Thursday, November 28, 2019
Consumer Driven Health Care Essay Example
Consumer Driven Health Care Paper Executive Summary The issues surrounding the full adoption of consumer driven health care range from cost pressures, employer concerns and the need of effectively engaging the consumers in decision making through the provision of adequate choice and information. Until now the government has been supremely instrumental in propelling the consumer driven health care system. While the merits remain engulfed in hot debates, the fact that consumer driven health care simultaneously creates both the movement, the financial responsibility, as well as the involvement in health care choices of the consumers has created serious concerns. As the evolution moves on, all stakeholders in the health care system are going to be affected. The plans will enable the consumers to personally navigate the system and directly engage with the providers. On the other hand, the pharmaceutical sector may become educators and an intermediary consumer movement may serve to satisfy the fact that transparent information will have bec ome a necessity for health care decisions. Leveled in line with these demands, the ensuing discussion analyzes the impacts on health care in terms of costs, efficiency and effectiveness in addition to the impacts with regard to the new consumer, and the stakeholders; notably the pharmaceutical sector. We will write a custom essay sample on Consumer Driven Health Care specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Consumer Driven Health Care specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Consumer Driven Health Care specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Introduction            Descriptively, consumer driven health care system allows individuals to draw from their Health Savings Accounts or their Health Reimbursement Arrangements or such similar payment products to directly meet routine health care expenses while protection from catastrophic health expenses is guaranteed by a high deductible health insurance policy. These policies cost less as the consumer meets routine medical claims from a pre-funded spending account. Should the balance in the account run out, medicals claims are paid just like in a regular deductible. Yearly unused balances increase future balances that can be invested for future medical expenses. The term â€Å"consumer driven health care†applies because routine medical claims are paid through a consumer controlled account verses a fixed insurance benefit. This scenario allows the consumers to occupy the role of a primary decision maker as regards the nature of health care they re ceive. Patients are therefore more likely to choose less expensive options and for those with chronic conditions, the system would promote compliance to treatment regimes(Goodman 2006).            Proponents of such a health care system argue that in the long run, Americans will pay less for health care provision because of reduced monthly premiums and increases free market variability. Market variability due to the use of Health Savings Accounts fosters competition which in turn lower prices and stimulate improvements in the quality and delivery of health care services. Opponents of the system cite the fact that individuals who are less wealthy and less educated will tend to avoid the health care cost burden, when this is coupled to the inability to make informed decisions, then the result is lowered health outcomes. Additionally, since the system simply shifts the cost burden to the patients, those with chronic conditions will never be able to save anything. In the end, inequality in health care quality and delivery may reign(Gross 2007).            Basically, consumer driven health care system is a derivative of the business model for health e-commerce ventures which were designed to enable consumers of health products and services to engage more directly with the providers in making the health care purchases. In essence, consumer driven health care is geared towards giving individuals more choice in making health care decisions and to help stabilize these costs. This system is a product of the same theories that sought to capitates payments to providers. The rejection of such a prompt gave rise to the consumer driven health care system(Kovner 2008). In the initial conceptual model, cost and quality of the relevant information was made available through the internet. The primary model relied on the creation of Health Savings Accounts(HSAs) before the inclusion of a second model; the Health Reimbursement Arrangements(HRAs) which are funded by the employers who receive tax benefits for funding such accounts(Grudzien 2006).            Impacts of Consumer Driven Health Care            The phrasal representation â€Å"consumer driven health care†is in itself a revelation of the transformation in health care where consumers of health care services and goods are gaining more and more importance in health care industry. The consumers being the purchasers of goods and services in the health care industry suggests an existence of economic relationships between the consumers and the suppliers. The word driven implies that the supplier is going to be compelled to react according to the consumers’ demands and position as regards the provision of these goods and services. Implicitly, the complete phrase can thus be used to describe a situation where there exists a two way business interaction that is able not only to transform the health system structure but also reconfigure the health industry to engage in a competitive conduct. Such a paradigm shift in the management of health care is bound to present strong chal lenges, advantages and disadvantages.            What effect will such a system of health care have on the effectiveness and efficiency of health care provision? Currently in the United States, over $ 1 trillion dollars is spent annually on health care. Critically analyzed, this is 15% of the Gross Domestic Product and is more per capita that anything spent in other developed countries. The magnitude of the expenditure itself calls for a need a novel idea such as consumer driven health care. If such a system of health care were to be adopted, then what forces will shape the new consumer of health care services? On this basis, it is prudent to discern the effects of the key players such as employers, insurers, providers, and government entities. All these forces will only support such a system if most beneficial to them. A third scale of analysis desires that we look into the ways in which the industry is going to change. This analysis borders on the certainty of a fundamental restructuri ng of the system through a set of rules governing the new competitiveness. These structural changes will most certainly be orchestrated by the new nature of buyer-supplier relationship(Ferrari 2004). The Effect of Consumer Driven Health Care on the Efficiency and Effectiveness            To understand the changes that may occur in the efficiency and effectiveness after the transition to consumer driven health care, it is prudent to establish the objective function which measures productivity. Generally, productivity is descriptive of the magnitude of outputs achieved for a given level of inputs. In the health care industry, the physical inputs like labor, capital and supplies should be able to achieve certain levels of health outcomes. In essence, this means that productivity will be used in providing improvements on the management or treatment of diseases since this is the fundamental production process of the health care system. However, the simplicity of the productivity measure can only be taken to be useful and sustainable if it is coupled to the variety of other societal entanglements as well as other complexities in health care provision.            Given that the current health care system in the United States is the most expensive system in the world, a comparison with other developed countries on the basis of mortality and life expectancy attests that the system is less productive. However, on the basis of four disease states (diabetes, cholelithiasis, lung cancer and breast cancer), evidence suggested that it was more productive comparative to Germany and the United Kingdom. The high costs were attributable to the high administrative costs, higher compensation of doctors and other medical personnel. Consumer driven health care poses as the most reliable option in changing features which contribute to productivity hence health outcomes. For instance, a transformation to prospective payment from cost plus system of reimbursement for health institutions. Other reimbursement plans that supremely focus on the health outcomes rather that the activity also furthers the gains(Ferrari 2004 ). Customer driven health care has the ability to create incentives for providers to adopt more efficient technologies hence increasing productivity due to the underlying market competitiveness.            Since this transformation does not in any way threaten the existence of a competitive market, the cornerstone of such a market will have to be an informed buyer who has the capacity to make an accurate judgment of the value of outputs received with reference to the level of inputs injected into the system. This would usher in an era of comparative shopping among the suppliers as well as differentially reward the suppliers who provide the best goods and services at the least cost. Moreover, the system would also allow the buyer to choose a level of productivity that is desirable and affordable and trade off other savings for needs outside the health care system. Given the nature of the transformation and the rewards consequent to the paradigm shift, it is reasonable to expect an increase in productivity, improvement in health outcomes and the improvement on the efficiency and effectiveness of the health care system(Forster 2007). Forces Shaping the New Consumer            There are two major forces that possess the potentiality of shaping the evolution and the pace of the novel system. The first force is the degree to which the buyers of health care goods and services become empowered to spend their own financial resources and making their own buying decisions. The second force is the quality of health care provision and the accessibility of the relevant information that pertains to the inputs and the outcomes in the health care process.  In the case of marginalized consumers with inadequate heath care information, there is going to a continuity of the turbulence as seen in the health care system today. Such a scenario slows down the transformation to consumer driven health care system. On the other hand, when marginalized consumers have the benefit of adequate information, the consumer as the main driving force in the system retains a marginalized role in the purchases but is also associated in the trade-offs(Herzlinger 2004). The end result is an unstable relationship among the players since consumers are well informed and possess the power to make their own decisions in seeking out productive suppliers.            Empowered consumers with inadequate information may create a scenario where there is a rush for the establishment of a brand making consumers to almost completely rely on the value associated with a brand. It is on the basis of such information that consumers will make their buying decisions. With the help of interpreters, superior information may be passed to consumers or alternatively, the interpreters may broker the brand to the consumers(Ferrari 2004). However, the best scenario is when there are empowered consumers in possession of adequate information. This scenario aptly captures the spirit of the productive economic system. It implies that the market is awash with consumers buying on their own account. The existence of such a scenario itself may eliminate the need for intermediaries. Not that there is going to be a vacuum where these intermediaries had occupied but that such a space will be occupied with a different faction, for instance, it may be the marketing or sales front end of the provider entities(Herzlinger 2007). This would demonstrate the productivity of the providers(suppliers of health services) to the consumers. Alternatively, the space may be occupied with an aggregator of consumers which may leverage the consumers’ volume power in negotiating a unit price for making the buying decisions.            In the end, the trend towards informed consumers who are able to make their own health care purchasing decisions will lead to an unprecedented change in the nature and quality of services and goods offered. These changes are not only positive in nature as they will shift the burden of health care costs on the shoulders of individuals. Such a change greatly challenges the deeply rooted societal perspectives on the roles of democratically elected governments. The creation of new consumer oriented intermediaries may usher in another era of misguided government regulatory intervention. Assuming that such a scenario does not arise then a consumer driven health care system has the potential to move health care provision to anew level of productivity hence better health outcomes for the United States citizenry.            On the contrary, because of these sub classifications of consumers based on empowerment and availability of information, individuals who are less educated and healthy may avoid the needed health care services due to the cost burden coupled to the ability to make well informed and appropriate health decisions. Moreover, as Jonathan Oberlander; a political scientist at the University of North Carolina, Chapel Hill reiterates, the system simply shifts the health care cost burden back to the patients. Patients suffering from chronic health sicknesses may not be able to afford such costs, since with a deductible of between $ 3000 to $ 4000, these patients will thus be unable to save anything in their accounts. Employers are specifically impressed because the system is beneficial to them. They will not adequately fund replenish the employees health care accounts even though they will save money(Gross 2007).            The success of the consumer driven health care is dependent on the ready access to relevant information on health services, products and pricing. Due to the absence of free market variables in the health care industry, the lack of transparency will saddle consumers with additional expenses. This means that despite the theory that health insurance based on higher deductibles results in consumers shopping around for better products and services(based on quality and price), the inadequacy of such pertinent information practically goes against the attainment of benefits in a consumer driven health care model(Shearer 2007). Impacts on the Pharmaceutical Industry Currently the pharmaceutical industry has been shouldering the blame for the double digit increase in health care costs. Between the year 2001-2002, the consumer price index for health care increased by 4.4% while the industry index grew by 5.5%. A simple analysis of these percentages shows that the industry can only account for all the increase in the event that all other health care components shrunk. These statistics aside, the expenditure pent on informing consumers; $ 2.8 billion and a further $ 13.2 billion on informing doctors invariably increase the costs of health care in the long run. Therefore, unless new products are distributed for consumption without additional costs from these activities of pharmaceutical industries, the health care costs will continue to be high(Herzlinger 2004). Consumer driven health care has the potential of eliminating these costs hence advancing quality health care at lower costs.            Health care markets are extremely sensitive to the presence of a market power. Medical device companies and pharmaceutical companies retain monopoly over devices and drugs for a considerably long period of time due to the patent laws. It is during this period before the expiry of the monopoly period that these companies earn monopoly rents, in effect leading to higher drug pricing. This is unlike the traditional neoclassical supply curve(Jost 2007). This trend will be reversed as consumers will be looking out for cheap but equally effective therapeutic alternatives, hence bringing the prices down in the long run.            With the death of the intermediary between the suppliers and the consumers, the pharmaceutical industry has started to align itself with the consumer of its products through direct to consumer advertising. This has only become necessary after the FDA lifted restrictions on direct to consumer advertising. This move has been viewed by many as a gap that allows the pharmaceutical companies to foist their drugs on the gullible public in the name of providing pertinent drug information. Moreover, the use of billions of dollars in advertising only increases the overall costs of the drugs.            On the other hand, there are those who view direct to consumer advertising as being revolutionary and instrumental in promoting consumer involvement. Such an exposure of drugs to consumers acts as an educational tool and helps the consumers to be more informed in making decisions in health care. Apart from getting information direct from the pharmaceutical companies, information technology is increasing consumer empowerment making them seek high quality but less expensive choices(Mason et al 2007). Therefore, even though the pharmaceutical companies bypassed the physicians and moved directly to the consumer in advertising and promotion, consumer empowerment means that the era in which the extra expenditures were passed onto the consumers will be long gone. Such an eventuality will stimulate a dramatic restructuring of the industry. Conclusion            The potential of a consumer driven health care system to improve the efficiency and effectiveness of the quality and delivery of health care are huge. However, the fact that access to health care is hinged on the ready access to relevant information remains the main obstacle in the realization of the full benefits. Health care and market forces are mutually exclusive. The existence of a competitive market; the cornerstone of which is an informed buyer increases the capacity of the buyer to make an accurate judgment of the value of outputs received with reference to the level of inputs injected into the system. So long as information is easily and cheaply accessible and transparency in the health care industry is promoted, the system may well be the answer to age old failures of the current most popular health care system. By putting insurance money under the complete control of the patients themselves, giving the employers cost relief, and eliminating the intermediary in the doctor-patient relationship, the system will undoubtedly achieve its health outcomes. References Ferrari, T. Bernard. (2004). Where Will Consumer Driven Health Care Take the Health Care      System. In Consumer-driven Health Care: Implications for Providers, Payers, and    Policymakers. Regina E. Herzlinger(Eds). John Wiley and Sons. p. 399-403 Forster, R. (2007). Market Forces and Health Care are Mutually Exclusive. Intelligently  Connecting Institutions and Expertise. Gerson Lehrman Group. Goodman, John (2006), Consumer Driven Health Care, Networks Financial Institute Policy      Brief, Indiana State University Gross, T. (2007). Fresh Air from WHYY, July 9, 2007. Diagnosing U.S. Health Care and Sicko,          Too. Terry Gross interviewing Jonathan Oberlander, associate professor, University of            North Carolina, Chapel Hill. Grudzien, L. (2006). Can Consumer Driven Health Care, Health Reimbursement Arrangements           and Health Savings Accounts Save Employer Sponsored Health Care Reform From Ruin.      Benefit Express. Herzlinger, Regina. (2007). Who Killed Health Care? Americas $2 Trillion Medical Problem    and the Consumer-Driven Cure. McGraw-Hill Press. Herzlinger, Regina E. (2004). Consumer-Driven Health Care: Implications for Providers,          Payers, and Policymakers. San Francisco: Jossey-Bass Publishers. Jost, S. T. (2007). Health care at risk: a critique of the consumer-driven movement. Duke           University Press. Kovner, R. A., Knickman, J., Jonas, S. (2008). Jonas and Kovners Health Care Delivery in  the United States. Springer Publishing Company. Mason, J.D., Leavitt, K. J., Chaffee, W. M. (2007). Policy politics in nursing and health care.            Elsevier Health Sciences. Shearer, G. (2007). Testimony of Gail Shearer, Director, Health Policy Analysis, Washington     Office, Consumers Union before the Joint Economic Committee, on Impact of   Consumer-Driven Health Care on Consumers.            http://www.consumersunion.org/pub/0225JECTestimonyNoSummary.pdf.
Sunday, November 24, 2019
Top Ten Tips I Learned about Getting Book Endorsements
Top Ten Tips I Learned about Getting Book Endorsements Putting yourself out there as an author feels very scary especially when it comes to requesting endorsements. One of the hardest things I had to deal with when requesting endorsements or â€Å"blurbs†for my debut memoir Accidental Soldier: A Memoir of Service and Sacrifice in the Israel Defense Forces was that of rejection. However, there’s a real art to getting them. These ten pointers will increase your chances of getting the right blurbs. 1.   Start with people you already know. It is always easier to ask people who feel a personal connection to you or your book for their time without renumeration. They will be way more prone to do you a favor than celebrity authors. Such contacts can also include those you’ve met at conferences, workshops and writer groups. 2.   Find blurbers via subject matter and demographics. As a former New Yorker, I googled 40-something writers from New York who wrote on Jewish subjects. I’m Israeli so I played the â€Å"Israel card†and reached out to Danny Ayalon, the former Israel ambassador to the US, who gave me a whopping â€Å"yes.†3.   Find blurbers from other books. Once I had exhausted all my personal contacts, I started reaching out to people whose endorsed books had a similar subject matter, theme or genre to mine. 4.   Ask your publisher or publicist for recommendations. They might also be able to make the connection, making the communication easier. 5.   Make your blurbers’ lives super easy. Offer to send a copy of your book in either electronic or print form, audio if you have it. Give guidelines, like a suggested word count, a deadline and where the blurb will be used. If they express time constraints, offer to write a sample blurb they can sign off on. 6.   Give, give, ask. Figure out what you can do to help potential blurb-writers before approaching them. I began an author interview series for newly featured books. I promoted their work widely. Since I made the effort to do something for them, some of those authors were happy to return the favor 7.   Always point out what you like the best about the potential blurber’s work. Pull the focus away from yourself. After all, you’re asking a major favor! 8.   Expect a 50 percent rejection rate. People are just busy and sometimes they cannot follow through with their initial commitment. Things come up. Don’t take their rejection personally. Authors are human, too. 9.   Ask experts. Since my genre is memoir, I reached out to Linda Joy Myers, president of the National Association for Memoir Writers. (NAMW) In some cases, you might get a more positive response from a big name expert than a famous author. 10.   Plan ahead. Before your book is published, identify the major players in your niche and carefully cultivate relationships with them. Factor in the time it will take for them to read your book, and write the blurb. The key is to stay persistent. I emailed 40 people and got 11 endorsers. With my book just a few months away from publication, I tweet the blurbs as part of my marketing plan. I sent each of the endorsers a copy of the book along with a thank you note. Public thanks can bring awareness to a cause and help you stand out from a sea of authors who are all trying to make a name for themselves.
Thursday, November 21, 2019
Asymmetric Information Essay Example | Topics and Well Written Essays - 500 words
Asymmetric Information - Essay Example The various forms of asymmetric information include adverse selection, cost monitoring and moral hazard. (Bebczuk, 2003).The financial market is mostly affected by any of these forms which in turn lead to problematic financial transactions. Asymmetric information leads to various problems out of which the opportunistic behavior is the most risky situation. Opportunistic behavior is a situation in which executives and managers of a company tend to differentiate the information. The original information is conveyed in two different ways to the people working in the organization and to the outsiders. (Karuratna, 2000).This is done to improve their contacts and financial transactions through which they can maximize their utilization of funds. This in turn affects the investors as they are not provided with proper information. Since the information is misinterpreted by the managers it leads to the predicament called as the opportunistic behavior. (Sharpe, 1990).The managers make use of this opportunity and their reported earnings get gradually increased. The opportunistic behavior shows desire of the managers and their urge to move on with the financial transactions. Managerial discretion may add up to the already sustainin g problems there by resulting in loss to the people involved in the contract. In addition to that, it eventually increases discretion among the managers which also leads to loss in the amount of shares. (Sun, 2008).The shareholders tend to invest more money in a particular company and managers take advantage of this situation. In a competitive financial market, opportunistic behavior poses greater risk to exporters as well as the party involved in transaction. The terms of contract are also not specified properly in the financial document. There are also two types of opportunistic behavior prevalent in financial markets. Opportunism
Wednesday, November 20, 2019
A Ethical Dilemma that was Shaped or Influenced by the Application of Assignment
A Ethical Dilemma that was Shaped or Influenced by the Application of Nursing Research - Assignment Example Ethical dilemmas can also arise when a patient’s autonomy is not respected. This is to do with the kind of treatment the patient wants, including refusal to treatment and euthanasia (Stevens, 2006). The article states that such ethical dilemmas can be solved if the nurses have better knowledge and skills, communication skills, authority and a proper knowledge of ethical principles guiding the nursing practice (Parker, 2007). Ethical dilemmas are difficult to solve. A single decision by the nurse may not please everybody concerned, including hospital management and the patient’s guardians and relatives. Although it is important to have the basic ethical principles and knowledge from research, it is still very difficult to make a decision in an ethical dilemma. Credentialing and statutory regulations are significant components of nursing practice. Without these important elements the nursing profession lacks authority to ensure protection of interests of the public (Bandman & Bandman, 2002). Licensing is meant to protect the public from unprofessional and unsafe medical practitioners while credentialing helps to verify the qualifications of medical practitioners, including
Monday, November 18, 2019
Managing the Financial Future Essay Example | Topics and Well Written Essays - 3500 words
Managing the Financial Future - Essay Example These are international standardized test used by various schools and universities of US, Australia and UK to select students for various courses. The education sector in general is experiencing a healthy growth rate and on an average 110,000 individuals sit in the tests that will be catered to by Prepgenie. Prepgenie provides the aspirants with test preparatory tools like practice exercises, test papers and online interactive gaming sessions. As a strategy Prepgenie outsources content creation to low cost destinations like Asian countries. Its development centers in India and Vietnam have a pool of English educated, highly qualified yet low cost professionals who create content. It helps Prepgenie in minimizing cost and yet provides quality products. As a unique strategy, Prepgenie also uses multiple platforms to deliver the preparatory and learning tools in order to reduce cost and increase customer retention and interactivity. The online proprietary interactive platform provides better learning experience for the aspirant and also allows Prepgenie to capture crucial data about individual learning preferences learning style. Prepgenie also uses its LMS to create a vibrant online community of test takers. However, an offline mode of content delivery is important - more so for overseas customers where access to the Internet is limited, or is expensive. However, this medium is expensive as it involves publication, stock maintenance and delivery. Digital download is by far the most inexpensive for Prepgenie, thereby enabling it to offer more volume of content. However, this mode suffers from three major disadvantages - possible piracy, higher cost of ownership for the user if s/he intends to print these documents and no interactivity with the company. A combination all three platforms helps Prepgenie to maximize profit, minimize cost and increase interactivity. PrepGenie aims to cater to 1000 students in its first years of operations. Over the next 3 years, it aims to expand its student base to about 5000 students across Australia, UK and US and increase its average revenue per student from the present USD 450 to USD 1000.As on Jan, 2009, Prepgenie has a small team of 17 team members. It plans to increase its team size to about 30 by year end and to 45 by the end of the 3rd year. Prepgenie plans to introduce low cost products as a market penetration strategy. However, within the 2nd year of its operations, it plans to introduce comprehensive, multimedia based preparatory tools that will let PrepGenie charge premium prices. On a long term basis, PrepGenie aims to be the most innovative test prep solutions provider for a range of tests. Question 2 Describe how finances are managed within your department or project, including the nature and use of budgets and how these are established. Explain how your financial management processes fit into the overall strategic and operational planning
Friday, November 15, 2019
Analysis of the Demographics in Europe
Analysis of the Demographics in Europe The Demographic Sector in Europe This dissertation will present a historical overview of European population trends before examining in greater detail specific causes and effects of certain demographic changes. In particular, demographic changes which occurred in the UK between 1950 and 1990 and the economic consequences associated with reforms in Eastern Europe will be examined with a view to assessing the possible welfare implications. Environmental stress is increasing, due to both â€Å"unsustainable consumption and production patterns†(including high resource consumption in wealthy countries and among better-off groups in all countries) and demographic factors such as rapid population growth, population distribution and migration. 1.1 Historical Overview In a European context, the population was never more than 100,000. This represented a far lower carrying capacity than gorillas, as humans were carnivores (Emceed and Jones, 1978). Human population began to spread as the Ice Age started to retreat (25,000 10,000 B.C.). Migrations took place into the Ar tic Circle, across the Bering Straits, and also to Australia via Indonesian archipelago. The human population in 10,000 BC was probably double what it was in 100,000 BC (earliest appearance of homo sapiens) – standing at approximately 4 million. The increase had been achieved by increasing range and opening up new territories -not by new food technologies. Population density was thus traditionally low. This was to change with the switch from traditional food (hunter)gatherer to food production (Old Stone Age paleolithic 30,000 BC -to New Stone Age neolithic 6,000 BC) and as a consequence, population density increased from 0.1 km2 to 1 per km2. In the period from 1000BC 400 BC the world’s population doubled from10m to 20m. Greece’s population however, tripled to 3m. Greece’population growth meant that they were able to forge a new civilisation and become the dominant force. Malthusian claims that uncontrolled population growth can potentially lead to population decline as result of increased competition for resources, war, famine and poverty,were somewhat realized through the Asia Minor conquest and an eventual decline in the Greek population to approximately 2million by 1 AD. The population of Italy was the next major European country to experience major growth. By 300 BC the population of Italy numbered 4million people. By 1 AD this had risen to 7 million whilst the total European population was only 31 million. By 200 AD the Roman Empire had 46 million subjects including approximately 78% of this total in Europe. This peak declined to 26 million in total during the following400 years. This obviously leads to the question whether or not economic/ political / military development is a precursor to, or consequence of population development. In Greece the malthusian limits were reached which resulted in out-migration / foreign conquests. Consequently the population of Greece fell between 300 B.C. and A.D. 1, to 2 million .Population density also fell four-fold. From the 8th century onwards there was a new increase in population,leading to a population level of approximately 36 million by 1000 A.D.,which compares to peak figures from the classical period. Population then continued to increase rapidly for nearly 300 years. By and large,increases were in the north and west, but there were also increases from the east (e.g. Portugal). The population in these regions were,however, relatively low to begin with. The continued population increase was brought to an abrupt halt in 1347 by bubonic plague -Black Death. Increases in mortality and reductions in nutrition had tremendous impact on the world’s population. Between a quarter and third of the population were to perish during this period. There was however, eventually a general recovery and by 1500 the world population was nearing 80 million, increasing to 100 million by 1600. Despite Religious wars, plague and economic upheaval which changed the political scene during the 17th Century, population rose to around 120million by 1700. Economic factors were vital in assuring continued population growth and were symbolized by better technology, sea route sand growing towns. The period 1750 – 1845 was marked by one of major growth. During this period the population level rose from 140 million in 1750 to 250 million in 1845. Mortality changed definitively resulting in growth being assured unless and until fertility fell. The modernisation and urbanisation cycle had begun with famine and plague seemingly belonging to the past, although there was an extreme exception Ireland. Despite this, Europe’s population reached 450million by 1914. Population in the 20th Century was to be ravaged by both war (WWI and WWII) and mass emigration to the USA, Canada and Latin America. 2. Main demographic trends in the UK post WWII Between 1951 and 1981, the total population of the UK increased from50.4million to 55.9million. The total number of births rose steadily from c.800,000 in 1950 to a peak of over one million (1,015,000) in1964. This was the so-called â€Å"baby boom†of the 1950s and early 1960s. In 1964 the crude birth rate of the UK stood at an all time high of18.8 per 1000. In 1963 the oral contraceptive pill first became available to women, and in 1968 the Abortion Act legalised abortion in certain circumstances. The combination of these two factors, especially the former, initiated a down-turn in birth rate which continued for 13 years until 1977 when the number of live births was 657,000 to give ac rude birth rate of 11.8 per 1000. For two years, 1976 and 1977, the number of births was actually less than the number of deaths and the country briefly experienced a natural decrease of population .Subsequently, during the 1980s, the number of births rose to about700,000 per year to give a crude birth rate of about 13 per 1000. This slight up-turn in birth rate has been explained as a result of couples postponing the start of a family. Between 1965 and 1985 the average age of mothers having their first child increased from 21 to 27 years of age. Mortality in the UK since 1950 has been subject to far less fluctuation than fertility during the same period. The total number of deaths in the UK each year since 1950 has been between 600,000 and 700,000. Crude death rates during a period of 40 years have stubbornly remained within the range of 11 to 13 per 1000. This is significantly higher than the crude mortality rate of most other countries of North West Europe. The causes of death have shown little change over the period with diseases of the circulatory system and cancer firmly established as the main killing diseases and jointly accounting for over 70% of all deaths by the 1980s. The failure of the UK to reduce its mortality rate during the second half of the 20th century has been attributed to various factors; namely, declining standards of health care, the maintenance sofa large stock of obsolete slum housing, high unemployment rates and high levels of poverty and deprivation. In the late-1980s, infant mortality rates, probably the most sensitive indicator of the quality of the social and physical environment for human life, actually rose in many parts of the country. Detailed statistics for the numbers of migrants entering and leaving the UK only extend back as far as 1964. Comprehensive statistics for the numbers of immigrants and emigrants are not available for the period of the 1950s and early-1960s when large numbers of West Indian sand Asians entered the UK. Post-1964 statistics reveal considerable short-term fluctuations in the numbers of both immigrants and emigrants. However, with the exception of just one or two years, the net migration balance is a negative one; that is to say, in most years more people leave than enter the UK. Despite the popular myths about the flood of immigrants entering the UK, the reality is that the UK Lisa net â€Å"exporter†of population in most years. Since the early 1960s,the numbers entering the UK have been checked and reduced by succession of Immigration Acts (1962, 1968, 1972 etc) designed to make the conditions of entry more demanding and settlement in the UK more difficult. The long-term trend for immigration and emigration appear to be related to â€Å"push†factors in the source areas rather than â€Å"pull†factors in the destination area. Thus, peaks of immigration appear to be related to particular overseas events. For example, the expulsion of Asians from Uganda by President Am in in 1972 corresponds with a minor peak in the flow of immigrants into the UK. Conversely, the rising tide of unemployment in the UK during the early-1980s corresponds with as harp up-turn in the numbers leaving the country between 1981 and 1985. One of the most obvious demographic changes in post-war Britain has been its transformation into a multi-racial and multi-cultural society.rior to 1991, the UK Census did not include questions on race and ethnicity, so that it was impossible to obtain precise information about the size and distribution of minority groups. However,â€Å"place-of-birth†statistics derived from the census show that by 1981about six percent of the UK population was â€Å"overseas-born†. The total percentage of overseas-born population is not large, but it is very unevenly distributed. Racial and ethnic minorities tend to cluster in the inner city districts of particular towns and cities. Discrimination in the fields of housing and employment produced tensions and unrest which finally erupted in urban riots in 1981 and again in 1985. 3. Post-war political economy The year 1989 heralded a great change within Eastern Europe, as revolutions throughout the region swept away the communist governments,marking an end to conditions of political, economic and social repression. The major impetus in precipitating change was the desire for freedom on the part of the masses. Allied to this demand for social freedom was a general will for improved standards of living conditions,with the belief of the majority being that this could be achieved through the reorganisation of society along the lines of western-style free market economies. There was certainly a need for substantial economic reform within Eastern Europe in terms of â€Å"freeing up†the market economy and the need for some type of transformation strategy. However, a great deal of debate is concerned not with the actual need for transformation, but with the actual method of transformation. One can best define the argument in terms of the proponents of a gradualist approach to transformation. There are a number of economists who favour a radical approach to transformation, arguing the necessity for speed,comprehensiveness and simultaneity of change, who have been accused by other economists of stressing an over reliance on the market, and of failing to fully understand the nature of market economies. To explore the debate fully it is necessary for one to consider the claims of those economists that are in favour or the radical approach to transformation. â€Å"Both economic logic and the political situation argue for a rapid and comprehensive process of transformation†(Lipton and Sacs, 1990). This quote is from two of the main advocates of the radical approach. They emphasise the speed and comprehensiveness of change within Eastern Europe, believing that there should be a seamless web of transition.The first stage, they claim, should be achieving a macroeconomic stability: â€Å"structural reforms cannot be put in place without a working price system; a working price system cannot be put into place without ending excess demand and creating a convertible currency; and a credit squeeze and tight macroeconomic policy cannot be sustained unless prices are realistic, so that there is a rational basis for deciding which firms should be allowed to close.†Thus as crucial to their arguments for a comprehensive reform process is the need for real structural adjustment, and for this macroeconomic shock to be accompanied by a num ber of associated measures such as selling off state assets, freeing up the private sector, establishing procedures for bankruptcy, the preparation of a social security net and widespread tax reforms. Advocates of shock therapy transformation use a number of political reasons for their emphasis upon rapidity. Perhaps the most important of the political reasons is that the new governments would be best able to carry out strong measures at the outset of their office, and thus deny opponents the chance to subvert the process of change and retain some of the irrationalities of the old style regime. A further argument in favour of the shock therapy transformation is that there is a view of the market as being an institutional package, that it is an integrated and â€Å"organic†whole, the elements of which cannot be introduced one Bata time and in a gradual fashion. Thus certain economists have argued that the only way for the market system to function is if all of it score institutions are introduced simultaneously, with the core institutions being a legal infrastructure, private property, free markets and prices, competition, and macroeconomic policy instruments. However, the shock therapy approach to economic transformation has benignities by a number of economists. Although by common consensus is a definite necessity for change the shock therapy approach presents us with a number of difficulties. Perhaps the greatest problem concerns the nature of markets, for there is little knowledge of how tactually establish a market system. The situation in Eastern Europe is most certainly unique, for never before have there been attempts to establish a market economies from the wreckage of the communist system,since historically the development of free markets went hand in hand with the process of industrialisation. â€Å"Post – communist countries,however, do have a more or less developed industrial infrastructure,social services and political expectations to be governed in some sort of western democratic fashion. In short, our knowledge does not extend to the conditions under which Soviet type economies have to be reformed†(Pick el, 1 992). Andreas Pick el identified a number of criticisms of the shock therapy. The emphasis placed upon comprehensive change stresses the need for the creation of a â€Å"critical minimum mass of market institutions†necessary for the function of the market economy. Picketer that at best we have only sketchy knowledge of what thisâ€Å"critical minimum mass†is, and that claims as to the necessity for comprehensive change ignore the complex realities of the situation.Take for example, what Perry in his list of measures with respect to the creation of â€Å"free markets with free prices: there must be free entry into the market and free exit from it. This mans that there are no barriers to entering market transactions, that workers and manager scan be fired, and that unprofitable firms go bankrupt. There is not as ingle existing market economy that fulfils this requirement†(Pick el,1992). Therefore how can we hope to ascertain what is necessary for the wholesale importa tion of the market economy. The justification for speed on the part of the shock therapists owe sits origins to a conception of two clearly defined and opposite systems, those of socialism and capitalism. Speed is necessary in the transformation because plan and market institutions are said to be incompatible, that the new system will work badly or not at all as lon gas it contains too many elements of the old system. Pick el argues that this is merely another way of invoking the â€Å"critical mass†argument again. â€Å"Granted that the quick establishment of essential institutions crucial for the success of reforms, at which point is it possible to slow this down in order to reduce, for example, some of the social costs of transformation, or to consider alternative options†(Pick el,1992). As with the â€Å"critical mass†argument we have little way of determining how quickly or for how long should the process be continued with pace. The necessity for simultaneity, as emphasized by the proponents of the shock approach, is criticised by Pickle as revealing problems with the radicals’ conception of economics as â€Å"systems†. Pick el mentions’s statement that â€Å"the need for simultaneous action on the institutional front arises from the holistic nature of systems, their essentially integrated order†. Pick el then attacks this stance,claiming that the â€Å"market system†only exists in textbooks, that there are as many institutional configurations as there are actually existing market economies. Essentially, claims as to the necessary institution sand processes are somewhat speculative, for when one considers today’market economies one can see that there have been numerous stages of growth, development and mutation. Virtually none of the modern market economies have developed along the lines of simultaneous establishment of core institutions as prescribed by the shock therapist theorists,suggesting it is indeed possible for transition to the market to be accomplished in disjointed and incoherent ways. It is most certainly possible for one to claim that economists who emphasise the speed, immediacy, and comprehensiveness of reforms in Eastern Europe, both overestimate the properties of the market and misunderstand the nature of market economies. It is important for one to bear in mind that the major difficulty that exists in the attempts to undergo the radical transition process as prescribed by the shock therapists is that the â€Å"wholesale institutional transformation produces range of unintended consequences that will undermine the realisation of the original goal†(Pick el, 1992). To this end Pick el uses the example of East Germany in order to illustrate the â€Å"ideal empirical test case for the strengths and weaknesses of the radical strategy. Pick el begins by claiming that the two treaties between the FRG and the GDR, on monetary, economic and social union and on unification, created what proponents of the shock therapy deem essential – â€Å"the speedy creation of what are considered to be the essential practical and economic institutions and the rules of capitalist democracy†(Picked,1992). Pick el claims that the radical shock therapy approach in East Germany created a number of unforeseen consequences which possessed implications for the future development of the country. The first of these consequences was the collapse of the state sector, resulting in massive unemployment and serious problems in the existing private sector, something which is still affecting Germany’s economy. The second consequence was that the restitution of pre-communist property rights and titles, which produced hundreds of thousands of claims and created an uncertain atmosphere for investors. The third unforeseen consequence was that there was an uninterrupted migration of workers from east to west and the fourth was the so cio-psychological and political disembowelment of large sectors of the East German population, that is, the colonisation or creation of a de facto group of second class citizens. The argument here is that the radical strategy in Germany failed in crucial respects. Rather than create the conditions necessary for sustained economic development, the radical approach led to the occurrence of a number of unforeseen circumstances that led to the collapse of the East German economy, creating lasting structural damage. Pick el claims that since the radical shock theory approach was attempted under rather favourable conditions in East Germany it generates a significant amount of concern for other countries where the conditions are not so favourable. 4. Sustainable development Population growth and distribution have significant roles to play in the sustainability of the worlds vast resources. Not only the number of people, but also the lifestyle, consumption patterns, and regions people inhabit and use directly affect the environment. The relationship between population growth and environmental degradation may appear to be rather straightforward. More people demand more resources and generate more waste. Clearly one of the challenges of growing population is that the mere presence of so many people sharing limited number of resources strains the environment. But when looking at the impact of human activities, the situation is more complicated due to the wide variety of government policies, technologies, and consumption patterns worldwide. The link between population growth and the environment is found somewhere between the view that population growth is solely responsible for all environmental ills and the view that more people means the development of new technologies to overcome any environmental problems. Most environmentalists agree that population growth is only one of several interacting factors that place pressure on the environment.High levels of consumption and industrialization, inequality in wealth and land distribution, inappropriate government policies, poverty, and inefficient technologies all contribute to environmental decline. Infarct, population may not be a root cause in environmental decline, but rather just one factor among many that exacerbate or multiply the negative effects of other social, economic, and political factors. Bio diversity is a term applied to describe the complexity of life. It is generally measured at three levels: the variety of species; the genetic diversity found within members of the same species (what makes you different from your neighbour); and the diversity of the ecosystems within which species live. These three levels are intimately connected. Genetic diversity is essential to the prosperity of the species, giving it the resources to adapt. And the number of species within an ecosystem is closely tied to the health and size of the ecosystem://www.ourplanet.com/aaas/pages/bio01.html # (Rosen,1999). However it is defined, bio diversity is the stuff of life. However far we may be removed from wild bio diversity in our daily lives, it remains the source of our food and most of our medicines. In addition,15 percent of our energy is derived from burning plant materials. Evening the United States, wild species contribute around 4.5 percent of GDP(De Leo and Levin, 1997). Some of our uses are direct. Billions of people still harvest wild orbush food around the world. Between a fifth and a half of all food consumed by the poor in the developing world is gathered rather than cultivated, while at global level we obtain 16 percent of our animal protein from sea fish caught in the wild. The World Health Organization(WHO) estimates that more than 60 percent of the worlds population relies on traditional plant medicines for day-to-day primary healthcare ( Bali ck and Cox, 1996), and 3 000 plant species are used in birth control alone (My ers, 1979). The primary cause of this loss is not hunting or overexploitation,though these play a part, but loss of natural habitat. Habitat loss is generally greatest where population density is highest. A study nobodies data from 102 countries found that in the most densely populated 51 countries (averaging 168 people per square kilo meter), 5.1percent of bird species and 3.7 percent of plant species were threatened. In the 51 less densely populated countries (averaging 22people per square kilo meter), the proportions of threatened species were only half as high at 2.7 percent and 1.8 percent respectively(UNFPA, 1997). 5. Political and socioeconomic geography of Europe The Second World War was a catastrophe in terms of the huge loss of life and indeed by this very fact it can bee seen as an important watershed in the development of Europe. The economic and social development of Europe was severely dislocated and fractured .Industrialisation trends were re orientated to serve the demands of the war machine. Most areas of Europe by the close of the war were facing the same problem, that of reconstruction. The war created the conditions which were conducive for the progressive restructuring of social institutions. The experience of war seemed to demonstrate that central governments could control economic development and most European nations introduced some form of economic planning in the postwar period. The working classes began to have a representative with the emergence of legitimate parties participating in the political process. There was a shift in governmental policy to welfare state policies with post-war Europe recognizing the need to integrate the working classes into political life. There were several factors contributing to the restructuring of Europe and these are important when examining any increase in the welfare of Europe’s population since the Second World War. At the end of the war Europe was divided into the capitalist West and the communist East.This resulted in differential economic and social growth as well as obvious differences in political ideology. The capitalist West benefited from substantial America Aid under the Marshal Plan. Rapid industrial development was favoured in Europe to counter the perceived threat from the East, but also important was the fact that America emerged from the war with expanded industries which were also more efficient and therefore they needed trading partners and investment opportunities. The Soviet Union however, were not as fortunate and suffered heavily from the destruction inflicted upon its people,agriculture and industry, all of which needed to be recreated. The war provided for opportunities of peacetime recovery and prosperity. It had forced and even closer union of science and technology and in the new world it seemed that all problems could be solved through the development and application of new technologies .Damaged production could be replaced by new equipment, raising efficiency and stimulating capital goods industries. The war itself had provided the impetus behind scientific and technological development,which would prove to be the key behind future European development. The great hardships of the 1930’s encouraged the view that national governments had a responsibility to protect and enhance the quality of life through improved systems of social security, health care and education. And it was improvements in these areas of welfare that the population of Europe has, more or less, been a benefactor. Birth rate shave declined in most European countries, whilst in Northwest Europe it was close to, or even below, the replacement levels by the early 1980s.Marriage rates also declined following a relative peak after the war.The lowest levels are again in Northwest Europe, particularly Sweden,whilst Eastern Europe displays the highest inutility rates. The cause for declining birth rates is complex. Women’s rates have changed, there has been increased urbanisation leading to a reduced need for farm labour, increased opportunities for higher education, declining influence of the Church. Of great significance in explaining a decrease in birth rates, and itself an indicator of social welfare, is the infant mortality rate. Infant mortality has been significantly reduced since the second world war. In france in 1950, the infant mortality rate was 52 per 1000 deaths before the age of 1 year old. By 1970 this had been reduced to 18 per 100. Sweden, Norway, Denmark and the Netherlands all had the lowest rates whilst Romania, Portugal and Yugoslavia suffered from the highest rates of infant mortality. In Europe, life expectancy is at its highest levels in history, with the average life expectancy being 75 years for someone in Western Europe and 72 in Eastern Europe. Death rates have decreased in virtually every European country since the Second World War due to improvements in medicine and medical care, sanitation, health provisions and technology. Demographic changes led to increasing proportions of the young and old dominating population structures. The welfare state had to respond accordingly with more emphasis having to be placed upon areas such as housing, education, child support,retirement and pensions. With increasing prosperity after the war,Europeans standard of living significantly improved and this move toward modernity employed classical demographic features involved in the process of modernisation. Several Western European countries experienced decolonisation and reparation of their expatriates and natives of former colonial areas.In Algeria 600,000 people â€Å"returned†to France in 1962 following independence. The boom of the 1960s resulted in some countries needing to attract migrant labour. Indian, North Africans, Spanish, Portuguese,Italians, Yugoslavs, Greeks and Turks all poured into the Northern and Western urban and industrial centres of Europe. Migrant workers were more numerate in the Low countries and exceptionally high in Switzerland, where, in 1974, 37 per cent of the workforce were foreigners. In 1982 there were 4.2 million foreigners working in France every 10th worker in France was non-French. In Germany there were 4.6 million non-Germans, of which Turkish, Italian and Yugoslav workers were the most dominant. These immigrant workers constitute a form of sub-proletariat, taking the jobs natives did’t want to do. They were(and are) often badly tre ated and denied political rights. They usually find themselves in ghettos, and in times of economic downturn find themselves the targets of racial abuse. Urbanisation was a major feature of postwar European society and was in essence a continuation of a nineteenth century trend. By 1975 most Europeans lived in cities – one-third of the Greek population lived in Athens. City growth was primarily the result of rural to urban migration, with such incentives as higher wages, better housing,attractive employment, educational opportunities and more access to recreation and entertainment. Urbanisation, particularly if it is coupled with high levels of immigrants can soon lead to overcrowded housing and poor sanitation. With huge increases in car ownership and the amount of automobiles on the road together with the location of industries in, or on the periphery of, cities, some major urban and industrial centres of Europe have become unpleasant areas in which to live. The subsidised housing which were created for the working classes under the social security provisions of the welfare state were often poor quality and consisted of high-rise buildings located in peripheral areas of the city. The HLM in France and estates on the north-side of Dublin, such as the Allah and Bally are examples of this type of housing. It is evident in such areas that the great disparities in income or certain social disadvantages were not dealt with despite some improvements in health-care, family allowances, education and other social services. Severe social problems face people caught in the poverty cycle in these areas and, consequently, with such levels of despair, the rates for drug abuse, crime and deviancy are relatively high. The decline of the agricultural sector of the economy and the loss of farm populations was another major feature of post-war Europe. This transition was to be expected as the workforce moved toward an industrially-based economy and later increasingly dominated by the tertiary sector. In 1950 80 per cent of the workforce in Bulgaria was engaged in agriculture. By 1980 this figure had declined to 20 percent. This trend can be seen in several other countries, for example46% of the population in Eire were engaged in agriculture in 1949 but had reduced to 20% of the population by 1979. Spain exhibited a similar trend with 52% of the population engaged in agriculture in 1940 but by1979 this had been reduced to 20% of the population. This trend had the greatest impact on peripheral European countries industrialising after the Second World War. Technological innovations had made agriculture more intensive and mechanised. This initiated mass migration to urban areas, and also was to result in increasin
Wednesday, November 13, 2019
False Memory Syndrome And The Brain Essay -- Neurological Biology Essa
False Memory Syndrome And The Brain In the mid-nineties, a sniper's hammering shots echoed through an American playground. Several children were killed and many injured. A 1998 study of the 133 children who attended the school by psychologists Dr. Robert Pynoos and Dr. Karim Nader, experts on Post-Traumatic Stress Disorder among children, yielded a very bizarre discovery. Some of the children who were not on the schools grounds that day obstinately swore they had very vivid personal recollections of the attack happening (1). The children were not exaggerating, or playing make-believe. They were adamant about the fact that they were indeed there, and that they saw the attack as it was occuring. Why would these children remember something so harrowing if they didn't actually experience it? What kind of trick was their brain playing on them? Why did it happen? False Memory Syndrome (FMS) is a condition in which a person's identity and interpersonal relationships are centered on a memory of traumatic experience which is actually false, but in which the person is strongly convinced (2). When considering FMS, it's best to remember that all individuals are prone to creating false memories. A common experiment in Introduction to Psychology courses include a test similar to this one: Look at this list of words and try to memorize them: sharp thread sting eye pinch sew thin mend After a few seconds, the students will be asked to recall these words, and are asked the following questions: Was the word "needle" on the list? Was it near the top? The majority of the class will vehemently agree that needle was, in fact, on the list. And not only that, it was actually quite close to being the first word. Some will attest to havin... ... memories", implant unhealthy and false ideas into the brains of their patients that havoc ensues. References 1)Recovered Memory Therapy and False Memory Syndrome, Recent Legal and Investigative Trends by Dr. John Hochman, M.D. http://www.pimall.com/nais/n.memory.html 2) Memory and Reality: Website of the False Memory Syndrome Foundation http://www.fmsfonline.org/ 3) BodytalkMagazine.com How Memory Works http://www.bodytalkmagazine.com/how%20memory%20works.htm 4) The Skeptic's Dictionary False Memory http://skepdic.com/falsememory.html 5) Salon.com Health and Body - The Story of Valerie Jenks http://www.salon.com/health/feature/1999/12/22/false_memory/ 6) How Memory Really Works Freud's Notion of Repressed Memory http://www.skeptic.com/memory/ 7) FAQ for the False Memory Syndrome Foundation http://www.fmsfonline.org/fmsffaq.html
Subscribe to:
Posts (Atom)