-to-date, international twist

Comparison of Healthcare Policies between France and the US The WritePass Journal

Comparison of Healthcare Policies between France and the US Introduction Comparison of Healthcare Policies between France and the US ) Health Statistics in 2013 reveals that life expectancy in France is high at 82.2 and is currently ranked third amongst OECD countries. In contrast, life expectancy in the US is amongst the lowest at 78.7 (OECD, 2013). The difference in life expectancy in both countries is a cause of concern since the US has one of the most expensive healthcare systems in the OECD and yet fares worse in health outcomes, including life expectancy(Baldock, 2011). The OECD (2013) notes that compared to France and other large OECD countries, the US spends twice as much per individual on healthcare. Interestingly, public health expenditure for health is highest in the US compared to all OECD countries. However, it does not practice universal healthcare coverage with the public supporting only 32% of the total healthcare cost (OECD, 2011). Individuals eligible for Medicaid include the elderly, families with small children and those with disabilities (Rosenbaum, 2011). Approximately 53% of the US population is covered through the Patient Protection and Affordable Act or Obamacare (Rosenbaum, 2011). Under this Act, employers are required to purchase health insurances for their employees. Only a small portion of businesses pays for full coverage with majority requiring their employees to share in the cost of their health insurances (Rosenbaum, 2011). The OECD (2009a) states that 46 million people in the US are left without public or private health insurance. This could place a significant burden to the US healthcare system that is struggling in providing equitable access to healthcare services in the country. The World Health Organization (2014) explains that equitable access is achieved when individuals, regardless of their socioeconomic status, enjoy the same type and quality of healthcare. This is not achieved in the US where statistics (OECD, 2009a) continues to show that high-income groups enjoy better health and appropriately covered by healthcare insurances while those in the lower socioeconomic status continue to have poorer health status. This disparity in health status and healthcare insurance coverage continues to be a challenge in the US. Public spending per capita in the US continues to be the highest in the OECD countries even with the increased participation of the private sector in financing healthcare in the country (OECD, 2013). In recent years, the OECD (2013) observes that public spending across OECD countries continue to decline. On average, healthcare spending of these countries only grew by 0.2% in the last 4 years. While there is a variation on the decrease of public spending, the major reason for the slowdown is due to drastic cuts in health expenditures. In France, the Statutory Health Insurance (SHI) currently covers almost all residents. Until 2000, SHI covered 100% of all residents (Franc and Polton, 2006). Today, almost all of the residents are still covered under SHI. However, a few have purchased private health insurances to complement SHI. Public spending for healthcare is 77.9% while France spends 11.9% of its GDP in healthcare (OECD, 2011). This is in contrast with the US where public spending for healthcare accounts to only 47.7% but spends 17.9% of its GDP on healthcare (OECD, 2011). Interestingly, SHI covers both legal and illegal residents in France. This is opposite in the US where illegal residents are not covered by publicly funded healthcare insurance. There are approximately 21 million immigrants in the US with most having an illegal resident status (Moody, 2011). Health coverage remains to be a concern for this group since they work on jobs that pay very low wages and with no healthcare coverage. Hence, this group is three times more likely to have no healthcare coverage (Stanton, 2006). Currently, this group comprises 20% of the total uninsured population in the US (Moo dy, 2011). The lack of universal coverage in the US suggests that healthcare policies in the US may not be inclusive as opposed to France where almost all residents have private or public health insurance coverage. Rosenbaum (2011) explains that the Patient Protection and Affordable Act or Obamacare is expected to boost healthcare coverage for legal immigrants who are in low paying jobs. However, only legal immigrants who have been in the US for at least five years could qualify for Medicaid or purchase state-based health insurances. Currently, all states in the US have expanded Medicaid coverage to low-income groups. Specifically, a family of four with a combined annual income of $33,000.00 and an individual with $15,800.00 yearly income are now eligible for Medicaid. This legislation provides health coverage to approximately 57% of the uninsured population in the US (CDC, 2011). For legal immigrants who have not reached five years of stay in the US or are earning more than the Medicaid limit are allowed federal subsidy when purchasing state-based health insurances (CDC, 2011). As opposed to France where illegal immigrants enjoy the same healthcare coverage as legal immigrants and citizens, those in the US on illegal status remain uninsured and could not purchase state-based health insurances (CDC, 2011). Healthcare access for this group is limited to community health centres across the country. It is noteworthy that only 8,500 community health centres are in existence today and yet they cater to at least 22 million people each year (CDC, 2011). Almost half of those who access primary health centres are the uninsured. While hospitals are required by law to provide emergency care for all individuals regardless of their resident status, those who are uninsured do not have health coverage to sustain their long-term healthcare needs (Rosenbaum, 2011). Current healthcare policies in the US might actually promote health inequality since it only provides primary basic healthcare services (CDC, 2011) to the marginalised group, which may include low-income and ethni c groups. In France, The Bismarckian approach to healthcare has been used for several decades but in recent years, there is now an adoption of the Beveridge approach (Chevreul et al., 2010). In the former, health coverage tends to be uniform and concentrated while in the latter, the single public payer model is promoted. In the Bismarckian approach, everyone should be given the same access to healthcare services while the Beveridge model allows for stronger state intervention (Chevreul et al., 2010). This also suggests that tax-based revenues are used to finance healthcare. The mix of both models is necessary to respond to the increasing demands for healthcare in the country and to regulate the increasing cost of healthcare. Chevreul et al. (2010) emphasise that the SHI is now experiencing deficit due to increasing rise of healthcare expenditure in the country. The French parliament, through the Ministry of Health regulates expenditure by enacting laws and regulations. Importantly, France regulates prices of specific medical procedures and drugs (Chevreul and Durand-Zaleski, 2009). This development is crucial since failure to regulate prices could further drive up healthcare costs. However, regulation of prices of medical devices remains to be poor. In a survey (OECD, 2009b), expenditures for medical devices is high and amounts to â‚ ¬19 billion annually. Although it comprises 55% of the pharmaceutical market, increased demand for medical devices have also increased SHI expenditures on these devices (Cases and Le Fur, 2008). It should be noted that only 60% of the medical devices are covered by SHI (Cases and Le Fur, 2008). Regulation of the prices of these medical devices is not as strong as the market for drugs and other major medical equipment. This implies that increasing healthcare costs of medical devices could have an impact on pu blic health spending policies in France. Healthcare Issues and Challenges One of the major issues in both countries is the rising healthcare expenditure. As noted by the OECD (2013), there is a disparity between healthcare expenditure and rising healthcare costs in OECD countries. The average increase in healthcare expenditure only amounts to 0.2% and yet healthcare cost continues to rise. In France, this disparity has promoted the Ministry of Health to increase private insurance of its members to help cover healthcare services not normally covered by the SHI. In the US, the debate on Obamacare and the reluctance of the government to cover illegal residents continue to be a challenge in providing equitable healthcare Meanwhile, high costs of medicines could have an impact on healthcare, especially amongst those who are covered by Medicaid and those who could barely afford state-subsidised healthcare insurances (Moody, 2011). This is in contrast to France where cost containment is in place for medicines. To illustrate the lack of healthcare costs regulations, the US spends more on developing medical technologies, which only benefits a few of the patients. The country is also burdened with high administration and pharmaceutical costs. Doctors in the country are also amongst the highest paid in the OECD countries (Greve, 2013). Moody (2011) argues that cost containment remains to be a problem since lowering down prices of medicines or healthcare costs for beneficiaries of Medicaid would lead to doctors’ reluctance to treat Medicaid patients. The lack of priorities in healthcare spending in the US has resulted in higher spending on certain areas and low spending on others. However, this does not translate to better health outcomes for the whole population. Elderly care is one area where there is high spending but the amount of spending does not necessarily translate to better health outcomes. As noted by Haplin et al. (2010), the elderly are more vulnerable to chronic healthcare conditions, such as dementia, cardiovascular diseases, type 2 diabetes. Hence, healthcare costs for this group are relatively higher compared to other members in a community. In a report published by Stanton (2006), approximately 40% of US healthcare expenditure is devoted to elderly care, but this group only comprises 13% of country’s population. It is projected that in the succeeding years, healthcare cost for this group will continue to rise with the ageing of the US population (Stanton, 2006). The same issue is also seen in France, where increasing healthcare cost for the elderly is also expected in the succeeding years (Franc and Polton, 2006). Both countries also lack coordination of care and gatekeeping for the elderly. Although there is an emphasis on elderly care in both countries, lack of continuity of care often leads to poor quality care, duplication of healthcare, waste and over-prescription (Franc and Polton, 2006; Evans and Docteur and Oxley, 2003; Stoddard, 2003). In France, this issue was first addressed through the creation of provider networks and increasing the gate-keeping roles of the general practitioners (GPs). However, the latter was largely unsuccessfully and finally abolished with the introduction of the 2004 Health Insurance Act (Franc and Polton, 2006). In this new legislation, patients have the freedom to choose their own healthcare providers or primary point of contact. Most of the primary points of contact are GPs. This scheme is successful in F rance due to incentives offered to the patients and GPs. This scheme has been suggested to improve the quality of care received by the patients since there is more coordination of care between GPs and specialists (Naiditch and Dourgnon, 2009). This scheme also drives up the cost of visits to specialists and could have influence healthcare financing policies (De Looper and La Fortune, 2009; Naiditch and Dourgnon, 2009). Another issue common to both countries is the competition between hospitals for patients who can afford private healthcare. Consumer demands for healthcare in the US have increased. Hospitals respond by increasing their services to separate them from their competitors (Moody, 2011). For instance, by-products of this competition results to increasing the size of the patient rooms and providing in-house services such as full kitchens, family lounges and business service. All these have not been related to improved health outcomes of the patients. In France, the differences in healthcare costs between publicly funded hospitals and private for-profit hospitals spark a debate on whether common tariffs are the solution to cost containment (Chevreul et al., 2010). Despite the implementation of common tariffs, there is still a growing difference on the healthcare costs between the private and public sectors. Currently, the reform plan Hospital 2007 (Chevreul et al., 2010) states that the obj ective of introducing a common tariff for public and private hospitals has been withheld until 2018. This shows that healthcare policies respond to current trends in health provision in France. ‘Convergence’ and ‘Path Dependence’ Starke et al. (2008) explain that history and institutional context all play a role in influencing healthcare policies in a welfare state. Healthcare policies that tend to be resistant to change illustrate institutionalist or ‘path dependence.’In the event where changes are needed, those that follow ‘path dependence’ change their policies but do so within the boundaries set in the original healthcare policies. On the other hand, healthcare policies that follow the ‘convergence’ pathway or functionalist perspective tend to integrate best practices and are more responsive to social, political and economic changes. Healthcare policies in France and the US tend to follow the ‘convergence’ pathway. The historical context of France reveals that a unitary presidential democracy was established in 1958 (Cases, 2006). In this system, the central government retains sovereignty and policies implemented in local or regional levels are approved by the central government. Despite the practice of central dirigisme, many regions in France have practiced coordination and decenstralisation. Political parties elected to the French government all have a common goal in financing the healthcare system in France. It practices cost-containment by regulating healthcare costs, reducing healthcare demands and restricting healthcare coverage (Chevreul and Durand-Zaleski, 2009). All these cost-containment policies have generally been met with public discontent. In recent years, the introduction of Supplementary Health Insurance enabled the French government to still deliver quality care at reasonable cost. Further, the introduction of direct payment, although reimbursable, also discourages wasteful consumption of healthcare (Chevreul and Durand-Zaleski, 2009). Although changes in healthcare policies tend to be restrictive more than three decades ago, France is now taking the ‘convergence’ pathway in its healthcare system. This suggests that healthcare policies are more responsive to social and economic changes. France also regards its people as equal but retain their freedom to choose a healthcare provider and hospital. The manner of healthcare financing in France allows service users to choose from competing healthcare professionals. Service users could also access specialists due to little gatekeeping in the country (Naiditch and Dourgnon, 2009). All these changes in the France’s healthcare system reflect ‘convergence’ rather than ‘path dependence’. Convergence in healthcare is also shown in both countries through its policies on increasing personal contributions of service users for healthcare (Mossialos and Thomson, 2004). There is also an increasing reliance on private health insurers to bridge the gap in public healthcare delivery. The increasing public-private mix exemplifies convergence. There is also a trend towards community healthcare and decentralisation of healthcare (Baldock, 2011; Chevreul et al., 2010; Blank and Burau, 2007). This trend relies on community healthcare practitioners to provide care in home or community settings. This has been practiced in other developed countries where patients with chronic conditions receive care in their own homes (Chevreau et al., 2010). This approach is also applied when caring for the elderly. Similar to other Welfare states, the US and France are experiencing population ageing. The proportion of the elderly in both countries is expected to rise in the succeeding years (Chevrea u et al., 2010). As mentioned earlier, this translates to increases in health expenditures and cost for this group. Marked increases in health expenditures for this group would mean further reduction on public spending or cost containment. All these could have an impact on public spending in the future and might increase insurance premiums of individuals. There is also the possibility of raising SHI contributions in France or reducing healthcare coverage of Medicaid in the US. Both strategies could fuel public discontent, increase the gap between the rich and the poor and promote health inequalities (OECD, 2008; Starke et al., 2008; Stanton, 2006). Since the main aim of the policies in both countries is to achieve optimal health for all, the realisation of this aim might be compromised with an ageing society. It is also noteworthy that since public funds are bankrolled by taxes, increasing number of elderly could mean reduction in number of employees who are economically productive. This could also lead to lower tax collections and decreased public funding for healthcare. As shown in both countries, healthcare policies are becoming more responsive to the social and economic changes. This does not only suggest a direction towards ‘convergence’ but suggests that this pathway could be the norm for many OECD countries. Conclusion Healthcare policies in the US and France have been influenced by social and economic changes in recent years. Although both aim to achieve universal coverage, it is only France that has achieved this with almost 100% of its citizens covered with healthcare insurance. The US is struggling to meet the healthcare needs of its citizens with almost 46 million still uninsured. Its Obamacare is still met with criticism for its failure to provide public healthcare coverage for most of its citizens. Only the poor and those unable to afford basic healthcare services are covered under Medicaid. In Obamacare, those with marginal incomes could purchase federal-subsidised healthcare insurances. Both countries are also faced with the challenge of an ageing society. The inequitable allocation of healthcare services to this group also promotes social discontent. Almost half of public expenditure is channeled to the elderly, which only comprises 13% of the whole population. The heightened demand for e lderly care, lowered public expenditure on healthcare and increasing healthcare costs have all influenced healthcare policies in the US and France. Finally, the recent changes in the healthcare policies of this country suggest convergence rather than path dependence suggesting that healthcare policies continue to be influenced by social and economic changes in both countries. It is recommended that future research should be done on how ‘convergence’ helps both countries respond to increasing complexities of healthcare in both countries. References: Baldock, J. (2011). Social policy, social welfare and the welfare state. Oxford: Oxford University Press. Blank, R. Burau, V. (2007). Comparative health policy. London: Palgrave. Cases, C. (2006). ‘French health system reform: recent implementation and future challenge’. Eurohealth, 12, pp. 10-11. Cases, C. Le Fur, P. (2008). ‘The pharmaceutical file’, Health Policy Monitort, May [Online]. Available from: hpm.org/survey/fr/all/2 (Accessed: 27th April, 2014). Center for Disease Control and Prevention (2011). NCHS Data Brief: Community Health Centers: Providers, Patients and Content of Care [Online]. Available from: cdc.gov/nchs/data/databriefs/db65.htm (Accessed: 27th April, 2014). Chevreul, K., Durand-Zaleski, I., Bahrami, S., Hernandez-Quevedo Mladovsky, P. (2010). France: Health System Review 2010. France: The European Observatory on Health Systems and Policies, WHO Regional Office for Europe, World Bank, European Commission, UNCAM, London School of Economics and Politic Science, and the London School of Hygiene Tropical Medicine. Chevreul, K. Durand-Zaleski, I. (2009). ‘The role of HTA in coverage and pricing in France: toward a new paradigm?’. Euro Observer, 11, pp. 5-6. De Looper, M. La Fortune, G. (2009). Measuring disparities in health status and in access and use of healthcare in OECD countries. Paris: OECD (Health working paper 43) [Online]. Available from: oecd-ilibrary.org/social-issuesmigration-health/measuring-disparities-in-health-status-and-in-access-and-use-of-healthcare-in-oecd-countries_225748084267 (Accessed: 27th April, 2014). Docteur, E. Oxley, H. (2003). Health-care systems: lessons from the reform experience. Paris: OECD (Health working paper 9) [Online]. Available from: irdes.fr/Publications/Qes/Qez133.pdf (Accessed: 27th April, 2014). Evans, R. Stoddard, G. (2003). ‘Consuming research, producing policy?’, American Journal of Public Health, 93, pp. 371-379. Franc, C. Polton, D. (2006). ‘New governance arrangements for French health insurance’. Eurohealth, 12, pp. 27-29. Glyn, A. (2006). Capitalism unleashed. Oxford: Oxford University Press. Greve, B. (2013). Routledge Handbook of the Welfare State. London: Routledge. Halpin, H., Morales-Suarez-Varela, M. Martin-Moreno, J. (2010). ‘Chronic disease prevention and the new public health’. Public Health Review, 32, pp. 120-154. Moody, K. (2011). Capitalist care: Will the coalition government’s ‘reforms’ move the NHS further toward a US-style healthcare market?’. Capital and Class, 35(3), pp. 415-434. Mossialos, E. Thomson, S. (2004). Voluntary health insurance in the European Union. Copenhagen, WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies [Online]. Available from: euro.who.int/__data/assets/pdf_file/0006/98448/E84885.pdf (Accessed: 27th April, 2014). Naiditch, M. Dourgnon, P. (2009). The preferred doctor scheme: a political reading of a French experiment of gate-keeping. Paris: IRDES. OECD (2013). Health at a glance 2013: OECD Indicators, Europe: OECD Publishing [Online]. Available at: http://dx.doi.org/10.1787/health_glance-2013-3n (Accessed: 27th April, 2014). OECD (2011). Human Development Index and its components. Europe: OECD. OECD (2009a). Society at a Glance 2009: OECD Social Indicators. Europe: OECD. OECD (2009b). Health data 2009. Paris: OECD. OECD (2008). Are we growing unequal? [Online]. Available at: www.oecd.org (Accessed: 17th April, 2014). Rosenbaum, S. (2011). ‘The Patient Protection and Affordable Care Act: Implications for Public Health Policy and Practice’. Public Health Reports, 128(1), pp. 130-135. Stanton, M. (2006). The high concentration of U.S. healthcare expenditures: research in action, issues 19. Rockville, MD: Agency for Healthcare Research and Quality. Starke, P., Obginer, H. Castles, F. (2008). ‘Convergence towards where: in what ways, if any, are welfare states becoming more similar?’. Journal of European Public Policy, 15(7), pp. 975-1000. World Health Organization (WHO) (2014). Health Systems: Equity [Online]. Available at: who.int/healthsystems/topics/equity/en/ (Accessed: 27th April, 2014).

Analyse the ways in which Ridley Scott creates an impact on the audience in the film Blade Runner Essay Example

Analyse the ways in which Ridley Scott creates an impact on the audience in the film Blade Runner Essay Example Analyse the ways in which Ridley Scott creates an impact on the audience in the film Blade Runner Essay Analyse the ways in which Ridley Scott creates an impact on the audience in the film Blade Runner Essay Essay Topic: Film Blade Runner, made in 1882 is a highly acclaimed film produced director Ridley Scott. In this film Replicants have successfully made it to earth and must be eliminated or retired by a blade runner or special policeman employed to remove the Replicants and preventing them from becoming a threat to the human race. The streets of China town 2050 are littered with dirt and grime. Polluted and left behind the earthy is now populated by misfits while their comrades have long ago left for colonies in outer space. The open scene leaves a shocking impression, as it shows us the polluted district that was once a beautiful region. The buildings are not unlike the ones that we are familiar with today but there are subtle differences such as the retro design applied to every building. This leaves an effective impression on the audience; it makes them wonder if this is mankinds destiny. The impression that we first acquire from this film is the initial shock we obtain from noticing the amount of pollution that has accumulated by 2050. The thick mist that hangs over everything makes us wonder if the landscape will look like by the time we reach the year 2050. Overall the scenes are dark and well chosen by the Director to have an unpleasant consequence helping you to believe that the Replicants are malevolent. Rain continually appears in the film because of the impression it gives out. Rain is normally associated with bad feeling and is perfect for this type of scene. As we come toward the end of the two films subtle differences in the change of camera angles and the actual clips used alter our perceptions on the different meanings conveyed by both films and impact that they place upon us differs as a consequence of this. From the changes we see the real weakness of the Blade Runner in contrast with the Replicant within The Directors Cut. Throughout the extract he tries to escape from the Replicant by jumping between two buildings. The Blade Runner fails to reach his target and grabs hold of an iron girder jutting out from the building, a changing camera angle points out the immense distance the Blade Runner will fall if he lets go. At this point we become concerned with the immediate welfare of the Blade Runner because we know that if the Replicant does not interfere, the death of the Blade Runner is imminent. As the Blade Runner follows we see the angle from behind the Replicant giving us the extract form his point of view. Just before he leaps skyward the camera angle changes showing the jump between building. In the original there are few changes in camera angle and so we do not see the strength of the Replicant conveyed as boldly such as we do in The Directors Cut. It is important to show these contrasting angles because without them we cannot visualise the viewpoints of the different characters, without them we do not appreciate the situation each character is facing. This shows the difference between the original film and directors cut and so differs our perception The improved camera angles in The Directors Cut bring out a more vivid picture overwhelming strength of the Replicant. After the death of the Replicant the two films return to the apartment of the Blade Runner. He finds his lover and makes it out safely with her. On the balcony out side the apartment an origami unicorn is left lying on the cold concrete floor. It is here that the main change between Cut and Original can be noticed; in the Original the Blade Runner places the unicorn on the dashboard of the hover police car and we see it fly into the distance. However in The Directors Cut the drive away scene featured in the original film is omitted. This is a notable difference as it alters our perception of the film entirely. It is this that sets aside the lasting impression we receive whilst conveying different messages, The Directors Cut leaves a subtle hint which points out that although is a Replicant she will live for much longer than previous Replicant models allowing her to stay with the Blade Runner for the remainder of their lives. The deduction of the drive away scene in The Directors Cut removes the sense that the two characters will live happily ever after and although will have a prolonged life the couples immediate future is still uncertain. The differences between the two endings of Blade Runner and The Directors Cut signals the main change in viewpoint over the two films and the impact they have on their audiences. The removal of the drive away scene leads us to believe that the characters futures are still uncertain and that they may not live happily ever after as the original Blade Runner film depicts. The altered camera angles in The Directors Cut give us a better perspective of the individual characters points of view. All of the changes made in the 1991 The Directors Cut vary our opinion of the true meaning of the film Blade Runner, the impact the film has an the spectators also changes noticeably as the transformations become more apparent to the viewers.

Sports Economic Essay Example | Topics and Well Written Essays - 1250 words

Sports Economic - Essay Example Therefore, Commission of AFL established a research board in 1999, in order to establish a body for administering the selection of priorities concerning research and allocation of resources (Booth, 2006). Projects began in 2000 contributing to Australian football becoming a strange paradox due to the game played exclusively in one continent and has transcended cultural barriers and ethnic divides through integration of communities (Australian Football League (AFL), 2012). In fact, the paper will focus on exploring issues related to Australian Football League (AFL). League behavior The players in AFL are expected to behave like sportsmen, whereby upholding their standards of professional conduct and avoid compromising the integrity and dignity of AFL football, clubs, AFLPA and players. In addition, during matches and training sessions the player are also expected to behave in the similar manner, which is in accordance to the Clause 2.1 of the Code (Borland & McDonald, 2004). However, in situations where there are findings by the AFL Tribunal related to misconduct against a player, they are parties involved are dealt with in accordance with the AFL rules. AFL policies One of the most commonly known policies is AFL Anti-Doping Code, which is varied according to the law 21.2 that apply to the payers participating in these games, in a situation where the Controlling Body has not adopted their own code or policy. Nevertheless, the policy that has been adopted by any Controlling Body has to be approved by the Australian Sports Anti-Doping Authority (ASADA) (AFL, 2012). Moreover, the Controlling Body has no obligation to perform testing of players unless directed by AFL, and they should not appoint third parties to undertake these testing procedures. The other policy stipulates that a player, who has been directed to leave the playing surface, should only be replaced by a player whose name is on Team Sheet. The other policy states that a replacement player should enter the playing surface at the same time when the player is leaving the playing surface, and if the replacement player fails to enter the playing surface before the other player has left, the Umpire should restart play. The other policy indicates that player are not allowed to wear any form of jewelers, boot studs, cletes or any protective equipment that is not approved by the Controlling Body. However, there are situations where the field Umpire is convinced that the item does not subject players in any form of risk related to injury. AFL Winning Percentage Team Win% Year Collingwood 100 1929 Geelong 95.45 2008 Essendon 95.45 2000 Carlton 94.44 1908 Essendon 94.44 1950 South Melbourne 92.86 1918 Collingwood 90.91 2011 St Kilda 90.91 2009 Carlton 90.91 1995 Melbourne 88.89 1956 Competitive Imbalance Remedies The measurement of competitive balance relates to two aspects, which include; within-season competition balance that are associated with relative quality of teams in a season, and between-season competitive balance that are aimed at relative quality of teams over a number of seasons (Booth, 2000). One remedy for competitive imbalance is the merits of various measures that canvassed prior to settling on two basic measures, which include; distributions of season win percentage within-season competitive balance and distribution of premierships that are a measurement between season competitive