Sam 322 unit 3 Assignment Example | Topics and Well Written Essays - 250 words

Sam 322 unit 3 - Assignment Example Illness prevention and health encouragement campaigns are another recent event that catalyzed the growth of modern sporting. Examples of these campaigns are Healthy People, Objectives for the Nation, Healthy People 2010, and the annual Surgeon General’s Report on Physical Activity and Health (Wuest and Fisette, 2012). A third recent event is the enactment of laws that encourage opportunities for both genders and disabled individuals to participate in sports and exercise science. Federal laws such as the PL 93-122 Section 504 of the Rehabilitation Act and PL 101-336 Americans with Disabilities Act have fostered the expansion of physical education and sports today by altering the administration of inter-college sporting competitions and challenging Title IX. Since the approval of this title, active modifications in physical education lessons have been quick and efficient (Wuest and Fisette, 2012). Lastly, the revival and commercialization of the Olympics are recent events that significantly contributed to the growth of physical education. Since its revival in 1896, the Olympics have been highly politicized and commercialized to include contemporary and conventional sporting activities. Recently, the characteristics of amateur sports have evolved in the Olympics along with quick and efficient soluti ons for fairness issues (Wuest and Fisette,

What's your Dangerous Idea Research Paper Example | Topics and Well Written Essays - 1250 words

What's your Dangerous Idea - Research Paper Example A sample such a situation is a college who, during exam week, chose to party every night instead of study. During his exams the next day he is unprepared and without answers to the questions being asked in the exam form. He is unable to answer enough right questions that would result in his passing the exam. The result of his first 2 previous actions determined that he would fail the test and thus, fail the class as well. Events such as the aforementioned situation prove the philosophy that all naturally occurring events will happen due to the laws of nature. In essence, all the events that take place in a persons life and its results are all part of a naturally occurring system in a persons life that is based upon a persons choices and decisions that are influenced by the motives of a person. In other words, the collective human actions will create conditions that will result in the occurrence of an event. No other event can result from the actions that a person executed. These actions are, as seen in the example above, to be considered pre-conditions that help determine the course and results of a previous event in a persons life. Such events are then defined to be a part of Causal Determinism which is understood to mean cause and effect. Theoretically, (causal) determinism is believed to be composed of moral choices that preclude free will. The reason that determinism is believed to take precedence over free will is because humans will act in a certain manner whether they like it or not. Factors combine in order to make people follow a certain path with a pre-determined result for them at the end of it. Therefore determinism necessitates that antecedent events and conditions come together like atoms in the laws of nature. It is because of these existing reasons that Determinism has been thought to have a deep connection with mans understanding of the physical sciences and its explanatory ambitions and our views about human

CARL ROGERS PERSON-CENTRED APPROACH

CARL ROGERS PERSON-CENTRED APPROACH Introduction Carl Rogers (1902-1987) a psychologist developed the person-centred approach theory mainly in relation to the therapist and the client and initially named it the client-centred approach. Rogers later referred to this theory as person-centred rather than patient-centred in order not to reduce the individuals autonomy and consequently lend the client to difficulties. The approach therefore is to turn individuals (clients) into subjects of their own therapy. In his theory it was noted that individuals are endowed with the power of self actualization and through their own perception of resources inherent in them, they can provide remedy for change in their difficult situations, provided a facilitating environment exists This view as expressed by Rogers implied that every person has a tendency to grow and attain a certain level of actualization. He observed that in order to allow the client (person) asses his/her own wisdom and self defeating behaviours and also engage in therapeutic move ment with the therapist, there must be a conducive climate. Three conditions were identified for this relationship to thrive favourably: Genuineness (Congruence), Empathy and Unconditional Positive Regard. GENUINENESS (Congruence) In this relationship the therapist is expected to show a real sense of genuine attitude towards the clients feelings and thoughts, be willing and ever present to assist them in whatever situation they may be. He should be transparent and discourage the attitude of being the superior in the situation. This attitude would in turn retain a high sense of confidence in the client towards realization of him/herself in therapy. Any deviation from this attitude renders the process unworkable. UNCONDITIONAL POSITIVE REGARD (Total Acceptance) According to Rogers, the therapist in this situation must show non-judgemental and total acceptance to the clients feelings and his perceptive world as a whole to enhance his process of recovery. This total acceptance of the clients attitude and perception should be devoid of whatsoever differences that might exist between them either culturally or socially. However in doing so the therapist should ensure the safety and security of the client. EMPATHETIC UNDERSTANDING In his theory, showing empathy refers to the ability of the therapist to show positive sensitivity to the clients world, his perception towards recovery and also communicate his feelings to the client. This will convey a special meaning to the client of his relationship with the therapist and consequently solidify their mutual relationship towards the expected therapeutic movement. Rogers continue to state that any deviation from these attitudes on the part of the therapist makes it difficult for the process to continue. This empathetic attitude is more exhibited by therapists who are more confident about their own identity and can cope with other persons world without any fear. PERSON-CENTREDNESS AS A CONCEPT Person-centeredness a concept in health care delivery has poor and conflicting definitions over the years and is considered one of the best ways of health care delivery in which patients are valued as individuals (Winfield et al. 1996). It has further been observed by (Slater 2006; Leplege et al 2007), that the concept of person-centredness has been described using different terms like patient-centred, client-centred, person-centred interchangeably which makes it most often unclear which consistent term to use in the description of the concept. Notwithstanding all these difficulties, Kitwood (1997) defined person-centredness as a standing or status that is bestowed upon one human being by others in the context of relationship and social being. It implies recognition, respect and trust. (p.8) Kitwood (1997) further used person-centredness to formulate ideas and ways of working which puts much emphasis on communication and building relationships in care. Brooker (2004), elaborating on person-centred approach found out that the definition of the term has such characteristics as:  · Respecting and valuing the individual as a full member of society  · Providing individualised places of care that are in line with peoples changing needs  · Understanding the perspective of the person and providing a supportive social psychology in order to help people live a life of relative well-being. Dwelling on these definitions of Kitwood and Brooker, it is evident that they are built on the works of Carl Rogers (1950), which developed person-centred approach as a way of facilitating psychological growth (Natiello 2001).In addition a critical look at Kitwoods definitions definitions showed that personhood has been considered very essential. (Dewing 2008) observed that Person-centredness is often associated with gerontological nursing and more particularly issues relating to dementia care and have personhood as a basis of promoting its practice. It is therefore relevant to explore the philosophical and theoretical underpinnings of personhood in as much as it recognised in person-centredness (Baker 2001; Ford McCormack 2000; Fares 1997). Baker (2001) declared that personhood is consistent with individuality and has three dimensions; the persons world which relates to understanding the persons needs, self relating to emotional and physical security and others which signify social and material world that considers the need for interventions and a sense of belonging and place. Similarly (Ford McCormack 2000) recognises personhood as the persons ability to rational make decision by virtue of his reflection on available needs, choices wants and desires. On the contrary this ability to make rational decisions might be difficult particularly in persons with dementia (Kitwood 1997), however choices can be offered to the person. Harre (1998, p.6) drawing on the work of Apter (1989),concludes that ; a sense of personal distinctiveness, a sense of personal continuity and a sense of personal autonomy important phenomenon that best described personhood. Elsewhere in literature, transcendence (a state beyond material or usual existence) has been referred to as an essential characteristic for description of personhood (Heron 1992 Kitwood 1990a, 1997).This goes to establish the assertion that personhood can be accessed from three type of literature- theology and spiritual, ethics and social psychology and each of these literature gives different meanings to attributes relating to personhood (Kitwood 1997, p.8). McCormack (2004) compared the definition of person-centredness by Kitwood and his own findings in an extensively reviewed literature and concludes that four concepts should be considered in describing person-centred nursing. These are: Being in Relation, Being in Social Context, Being In Place, Being With Self. Being In Relation Being in relationship emphasizes the point that, for any effective person-centred care to commence, continue and achieve success ,the nurse and the patient should be in a good interpersonal relationship and this relationship requires valuing of self, moral integrity, reflective ability, knowing self and others as derived from reflection on values and their place in the relationship. Being in relationship is also reflected in one of the seven attributes of person-centredness identified by Slaters (2006) concept analysis-evidence of a therapeutic relationship between person and health care provider. He further states that this relationship between the person and care provider must be one of mutuality, mutual trust and non-judgemental which does not take into consideration the balance of power. Being In Social Context This is the interconnectedness of persons with the social world in which individuals create meaning to themselves through being in the world. Being able to understand the social world of the person enables one to clearly identify things that are considered paramount in their lives Slater (2006). Being In Place Andrew (2003) declares that concept of place and its impact on health care delivery is poorly understood in nursing. Andrew further argued that places are not just physical but involve situated human intentions within them.(Andrew, 2003; Luckhurst Ray, 1997; Hussain Raczka, 1997) contends that attention must be paid to place in care relationships for its important role. In order for nurses to be facilitators of person-centredness, care values must be balanced with other organisational values no matter how difficult it might be, to enable the process of the concept to continue smoothly (Woods 2001). A similar idea was expressed by Johns (1995) that nurses cannot freely fulfil their moral obligation to patients without taking cognisance of organisational and professional implications. To buttress this McCormack et al (2002) asserts that whilst it is important for nurses to facilitate person-centredness, other contextual issues such as staff relationships, organisational systems, power differentials and the extent to which the organisation tolerates innovative practices and risk taking should be worth noting. Being with Self Knowing self is very central in person-centred nursing approach. This is important in that, health care providers need to identify their personal values first in order to respect the values of other patients under their care, to avoid trampling over their autonomy and cultural needs paramount to person-centredness (Downs, 1997; Ford McCormack, 2001; McCormack, 2001b; Nolan, 2000).Further, knowing self enables the nurse to make comparisons of current lifestyles and behaviours of the patient with his preferences and values of life in general as a clue to enhance care process (Meyers,1999). PERSON-CENTRED PRACTICE BASED ON AUTHENTIC CONSCIOUSNESS Based on the four concepts- Being In place, Being In relationship, Being with self, Being In social context, McCormack (2003) outlined five conceptual models in consistent with current nursing principles. These are: Authentic consciousness (McCormack 2001a, 2001b, 2003 and 2004), Positive person work (Packer 2003), the senses Framework (Nolan et al 2001), Skilled companionship (Titchen 2000, 2001 p.80) and The Burford Nursing Development unit model (Johns 1994). McCormack developed a conceptual framework for person-centredness practice based on Authentic consciousness. He identified five imperfect duties on which the framework will operationalize.further, McCormack (2003) declared that for person-centredness to operate effectively in practice, factors such as the patients value, the nurses values and the context of care environment. For the purpose of this study, imperfect duties and factors (Patients values, the nurses values, context of care environment) on which person-centred practice operationalize will be explored to highlight their effect on the concept. According to Immanuel Kants morale theory cited in (Sullivan, RJ 1990), imperfect duties are described as wide, broad and limited such that it gives room for discretion but within the rules of the organization within which one works. There is no means of offering an exhaustive and a priori account of how the duties are to be fulfilled. The five imperfect duties discussed earlier are as from (the conceptual framework of McCormack 2003):  · Informed flexibility: this is the facilitation of fdecision making based on information dissemination and the integration of new information into established perspectives and care practices.  · Mutuality: the recognition of the others values as being equally paramount in decision making.  · Transparency: making clear the intentions and motivations for action and the boundaries within which care decisions are set.  · Negotiation: patient participation through a culture of care that values the views of the patient as a legitimate basis for decision making while recognizing that being the final judge of decisions is of secondary importance.  · Sympathetic presence: this is an engagement takes into consideration the uniqueness and value of the individual by appropriately responding to cues that maximize coping resources through the recognition of important agendas in daily life. PATIENTS VALUES In person-centred practice respect for patients values are identified as being central in order to achieve an effective process of the concept (Dewing, J. 2002; William,B. Grant. 1998; McCormack 2001).It is important to develop a clear picture of what patients values about their life and how they make sense of what is happening around them. Helping the individual to have realization in care makes them to tolerate the incongruency of their illness and also helps them to plan for future, to do this, there is the need to build a baseline value history of the patient through biographical accounts and narrative story.(Meyers, D.T. 1989).The complex nature of most health care decisions couple with anxiety, fear of illness, dependency and other aggressive tendencies results in the patients decision making ability being diminished.( Buchanan Brock, 1989) Argued that if patients are left to be in total control of their health care decisions, most often than not their choice of treatment dec ision might not work effectively towards their well being as expected. They further argued that, as much as patients are expected to participate in decision making regarding their health, they should also be protected sometimes from harmful consequences of their own choices. According to Seedhouse, D. (1986) health has different meanings to different people and is also given various degrees of relevance by individuals. It therefore implies that there is no single care intervention that can be considered best for everyone. Whiles are a particular approach is applicable in one situation it may not be same in the other. In view of these, health care decisions need to adopt a negotiated approach between the patient and the practitioner (McCormack, 2001). NURSES VALUES In spite of partnership being a common phenomenon in person-centred practice where nurses are encouraged to be lenient in their presentation to patients, it is unusual for nurses to present their own views as a part of information that patients are given to help their decisions.Gadow (1980) argued that in as much as patients values should be dominant in the decision, nurses values also contribute to enhance the efficiency of the process but in a less explicit manner. Nurses expressing their values in care decisions should not really be a problem if there is partnership, since these will help the patient to have more insight into the nurses position regarding their care. CONTEXT OF PRACTICE ENVIRONMENT Despite more attention on nurses and patient values the care environment also play a significant role in the person-centred process in which there is the tendency to either promote or hinder its smooth running (McCormack et al 2002; Rycroft-Malone et al 2002).In facilitating person-centredness nurses are faced with difficulties of having to cope with the morale obligations to patients as well as organisational and professional implications (Johns, 1999).this situation has been confirmed by recent analysis f context undertaken by McCormack et al (2002). Yarling (1990) expressed a similar view to earlier researchers above that, in modern health care delivery, while nurses are expected to engage in autonomous decision making they are limited in exercising their authority. THE CONCEPT OF PERSON-CENTREDNESS IN REHABILITATION Clare et al. (2006) define rehabilitation as an individualized approach to helping people with cognitive impairments in which those affected, and their families work together with health care professionals to identify personal-relevant goals and strategies for addressing these. This definition clearly shows a connection between rehabilitation and the concept of person-centredness. Leplege et al (2007) argued that the notion of person-centredness have been used interchangeably as patient- centred ,client-centred, individual- centred, person-directed. Reasoning along this argument, implies that the term has a multidimensional use. In order to establish further the description of this terminology, Leplege and his colleagues undertook a conceptual analysis of person-centred concept in the field of rehabilitation and identified few supportive concepts that clearly elaborate on the use of the term. THE PERSONS SPECIFIC HOLISTIC PROPERTIES AND DIFFICULTIES IN EVERYDAY LIFE Person-centredness as a means of addressing the persons specific and holistic properties suggests that in dealing with individuals, their biological and psychosocial needs must be considered as paramount as opposed to classical analytic medical attention on the functionality of specific organs and related medications prescribed for relief of ailment. In their view regarding person-centredness in rehabilitation, the term seeks to address difficulties in everyday life of disabled persons in such a manner as to reflect their needs and social adjustment. Rehabilitation alone without person-centredness seems more technical and ignores other aspects of the patients life. PARTICIPATION AND EMPOWERMENT It is further argued that disabled persons be given more decisional autonomy in order to be aware of what is happening to them, the way they perceive treatment and care offered them and other variations about care available to them. Patients of disability should not be passive about interventions available to them; they should be allowed as key participants. It is however stressed that the concerns of disabled persons are not different from able persons and therefore equal attention is supposed to be given to both. RESPECTING THE PERSON BEHIND THE IMPAIRMENT Respecting the person in spite of his/her impairment or the disease reflects the notion that disabled persons be accorded the dignity and respect they deserve, because disability can be considered as part of normal life and therefore should not be treated with pity and stigmatization. Leplege et al therefore declared person-centredness as anti-reductionism which seeks to hold in high esteem views and rights of disabled persons in decision making regarding their health care. PERCEPTION OF PERSON-CENTRED NURSING ACROSS NATIONAL AND INTERNATIONAL DIVIDE The concept of person-centred care has long been associated with the nursing profession, and understood in principle as; establishing mutual trust and understanding with individuals, respecting their values and rights as a person, and developing therapeutic relationships with them and others associated with their care. The good aspect of delivering care in the philosophical context of person-centredness cannot be over emphasised, but it has been observed that translating the main concept into daily practice is always met with challenges (McCormack McCance 2006).The reasons for these inefficiencies manifest in different forms and are seldom indicative of the context in which care is delivered, coupled with constant changes that occur particularly within health and other social care sectors. Person-centredness has been in existence with health care delivery for some time now and is consistent with policy direction and reflected in many approaches to delivery of care. The concept manifests itself in policy directions across both national and international health care sectors. In the United Kingdom the concept of person-centredness is embedded in most health care policies such as The Dignity in Care Campaign (DoH, 2006) and The National Service Framework for older people (DoH 2001). Further, recent publications by the Royal College of Nursing (RCN) emphasised challenges for nurses and midwives in provision of dignified and sensitive care, in its report on health care. In Northern Ireland, the focus is on promoting person-centred standards- (respect, attitude, privacy and dignity, communication, behaviour) across health and social care sectors. It has been observed that within the health service, the drive to promote effectiveness and efficiency in performance management has not been high. As a result, patients, clients and their families receive less attention in care delivery as indicated in a range of quality and clinical indicators (DHSSPS 2007a; Nolan, 2007). Whilst the term person-centred care is rampant in the UK health and social care literature and policy documents, the underlying principles of person-centred care are similar to that of international movements that is focused on humanizing the health and social care experience. This is evident in the Skaevinge Project carried out in Denmark (Wagner L. 1994). In his action research, focus was on preventative work and also to ensure the rights of residents in care homes as citizens in society. This model again helps in putting to shape the future of residential care and the design of care homes internationally. Wagner infused into his work such principles underpinning person-centred care as autonomy, citizenship, dignity and respect, to enhance efficiency of his model. Health care policies around the world adopt these principles and use them in several policy frameworks related to social and health care sectors. In Australia for instance, person-centred care has been a solid foundation of facility accreditation in The Aged Care Standards and Accreditation Agency and the New South Wales department of nursing has its focus on enhancing practices and models of care to support person-centredness across all specialities. Developing models that enhance care and promote person-centred principles has become a vital issue in health and social care. A notable instance is the Institute for Health care Improvement (IHI) in the United States of America. Most governments in the West have initiated transformations and innovated frameworks in health and social services through most of the practices of the IHI. Majority of the plans initiated by these governments focused on person-centred care mainly through transformation systems and redesign of clinical services.

Free Mending Wall Essays: The Two Walls :: Mending Wall Essays

The Two Walls in Mending Wall   Ã‚   It is arguable that the self-righteous speaker of "Mending Wall" is himself obsessively committed to wall building, far more intractably and instinctively committed than his clichà ©-bound neighbor. While the speaker of "Mending Wall" justifiably castigates his unthinking neighbor and is himself far more aware of the powers of language for good and for ill, he is nonetheless caught up, ironically perhaps, in the same actual task, wall building, which will have the same results and look no different from his neighbor's contribution despite the narrative he brings to it. There are several possibilities for irony here, depending on the level of Frost's self-awareness. Wall imagery pervades his poetry, as a conscious poetic image and as a psychosexual marker of control and limitation. That the speaker is the one who calls the neighbor to mend the wall is vitally important, then, but it is not clear that Frost meant for the speaker to be ironically perceived as a hypocrite. The simple explanation, that the speaker acts out of a sense of inevitability, knowing his neighbor's habits, seems hardly enough given the contextual symbolism of the wall in Frost's poetry; the psychological explanation attendant upon this version might suggest that Frost's conscious intent was subverted by his own unconscious need for walls. So while Frost might not mean the speaker to be self-parodic, the reader might judge that there is an ironic discrepancy between what is said and what is meant, both by the speaker and by the poet. On a deeper level even than this is the possibility that Frost was aware of, had taken account of and justified, his own need for barriers. One does, after all, need something against which to push. In this case, the poem might be completely unironic, for while both men are engaged in the same task, each brings a different narrative to it, the one limited to a thoughtless clichJ , the other enriched philosophically.

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

Affordable Care Act Introduction   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The purpose of this paper is to research about the general health care condition of the United States citizens. The paper also argues about the advantages of individual payment of health insurance as opposed to compulsory insurance. Financial benefits of obamacare affordable care Act are also illustrated throughout the paper. The paper also illustrates about the rising costs of health care in United States where the US has the highest healthcare expenditure globally. The U.S healthcare system is also compared with other systems adopted by other developed countries to show the pros and cons of the United States system. The paper describes also about PPACA and how it solves many serious challenges which are faced by the small business owners such as lack of affordable coverage, rising health insurance costs, limited choice of health plans and escalating costs of health care.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Affordable care Act refers to the healthcare reform law in the United States. It is aimed at making health insurance and healthcare to be more available and more affordable to more American citizens. The act does this by new regulations, new rules and consumer protections the industry of healthcare, through establishing a marketplace purposed for insurance which is subsidized and also by expanding and reforming public programs on healthcare programs such as Medicaid and Medicare. Affordable care Act also incorporates measures which are aimed at reducing healthcare spending in United States. Many American citizens are unaware that since 2010 when the Affordable care Act became into law after being signed they have been enjoying from the protections, rights and benefits of obamacare (Faria, 2012). Before this Affordable care Act many small businesses and low and middle income earning American citizens found it challenging to afford healthcar e for their families and also for themselves (Burkhauser & Lyons, 2011). In the past the many sick people were denied health treatment or coverage with diminutive right for appealing. Insurance companies charged individuals more on basis of their health status where women were required to pay higher rates. Affordable care Act entails provisions which are aimed at solving all these challenges. Obamacare gives rise to clear financial benefits for all stakeholders: the government, the individual and the insurance companies. BODY Macroeconomic angle Non –return on high healthcare expenditure America’s high healthcare expenditure   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   United States expenditure on health care is very high becoming a great concern however it is the medical expenditure growth rate and not its level which determines the financial security of United States. United States expenditure exceeds one -sixth of the economy of the country and the percentage keep rising every year. Unfortunately, this system does not deliver value to match the annual health care expenditure totaling to approximately 2.7 trillion dollars. Experts claims that approximately 20% to 30% of that spending which totals to about 800 billion dollars annually is spent on care that is inefficient, redundant and wasteful (Miller, 2001). This rise in healthcare expenditure harms the country in many ways. For seniors and families, the increasing medical care cost means increased expenses making them to make hard choices regarding to rent, needed care and balanced food. For the local, state and federal governments, increasing health costs result to higher Medicaid and Medicare costs, and decreased funding on key priorities like education, public safety and infrastructure (Oberlander, 2012). For the fortune 500 employers and small businesses these costs makes it challenging for them to add new workers, maintain retiree coverage becomes a great challenge for them and they are unable to compete in world economy. The net outcomes of increasing health care costs are ominous and far –reaching: increased costs for health insurance, erosion of global competitiveness, fraying of nation’s safety net and fiscal insolvency which is long-standing. Although health reform law has made important steps in spreading out coverage, more efforts should also be directed to reducing the increasing healthcare cost (Sade, 2012). Comparison with other developed nations   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   U.S health care expenditure is the highest compared to other nations yet the American citizens experiences more illnesses and die sooner compared to citizens from other developed countries. United States is ranked 37th position out of 191 nations according to the world health organization (WHO) health care systems rankings. This means that despite the fact that the united states citizens spends a lot of money on healthcare and the cost is still increasing however they are offered product which is ranked 37th position in quality. When comparing United States with other nations which are developed, it is evident that America performs poorly on infant mortality and life expectancy. Also United States tops list of deaths which are perceived to be preventable when diagnosed early and adequate early care is administered. Typical American citizen has very few doctor appointments annually compared to citizens from other nations but yet spends more for this privilege. When U.S citizen is admitted one day in a hospital, it would 5.6 times more when compared to what it would cost a Japan citizen. Also United States top all other developed nations in healthcare cost where it spends 8,233 dollars more per individual annually than other developed nations, although 47 million of those U.S citizens are still uninsured ( Hodge, Arias and Ordell, 2011).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The figure $8,233 per citizen annually spent by united states is over two and a half times more compared to what other developed countries spend per citizen annually globally including Europeans nations which are relatively rich such as united kingdom, Sweden and France. On an advanced global scale, it is clear that health care costs of United States represents 17.6% of the nation’s GDP.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   According to reports from OECD (organization for Economic Co-operation and Development) which is an international economic group which consists of 34 member countries, American citizens are not getting what they expect.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   United States has fewer physicians per individual compared to most other OECD nations. For example United States had 2.4 physicians per 1000 citizens in 2010 which is below 3.1 which is OECD average. In 2009, the hospital beds number in United States was 2.6 per 1,000 individuals which is lower than 3.4 beds which is OECD average.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Between 1960 and 2010, Life expectancy in the U.S increased by approximately nine years however those years were few compared to Japan where there was an increase of 15 years and also it was below 11 years which the average in OECD nations. Also, in 2010 the average U.S citizen lived 78.7 years which is below 79.8 years which is the average.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   However, United States tops globally in the cancer treatment and health care research, for example. The breast cancer survival rate is very high in United States compared to other OECD nations and also U.S is among the best in survival from colorectal cancer. The poor general health condition of American citizens   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   United States citizens spend a lot of money on healthcare and the cost is still increasing however they are offered product which is ranked 37th position in quality. This means that Americans are offered poor general health care. U.S healthcare system does not deliver value to match the annual health care expenditure totaling to approximately 2.7 trillion dollars. Experts claims that approximately 20% to 30% of that spending which totals to about 800 billion dollars annually is spent on care that is inefficient, redundant and wasteful. Also United States tops list of deaths which are perceived to be preventable when diagnosed early and adequate early care is properly administered.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The leading cause of disability and death in United States is the chronic diseases. They lead to 7 out of 10 deaths annually. Stroke, cancer and heart disease leads to more than 50% of all deaths annually.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Out of 107 million American citizens approximately 1 out of every 2 adults aged 18 or much older had at least 1 of 6 reported chronic ailments which includes asthma, arthritis, diabetes, cancer, cardiovascular disease and chronic obstructive pulmonary disease. Typical American citizen has very few doctor appointments annually compared to citizens from other nations but yet spends more for this privilege. When U.S citizen is admitted one day in a hospital, it would 5.6 times more when compared to what it would cost a citizen from other nations. When comparing United States with other nations which are developed, it is evident that America performs poorly on infant mortality and life expectancy. United States has fewer physicians per individual compared to most other OECD nations. In 2009, the hospital beds number in United States was 2.6 per 1,000 individuals which is lower than 3.4 beds which is OECD average. These facts from various resea rches shows that American citizens experiences poor general health condition despite the fact that they spend the highest amount on healthcare but they end up getting poor quality compared to other developed countries. Therefore, it is evident that despite the fact that although America is among wealthiest countries globally however, it is far from becoming the healthiest nation (Sage, 2011). The nine health domains studied by Committee on Population, and Board on Population Health and Public Health Practice. When United States is compare with peer nations which are average America is ranked poorly in the following nine health domains. Adverse birth results: For many years America has experience huge infant mortality rate of high income nations and also ranked poorly on other birth results, like low birth weight. Kids in America are unlikely to live to age 5 compared to kids in other nations with high incomes. Injuries and homicides: Violence, deaths emanating from motor vehicle accidents and injuries which are not related to transportation occur at much more commonly in U.S than in other nations and are a primary cause of deaths in kids, young adults and adolescents. Since 1950s, Young adults and adolescents in United States have died at an alarming rate from homicide and traffic accidents than in other nations. Sexually transmitted infections and Adolescent pregnancy: since 1990’s , among all the developed nations the united states adolescents have had high chances of acquiring infections which are sexually transmitted and also have the highest number of pregnancies. HIV and AIDS: America is the second leading nation among 17 peer nations with high pervasiveness of HIV infection. Drug-related mortality: united states lose more life years to alcohol and also other drugs compared to individuals from peer nations, even after excluding deaths emanating from drunk driving. Diabetes and Obesity: For many years America has experienced the highest rates of obesity among the developed nations. High occurrence rates for obesity are experienced in United States kids and also in every age group subsequently. From 20 years onward the adults in America have among the highest occurrence rates of diabetes among peer nations. Heart disease: Death rate in America emanating from ischemic heart disease is second leading among the 17 peer nations. Citizens from united states attain age 50 with less favorable cardiovascular risk profile compared with their peers in Europe and also adults aged over 50 years have higher chances of developing and dying from cardiovascular disease compared to older adults in developed nations. Chronic lung disease: Lung disease are more common and linked with high mortality rates in America compared to UK and other European nations. Disability: older adults in United States depicts higher occurrence of activity limitations and arthritis compared to their counterparts in Japan, UK and other European nations (Sade, 2012). Comparison with other developed nations   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   For many years, Violence, deaths emanating from motor vehicle accidents and injuries which are not related to transportation occur at much more commonly in U.S than in other nations and are a primary cause of deaths in kids, young adults and adolescents. Since 1950s, Young adults and adolescents in United States have died at an alarming rate from homicide and traffic accidents than in other nations.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   America has experience huge infant mortality rate of high income nations and also ranked poorly on other birth results, like low birth weight. Kids in America are unlikely to live to age 5 compared to kids in other nations with high incomes (Majette, 2011).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   since 1990’s , among all the developed nations the united states adolescents have had high chances of acquiring infections which are sexually transmitted and also have the highest number of pregnancies.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   America is the second leading nation among 17 peer nations with high pervasiveness of HIV infection. united states lose more life years to alcohol and also other drugs compared to individuals from peer nations, even after excluding deaths emanating from drunk driving.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   For many years America has experienced the highest rates of obesity among the developed nations. High occurrence rates for obesity are experienced in United States kids and also in every age group subsequently. From 20 years onward the adults in America have among the highest occurrence rates of diabetes among peer nations.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Death rate in America emanating from ischemic heart disease is second leading among the 17 peer nations. Citizens from united states attain age 50 with less favorable cardiovascular risk profile compared with their peers in Europe and also adults aged over 50 years have higher chances of developing and dying from cardiovascular disease compared to older adults in developed nations.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Lung disease is more common and linked with high mortality rates in America compared to UK and other European nations.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Older adults in United States depicts higher occurrence of activity limitations and arthritis compared to their counterparts in Japan, UK and other European nations (Sade, 2012). Financial justification for system overhaul   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   United States healthcare system in not universal, where some people benefits more from the system compared to others. This system does not deliver value to match the annual health care expenditure totaling to approximately 2.7 trillion dollars. The Experts claims that approximately 20% to 30% of that spending which totals to about 800 billion dollars annually is spent on care that is inefficient, redundant and wasteful. United States top all other developed nations in healthcare cost where it spends 8,233 dollars more per individual annually than other developed nations, although 47 million of those U.S citizens are still uninsured. This necessitates an overhaul of the entire healthcare system which is both complex and gigantic. When comparing America healthcare system to Dutch system there are many improvements that are required in order for the US system to be successful. Some of these improvements should be trying to make it transparent and simpler for consumers to purchase health insurance easily through aggressive regulation of the insurance marketplace in such a manner that the products are universal.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Obamacare has four types of fundamental insurance packages which includes platinum, gold, silver and bronze. Dutch system has just one type of package for fundamental insurance. The system should not discriminate some applicants by charging them higher premiums depending on their age, health status, gender and just like Dutch system they should charge all the applicants the same price. Under the obamacare system the older applicants are supposed to pay three times as much in terms of premiums than the young ones. This means in obamacare system an applicant is supposed to input and then verify their age in order for their charge to be determined.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The system in US should be modified to be transparent where consumers should be allowed to compare prices and buy insurance through private sector portal websites instead of government run website. This will led to an aggressive way of restructuring and regulating the private sector industry as consumers will be able to compare the prices and decide which insurance to buy thus reducing consumer exploitation and increasing transparency. In this way the government will be able to reduce the rising healthcare costs and the number of the insured citizens will increase (Pipe, 2013). Microeconomic angle: Opposing views and rebuttals The individual’s point of view The individual mandate: compulsory insurance Opposing view: compulsory insurance places financial burden on citizens   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Universal healthcare system where compulsory insurance is introduced to everyone would do more harm to the citizens due to the financial burden it would implicate to the citizens. This would give the insurance companies a chance to increase the premiums since government will not be able to cover everyone where some people will be coerced to purchase insurance from the private sector insurance companies since it is a compulsory insurance. The poor and low income earners would be required to dig deep into their pockets and purchase the insurance despite the fact that insurance premiums are rising. During presidential campaign in 2008, president Barrack obama who was then a Democrat senator assured American citizens to improve the health care where he claimed that 47 million American citizens were not in a financial position to afford health insurance. He instead advocated for creation of government run, federally administered health care sys tem where people would pay individually for their health care and insurance instead of compulsory insurance which overburdened the poor. He also explained that people could be offered subsidized government coverage making insurance affordable to many. Requiring for citizens to buy mandatory health care insurance from private companies at any price they decide to charge will be directly overburdening the citizens while promoting the insurance industry. This is because insurance premiums rise faster than income thus reducing the disposable income of the citizens.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   For the poor and those who earn low incomes they will be forced to choose low premium plans which have high deductibles and co-payments. This is because they cannot afford the best plans due to high premiums. Therefore many poor citizens will be left with healthcare insurance which is unaffordable to use but they are mandated to purchase such insurance anyway         Compulsory insurance is extremely regressive and in some cases the mandated insurance plus the co-payments can add up to almost a third of the income which is a great financial burden to the citizensRebuttal 1: The ‘health promotion’ theory of insurance   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Health promotion refers to the approach of allowing people to increase power over the health determinants thus improving their health. It is the most sustainable, efficient, effective and ethical approach to attaining good health.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   PPACA invests in research to identify relative value of healthcare procedures.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   PPACA solves many serious challenges which are faced by the small business owners such as lack of affordable coverage, rising health insurance costs, limited choice of health plans and escalating costs of health care. PPACA is highly popular as the most fundamental health care legislation since establishment of Medicaid and Medicare about 10 years ago. The act was enacted in 2010 and it was aimed at taking effect in phases in a period of 8 years and incorporates reforms like expansion of Medicaid eligibility, subsidizing of insurance premiums, providing businesses with incentives to offer health care benefits and prohibiting the insurers from denying some applicants coverage for the pre-existing conditions. It persuades states to introduce exchanges of health care where small businesses and adults who are uninsured can purchase insurance from a variety of the private insurers. One element of PPACA is promoting comparative effectiveness res earch. This is aimed at comparing treatment options which are available. The core benefit of PPACA is to reduce the number of the uninsured individuals and providing them with high value healthcare (Gray & Sullivan, 2011). It uses a mixture of subsidies, tax credits and mandates in encouraging people and corporations on buying coverage and also it protects applicants who are hard to insure including those who possess conditions which are pre-existing. Other elements of legislation will be aimed at encouraging evidence based decision making and improving healthcare practices. United States tops globally in the cancer treatment and health care research by PPACA, for example. The breast cancer survival rate is very high in United States compared to other OECD nations and also U.S is among the best in survival from colorectal cancer thus ensuring high value healthcare. The comparative effectiveness research (CER) involves a board which lowers overall expenditure through determining whic h procedures, treatments and medicines which are most perfect, their price tags and identifying those who ignore justifying identifying the evidence based health benefits. Through PPACA as the acknowledgement Medicare has been successful in rewarding certain health coverage providers and punishes some providers on basis of value of care. Through PPACA Medicare is required to measure performance and change payments of providers on basis of scoring system in its current value based purchasing program (Skocpol, & Williamson, 2011). PPACA promotes consumption of ‘high value’ healthcare.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The core benefit of PPACA is to reduce the number of the uninsured individuals and providing them with high value healthcare. It uses a mixture of subsidies, tax credits and mandates in encouraging people and corporations on buying coverage and also it protects applicants who are hard to insure including those who possess conditions which are pre-existing. Other elements of legislation will be aimed at encouraging evidence based decision making and improving healthcare practices. Through PPACA as the acknowledgement Medicare has been successful in rewarding certain healthcare providers and punishes some providers on basis of value of care. PPACA solves many serious challenges which are faced by the small business owners such as lack of affordable coverage, rising health insurance costs, limited choice of health plans and escalating costs of health care. Through PPACA Medicare is required to measure performance and change payments of provid ers on basis of scoring system in its current value based purchasing program. PPACA is highly popular as the most fundamental health care legislation since establishment of Medicaid and Medicare about 10 years ago. The act was enacted in 2010 and it was aimed at taking effect in phases in a period of 8 years and incorporates reforms like expansion of Medicaid eligibility, subsidizing of insurance premiums, providing businesses with incentives to offer health care benefits and prohibiting the insurers from denying some applicants coverage for the pre-existing conditions. It persuades states to introduce exchanges of health care where small businesses and adults who are uninsured can purchase insurance from a variety of the private insurers. One element of PPACA is promoting comparative effectiveness research. This is aimed at comparing treatment options which are available. The comparative effectiveness research (CER) involves a board which lowers overall expenditure through determin ing which procedures, treatments and medicines which are most ideal, their price tags and identifying those who ignore justifying identifying the evidence based health benefits. United States tops globally in the cancer treatment and health care research by PPACA, for example. The breast cancer survival rate is very high in United States compared to other OECD nations and also U.S is among the best in survival from colorectal cancer thus ensuring high value healthcare (Kotlikoff, 2007). Rebuttal 2: The ‘financial security’ model of health insurance   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Individual’s financial risk due to unforeseen illness   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Insurance companies play a great role in managing the risk of individuals. These companies enable individuals to share their liability through pooling the personal risk and assist them through reducing chances of facing financial desolation. Due to many risks that individuals faces on a daily basis, these insurance companies have advanced over the years to meet the needs of the average human beings and have come up with different products and policies which covers almost entire risks. These companies normally provide financial coverage of loss that a certain person is expected to suffer as a result of unforeseen events thus reducing the effects of a certain event. They compensate the financial damage and people whose peril can be pooled. An individual who want to be insured is expected to pay a premium which is dependent on the probability of the event occurring where high probabilities will lead to high premiums. In a case of health insur ance the insurance is able to insure individuals through pooling the risk of illness. The health care cost is easily balanced in the pool since some individuals go through life devoid of catching a cold whereas others have to spend many dollars for treatment. The act of pooling the peril with other individuals is a prudent decision since no individual is able to predict what their health will be, and also how much they will have to pay in order to be treated. It is therefore advisable for individuals to pay for their individual health insurance to avoid financial challenges that may face them in case of unforeseen illness (Woolf & Aron, 2013)   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The escalating costs of health insurance prior to PPACA.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   PPACA solves many serious challenges which are faced by the small business owners such as lack of affordable coverage, rising health insurance costs, limited choice of health plans and escalating costs of health care. The core benefit of PPACA is to reduce the number of the uninsured individuals and providing them with high value healthcare. It uses a mixture of subsidies, tax credits and mandates in encouraging people and corporations on buying coverage and also it protects applicants who are hard to insure including those who possess conditions which are pre-existing. Other elements of legislation will be aimed at encouraging evidence based decision making and improving healthcare practices. Before PPACA the health insurance costs were very high and still escalating year after year. This was as a result of requiring citizens to buy mandatory health care insurance from private companies at any price they decide to charge which directly ov erburdening the citizens while promoting the insurance industry. This made insurance premiums to rise faster than income thus reducing the disposable income of the citizens. The number of uninsured Americans was very high where 47 million American citizens were not in a financial position to afford health insurance. President obama was against this and he launched PPACA aimed at reducing the escalating health insurance costs. He also advocated for creation of government run, federally administered health care system where people would pay individually for their health care and insurance instead of compulsory insurance which overburdened the poor. He offered subsidized government coverage making insurance affordable to many. PPACA reduced the rising costs of health insurance which resulted to increased number of people who were insured (Hofer, Abraham, & Moscovice, 2011). Cost-sharing requirements under older health insurance regime.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   There was a universal insurance regime where every person was supposed to be responsible for his or her health insurance. This regime required citizens to buy mandatory health care insurance from private companies at any price they decide to charge which directly overburdening the citizens while promoting the insurance industry. This made insurance premiums to rise faster than income thus reducing the disposable income of the citizens. The number of uninsured Americans was very high where 47 million American citizens were not in a financial position to afford health insurance. The insurance market place was not controlled by government which gave the insurance companies a chance to raise the premiums. Every individual was required to be covered where those who did not have a cover were faced by financial fines. Non-insurance or under-insurance as result of the above   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   This healthcare coverage approach made many people who were unable to pay the good plans to opt for the buying covers that were not helpful to them just because they wanted to fulfill the requirement. Many other people were unable to purchase any cover as a result of increased premiums as a result of uncontrolled insurance marketplaces. Also, most of the people were under insured due to financial constraints. This made many people in reality to be non -insured since the covers they purchased could not be used to compensate them during an event of illness. Also those who were under insured were not able to get fully compensation in an event of illness. Therefore, this led to poor general healthcare situation for many citizens (Hoffman, 2011).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   PPACA places reasonable limits on financial insecurity due to health hazards   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   PPACA is aimed at reducing the number of the uninsured individuals and providing them with high value healthcare. It uses a mixture of subsidies, tax credits and mandates in encouraging people and corporations on buying coverage and also it protects applicants who are hard to insure including those who possess conditions which are pre-existing. Other elements of legislation will be aimed at encouraging evidence based decision making and improving healthcare practices. Through PPACA as the acknowledgement Medicare has been successful in rewarding certain healthcare providers and punishes some providers on basis of value of care. PPACA solves many serious challenges which are faced by the small business owners such as lack of affordable coverage, rising health insurance costs, limited choice of health plans and escalating costs of health care. Through PPACA Medicare is required to measure performance and change payments of providers on basis of scoring system in its current value based purchasing program. PPACA is highly popular as the most fundamental health care legislation since establishment of Medicaid and Medicare about 10 years ago. The act was enacted in 2010 and it was aimed at taking effect in phases in a period of 8 years and incorporates reforms like expansion of Medicaid eligibility, subsidizing of insurance premiums, providing businesses with incentives to offer health care benefits and prohibiting the insurers from denying some applicants coverage for the pre-existing conditions. It persuades states to introduce exchanges of health care where small businesses and adults who are uninsured can purchase insurance from a variety of the private insurers (Hoffman, 2011).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The comparative effectiveness research (CER) involves a board which lowers overall expenditure through determining which procedures, treatments and medicines which are most ideal, their price tags and identifying those who ignore justifying identifying the evidence based health benefits. United States tops globally in the cancer treatment and health care research by PPACA, for example. The breast cancer survival rate is very high in United States compared to other OECD nations and also U.S is among the best in survival from colorectal cancer thus ensuring high value healthcare. One element of PPACA is promoting comparative effectiveness research. This is aimed at comparing treatment options which are available (Sade, 2012). Financial relief to the individual   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Insurance companies enable individuals to share their liability through pooling the personal risk and assist them through reducing chances of facing financial desolation. They play a great role in managing the risk of individuals and providing financial relief to individuals who are faced by a calamity which they had insured. These Due to many risks that individuals faces on a daily basis, these insurance companies have advanced over the years to meet the needs of the average human beings and have come up with different products and policies which covers almost entire risks. These companies normally provide financial coverage of loss that a certain person is expected to suffer as a result of unforeseen events thus reducing the effects of a certain event. They compensate the financial damage and people whose peril can be pooled. An individual who want to be insured is expected to pay a premium which is dependent on the probability of the ev ent occurring where high probabilities will lead to high premiums. In a case of health insurance the insurance is able to insure individuals through pooling the risk of illness. The health care cost is easily balanced in the pool since some individuals go through life devoid of catching a cold whereas others have to spend many dollars for treatment. The act of pooling the peril with other individuals is a prudent decision since no individual is able to predict what their health will be, and also how much they will have to pay in order to be treated. It is therefore advisable for individuals to pay for their individual coverage to avoid financial challenges that may face them in case of unforeseen event. Rebuttal 3: The ‘brute luck’ theory of health insurance   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Underwriting; Insurers’ discrimination on the basis of unavoidable risk factors, resulting in high insurance costs   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The insurance companies look at many determinants when determining the premiums to be paid by the applicant for them to be covered for a certain risk. Some applicants are supposed to pay higher premiums due to their health status, gender, race, religion, national origin, age among other factor. For instance, older adults are asked to pay higher premiums by health insurance providers than the premiums expected for young adults and kids. In this regard the insurers charge different premiums depending with groups on basis of their risk. These health coverage providers categorize their insureds into different risk pools on basis of their differences in their risk probabilities (Hoffman, 2011). PPACA prohibits above-mentioned discrimination   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   PPACA is against these discriminatory laws and requires the coverage providers to stop this discrimination and charge the applicants fairly without considering their pre-conditions. It protects applicants who are hard to insure including those who possess conditions which are pre-existing from this discrimination. This is aimed at ensuring that no one is penalized for their propensities and genetics or for factors and events which are beyond their control (Hoffman, 2011). Financial relief to the ‘unlucky’ individual   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Insurance companies play a great role in managing the risk of individuals and providing financial relief to unlucky individuals who are faced by a calamity which they had insured. This is because they enable individuals to share their liability through pooling the personal risk and assist them through reducing chances of facing financial desolation. As a result of many risks that individuals faces on a daily basis, these insurance companies have advanced over the years to meet the needs of the average human beings and have come up with different products and policies which covers almost entire risks. These companies normally provide financial coverage of loss that a certain person is expected to suffer as a result of unforeseen events thus reducing the effects of a certain event. They compensate the financial damage and people whose peril can be pooled. An individual who want to be insured is expected to pay a premium which is dependent on the probability of the event occurring where high probabilities will lead to high premiums. In a case of health insurance the insurance is able to insure individuals through pooling the risk of illness. The health care cost is easily balanced in the pool since some individuals go through life devoid of catching a cold whereas others have to spend many dollars for treatment. The act of pooling the peril with other individuals is a prudent decision since no individual is able to predict what their health will be, and also how much they will have to pay in order to be treated. It is therefore advisable for individuals to pay for their individual coverage to avoid financial challenges that may face them in case of unforeseen event. This is because if they are unlucky they will be provided with financial relief by their health insurance providers (Hoffman, 2011).. The insurers’ point of view Opposing views & rebuttals Objection 1 & rebuttal Objection: Insurance companies’ bottom lines hurt through limitations on deductibles, co-insurance and co-payments, and prohibition on underwriting.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Employee expenses on cost sharing include coinsurance, deductibles and co-payments. Insurers companies are experiencing unfavorable impact due to the limitations on co-payments, coinsurance, deductable and prohibition on underwriting as they increases the risks therefore increasing the amounts paid as compensation thus reducing their returns. Rebuttal 1: Insurers’ losses from reduced profit margins mitigated through broadened customer base   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Insurers’ losses from reduced margins can be reduced by increasing their customer base. This is because insurance use the pooling of risks approach where broadened customer base will result to high returns. This is because more customers will lead to more funds in funding pool of risks while the amount paid out to the unlucky individuals as compensation will be low than the premiums paid therefore leading to increased profit margins. Also, increased broadened customer base also serves as a way of diversifying the risks. Rebuttal 2: View disproved by financial statements and stock market movements   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Such a view which is refuted by stock market movement and financial statements should not be used and should be regarded as void. Stock movements are un predictable and an insurance company should not be forced to compensate an unlucky individual who loses unless such a claim is validated. Objection 2 & rebuttal Objection: Compulsory acceptance of foreseeable risks unfair burden on insurers   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   PPAC protects the applicants from the insurer’s discrimination where the insurance companies are forced to accept foreseeable risks thus reducing the profit margins. This mandatory acceptance of these foreseeable risks will lead to increased expenses which are paid to the unlucky individuals as compensation which eventually leads to reduced returns. This act is unfair to the insurers since they should be given an opportunity to consider whether to accept or reject insuring individuals with foreseeable risks. This is because increase in amounts paid for these foreseeable risks as compensations will reduce the profits margins to an extent of making losses which may lead to such companies deciding to exit the industry due to constant loss making.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Rebuttal: Insurers allowed to underwrite avoidable risks and discriminate on the basis of lifestyle choices   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Insurers should be allowed to discriminate based on lifestyle choices and underwrite avoidable risks. This is because the individual to be covered should be responsible. The fear that individuals may have that they may not be compensated if the risk was avoidable would prevent them from making choices which are reckless thus protecting the insurance companies from paying unfair amounts as compensation. Also individuals should be responsible and they should put necessary measures or efforts to ensure that the risk doesn’t occur, so as not to overburden the insurance provider with expenses which are avoidable. In this regard individuals should be ready to bear the responsibilities for the consequences of their freely made decisions. Summing up & Conclusion   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Affordable care Act also incorporates measures which are aimed at reducing healthcare spending in United States. Many American citizens are unaware that since 2010 when the Affordable care Act became into law after being signed they have been enjoying from the protections, rights and benefits of obamacare. Before this Affordable care Act many small businesses and low and middle income earning American citizens found it challenging to afford healthcare for their families and also for themselves. In the past the many sick people were denied health treatment or coverage with diminutive right for appealing. Insurance companies charged individuals more on basis of their health status where women were required to pay higher rates. Affordable care Act entails provisions which are aimed at solving all these challenges.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The cost of health care in United States keeps rising year after year at an alarming rate. This rise in healthcare expenditure harms the country in many ways. For seniors and families, the increasing medical care cost means increased expenses making them to make hard choices regarding to rent, needed care and balanced food. For the local, state and federal governments, increasing health costs result to higher Medicaid and Medicare costs, and decreased funding on key priorities like education, public safety and infrastructure.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   For many years America has experienced the highest rates of obesity among the developed nations. High occurrence rates for obesity are experienced in United States kids and also in every age group subsequently. From 20 years onward the adults in America have among the highest occurrence rates of diabetes among peer nations. However, United States tops globally in the cancer treatment and health care research, for example. The breast cancer survival rate is very high in United States compared to other OECD nations and also U.S is among the best in survival from colorectal cancer thus ensuring high value healthcare.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In conclusion, although obama care has been faced by many challenges however it has resulted to many benefits than costs. Before this Affordable care Act many small businesses and low and middle income earning American citizens found it challenging to afford healthcare for their families and also for themselves. In the past the many sick people were denied health treatment or coverage with diminutive right for appealing. Insurance companies charged individuals more on basis of their health status where women were required to pay higher rates. Affordable care Act entails provisions which are aimed at solving all these challenges. Although it have been faced by many challenges obamacare remains a good system which should not be done away with since it gives rise to clear financial benefits for all stakeholders: the government, the individual and the insurance companies. References Burkhauser, R. V., & Lyons, S. (2011). The importance of the meaning and measurement of â€Å"affordable† in the Affordable Care Act. Cambridge, Mass.: National Bureau of Economic Research. Faria, M.A. (2012). ObamaCare: Another step toward corporate socialized medicine in the US. Surgical Neurology International, Jan. 2012, 386+. Gray, B. J., & Sullivan, K. C. (2011). Provisions in the Patient Protection and Affordable Care Act (PPACA). New York: Nova Science Publisher’s, Inc. Hodge JG., Arias J., and Ordell, R. (2011). Nationalizing Health Care Reform in a Federalist System. Arizona State Law Journal, 42(4), 1245-1275. Hofer, A.N., Abraham, J.M & Moscovice, I. (2011). Expansion of Coverage under the Patient Protection and Affordable Care Act and Primary Care Utilization. The Milbank Quarterly, 89(1), 69–89. Hoffman, A.K. (2011). Three models of health insurance: The conceptual pluralism of the Patient Protection and Affordable Care Act. University of Pennsylvania Law Review, 159(6), 1873-1954. Kotlikoff, L. J. (2007). The healthcare fix: universal insurance for all Americans. Cambridge, Mass.: MIT Press. Majette, G.R. (2011). PPACA and public health: Creating a framework to focus on prevention and wellness and improve the public’s health. Journal of Law, Medicine & Ethics, 39(3), 366-379. Miller, E. A. (2001). The Affordable Care Act: advancing long-term care policy in the United States. Norwood, NJ: New Age International. Oberlander, J. (2012). The future of obamacare. The New England Journal of Medicine, 367(23), 2165-7. Pipes, S. (2013). The cure for Obamacare. New York: Encounter Books. Sade, R.M. (2012). Introduction: The health care reform law (PPACA): Controversies in ethics and policy. Journal of Law, Medicine & Ethics, 40(3), 523-525. Sage, W.M. (2011). Brand new law! The need to market health care reform. University of Pennsylvania Law Review, 159(6), 2121-2146. Skocpol, T. & Williamson, V. (2011). Obama and the transformation of U.S. public policy: The struggle to reform health care. Arizona State Law Journal, 42(4), 1203-1232. Woolf, S.H., & Aron, L.Y. (Eds.) (2013). U.S. health in international perspective: shorter lives, poorer health. Retrieved from http://www.nap.edu/catalog.php?record_id=13497. Source document

Excellence in Customer Service & Organisations

BSBCUS501C Work Related Project Question 1 Excellence in customer service is the objective of all organisations wishing to be successful. However, there is often a gap between customer expectations and management perceptions of customer expectations. Organisations often fail to get close to their customers and correctly read their expectations. Other reasons for customer service problems include: not listening to or collecting information from customers * poor, or no, focus on the actual design of processes to turn identified customer needs into products and services * gaps between what the organisation intends to produce for its customers and what its systems do actually produce * gaps between what the system is intended to deliver for customers and what it actually does deliver * cost constraints, or failure to set and meet realistic performance standards, which affect what the organisation can actually deliver * poor staff attitudes, training levels and working materials * gaps be tween what salespeople promise and the actual service or product quality Source: Zeithaml, Parasuraman & Berry (1990) In approximately 2000 words comment on these statements. By implementing customer feedback strategies, the organisation will be able to discover the company's strengths and potential weaknesses, as set by the actual customer. Reacting on the feedback in a timely and appropriate manner will increase revenues and customer satisfaction.Although a customer feedback programs will be an added cost in the beginning, long term it will save money for the organisation, as it costs far more money to get new customer’s than keep a satisfied, existing customers. Understanding what customers think of the organisation will improve service delivery and quality of products leading to business sustainability. By conducting market research and analysis of customer’s needs and expectations, an understanding of what the customers think about the organisation can enhance the continuous improvement process within the organisation. Customer perceptions are a subjective assessment of actual service experiences. Customer erceptions and customer expectations play an important role in service marketing and are the standards of performance against which service experiences are compared, and often formulated in terms of what a customer believes should or will happen. Supplying reliability to the customer will have the highest influence on the customer’s perception of quality and ability to perform the promised service effectively with efficiency. Responsiveness from employee’s and the willingness of the organisation to help customers and to provide them with a prompt service to deal with their queries, concerns or complaints will determine how the customer perceives the organisation.Giving the customer assurance and inspiring trust and confidence in the product or service supplied will encourage and support the organisations objectives or goals. Showing the customer empathy, caring and individualized attention during the process will enhance the customer’s individual experience with the organisation. By not knowing what customers expect is one of the root causes of not delivering to the customer their expectations. This is the difference between customer expectations of the service and the organisations understanding of those expectations. Unwillingness to ask customers about their expectations will not address current issues, service providers may think that they know what is best for their customers but without research, information and data, they may well be misaligned.Feedback strategies may include electronic feedback mechanisms using intranet, internet and email, feedback forms, questionnaires, formal or informal surveys and interviews or databases and other controls to record and compare data over time. Market segmentation to understand the needs of the market are important. Market segmentation is the grouping of customers sharing similar requirements, expectations and demographic or psychographic profiles. Segmentation is usually done to understand the needs of customers more elaborately or distinctly. When asking customers for their input or feedback, they need to feel as if their opinions matter, they are more likely to continue supporting the organisation if they feel their feedback has been taken seriously and into consideration.Listening to the customer and acting timely on their feedback is important for the organisation, failing to understand a customer’s needs can result in widespread negative comments about the organisation and the loss of customers and potential customers. By not listening to customers and understanding what they need from a product or service will not allow the organisation to maintain its effectiveness in the market place, producing poor quality products or service and effecting overall profitability for the organisation. Each organisation needs to de velop and establish procedures, standards and guidelines for customer service requirements and communicate these to all staff. By establishing courses of action to accomplish specific goals, utilising information and data obtained through feedback will assist in identifying and acting upon the customer’s needs.These may be established through strategic or action plans that identifies the customer’s need, arranges for, and obtains resources needed to accomplish the desired goals and objectives. By collecting information and data, planning areas for improvement that will improve the final output, will increase the quality of the service or product supplied. Identifying and acting timely on these inputs will ensure a competitive edge is maintained for the organisation. Identifying existing and potential problems or issues and obtaining relevant information about the problem will ensure the specific or root cause of the problem is identified. Once this has been achieved re commendations and corrective actions can be developed and proposed for implementation.By performing a gap analysis to measure the organisations current performance against their desired outcomes can identify areas for improvement. Analysing data and quantifying the information will establish where the organisation currently is and where they need to be. Gaps may exist in various stages of the input process that affects the outcome. Poor quality raw materials or excessively priced materials will directly affect the quality and cost of the final product or service. Gaps may exist in the process and need to be identified promptly. Ensuring all customers internal and external are part of the review process ensures opportunities for improvement are identified and acted upon timely.Gaps or areas for improvement need to be identified so quality products or service can be maintained. Employee loyalty needs to be earned, rather than assumed and this is achieved through commitment and communi cation by the management team. Organisations need to express and act on a commitment to develop employee’s career objectives by introducing initiatives that make employees believe that their current job is the best path to achieving their career goals, delivering customer satisfaction and feeling valued within the workplace. By including opportunities for personal growth and investing in the professional development of people within the organisation will improve outputs.Identifying correct resources and developing well-defined career paths and conducting analyses of current practices will highlight these areas where training, mentoring, and coaching, or areas of improvement are required within the organisation. Establishing effective working relationships among team members and participating in solving problems and making decisions allows employees to be empowered and part of the process, increasing participation levels and drive to complete desired changes. Communication to employees and customers, expressing ideas and information clearly and concisely, sharing information will all assist with accomplishing the goals or vision set out. A common characteristic of successful services is teamwork. A feeling of teamwork is created when employees see other employees and management as key members of the team.The lowest-level employee must feel that management; from their immediate supervisor to the CEO of the company, cares about them and that they are a critical part of the organisation’s success. This is achieved when every employee is involved in the organisation’s decision process and committed to providing a high level of service to customers, the company and to other employees. Cost constraints can affect the quality or price of the final service or product. Good purchasing practices are integral to organisational success. Developing budgets and resource plans, managing materials, equipment or labour will create quality products for custo mers. During the planning process of resource procurement, identifying the need is the first step in the process.Organisations may be required to upgrade the current capacity of buildings or machinery used in the process to meet new orders or upgraded products. Investment funding may be necessary if new plant and facilities are needed. Skills of the workforce may need to be improved or obtained to operate new systems and produce the new product or service effectively. A raw material needs to be assessed for cost and quality as an input. If materials are too highly priced the end product would be too expensive for the consumer, equally, if the materials were of poor quality, the end product may not reach the customers expectation levels, in each case the consumer would be hesitant in purchasing the goods or product.Ensuring a timely supply of raw materials enables the organisation to supply a constant flow of service or product outputs. Healthy cash flow is essential if business is t o respond to changing demands and requirements in any production activity. Quality management of resources bring together all inputs, ensuring that these are timely and consistent that will achieve quality products and an effective, efficient workforce. Employee’s need to understand the needs of the customer and what they actually require. By understanding who the customers are, both internally and externally, and actively listening to the customers to identify their needs, the employees can then check that customer needs have been met.Proactively engaging with customers to understand their needs and gaining feedback will highlight areas for improvement. Employee attitudes can affect an organisation's growth and profitability. Early detection and resolution of employee attitude problems can minimize the effect of poor performance and strained relationships within the workplace. Recent organisational changes may have contributed to changes in employee attitudes that may not ha ve clearly described the role requirements. Employee’s attitudes may have changed based on the availability of resources necessary to perform their job functions or because of poor relationships with supervisors and managers. In some cases, the employee's job functions may be too challenging for their skill set.Training informally or formally utilising mentoring, coaching or external facilitation may be required. To perform their job role according to the organisational standards, employees must have the correct equipment and resources. The equipment needs to be in good condition and the employees must have the knowledge and training to properly use the equipment to enhance the quality of their work. Retaining customers through effective customer service enables easier growth, indirectly and directly by sustaining healthier volumes and margins, and by business expansion from word-of-mouth referrals. An improved level of customer retention through effective customer service al so improves staff morale, motivation and an increased productivity.Improved employee morale and motivation resulting from reducing customer attrition also positively benefits staff retention and turnover. Improving customer service, especially empowering and listening to customer service staff, offers many organisations a bigger return on investment. Employees who follow established procedures and guidelines for customer service and who are committed to customer needs, presenting themselves in a polite manner even under situations of high pressure can quickly attend to the customer’s requirements. Understanding the level of service required ensuring quality procedures are followed in providing services and taking corrective actions where possible to meet the customer’s needs will re-enforce the organisations commitment to service quality.Providing frequent and clear concise communication from management on what is expected and how the service is to be performed will su pport established policies and procedures. Providing employees with constructive feedback to help them understand how the service is to be performed and what management expects from the service, will provide employees with product and service knowledge so they can perform their jobs in a professional manner. Training employees in the correct methods of performing the service and how to communicate effectively with customers, supervisors and with other employees will enhance professionalism within the organisation.The quality of service delivers results in customer satisfaction and their retention, as it reinforces the perception that the value of the service received is greater than the price paid for it. Promises are made to consumers by organisations advertising using sales promotions and sales staff to promote products and services. These promises may be explicitly stated or they may be implied that the organisation can offer these services. If the organisation does not provide t he service that is promised, there is a gap between what customers expect and the service received. To increase customer exposure, organisations are tempted to make promises that may be difficult or even impossible to deliver.Communication through these channels tends to raise customer expectations and set certain standards to assess the service in the minds of customers. Any discrepancy between promised and actual service tends to broaden the customer gap. The tendency to over promise increases with pressure to achieve greater profits or to meet competitive claims. In both cases, severe damage to the organisations image can occur since it is unlikely the organisation can fulfil the service as promised. Each organisation should ensure that what they say they can offer, they will give to the customer as promised. This forms the backbone of the service bundle established by the organisation to achieve expected customer service.

Six Practical Tips to Find Clients

Six Practical Tips to Find Clients In June 2015 I swallowed my fear and pride and made the decision to call myself a writer. Since establishing my own writing business I have found success in two niches: writing articles for popular websites and writing blogs for corporate clients. Its no secret that the corporate clients I have are my real money-makers, and my source of steady income. Where are all these businesses that are willing to pay good money for a blog post? Follow these six tips and you will find more clients for your writing business too. 1. Â   Â   Â  E-mail potential clients. Sit down and write a list of 25 people you know who own a business and would benefit from a blog. Look through your Facebook and Twitter page. Ask your Mom if she knows of anyone. Then, write an email introducing yourself, the benefits of blogging, and exactly why you think this opportunity would benefit the individual business specifically. This email needs to be clear and concise and not feel like you sent it to 25 people. 2. Â   Â   Â  Offer incentives to current clients. If you are looking to build your client base it is a good idea to ask your current clients for some help. Once you feel youve established a good relationship with your client, approach them with an offer that they cant resist. For example, let your client know you are hoping to build your business and appreciate their trust and positive feedback. Then, offer them one free blog post per client referral. 3. Â   Â   Â  Use networking sites to build relationships. Use websites like LinkedIn and Facebook to network with potential clients. Share compelling information about the importance of online marketing and blogging to pique their interest. But make sure to take things one step further and reach out to those you are networking with. Introduce yourself and let them know you are available to talk more about your work and the value of your writing services. 4. Â   Â   Â  Introduce yourself to other popular writers Sometimes the way to break into the business is 5. Â   Â   Â  Put an ad in the paper. This may seem like an outdated idea, but the truth is many potential clients simply arent online. Consider putting an ad in your local paper letting people know you are a freelance writer specializing in corporate blogging. Make sure your advertisement is clear and professional, and consider hiring someone to make it for you. 6. Â   Â   Shout it from the rooftops. The best way to find potential clients is to look at every single person you come into contact with as a potential client. Keep a few business cards with you at all times. Let people know on all your social media platforms what you do. Chat with people at your local Starbucks and in the checkout line at the grocery store. Introduce yourself to your neighbors. Make sure everybody knows who you are and what you do, and watch your business grow. Now go out and use these tips to grow your client base. Come back here and let us know when you do!

What Is Eating Gilbert Grape Review (for a Special Ed Class) Essay Example

What Is Eating Gilbert Grape Review (for a Special Ed Class) Essay Example What Is Eating Gilbert Grape Review (for a Special Ed Class) Paper What Is Eating Gilbert Grape Review (for a Special Ed Class) Paper Essay Topic: The Birthday Party Summary Written by Peter Hedges, What’s Eating Gilbert Grape is the story of the Grape family, which consists of Gilbert, Amy, Arnie, Ellen, and Bonnie. The movie is narrated by Gilbert Grape. Arnie is one of the main characters in the movie. Arnie is a 17-year-old male who shows signs of having Mental Retardation and Autism. Throughout the majority of the movie, Arnie is looking forward to the birthday party his family is going to be throwing for him for his 18th birthday. The movie is based on how the members of the Grape family are affected by Arnie’s disabilities, and the daily struggles they go through while caring for a family member with disabilities. All of Arnie’s siblings help out, but Gilbert does the majority of the work when it comes to caring for Arnie. Gilbert takes Arnie to work with him at the local grocery store, gives him his bath on a daily basis, and is always looking after him. Although, sometimes, Gilbert does not watch his brother close enough and he usually ends up climbing the water tower in town or is getting into some other kind of trouble. Gilbert Grape was the one appointed to caring for Arnie since he is the only man left in the house since Mr. Grape committed suicide seven years ago. Mr. Grape’s death left their mother, Bonnie, severely depressed and morbidly obese. Bonnie has not left the house in seven years, and her weight has left her incapable of caring for Arnie for years. Although it is obvious that Bonnie does feel guilty about leaving the care of Arnie completely up to her children, it is at times apparent throughout the movie that Bonnie and the children make it sound like Arnie may be the cause behind the death of Mr. Grape and the reason for the depression and current condition of their mother. It is evident throughout the movie the stress the Grape family is under. They are always arguing, and all of their arguments seem to revolve around one thing; Arnie. Accuracies, Inaccuracies, Stereotypes In What’s Eating Gilbert Grape, there were many things about the movie that were very truthful. The performance of Arnie Grape, played by Leonardo DiCaprio was very believable and consistent throughout the entire film. His portrayal of an individual with disabilities was spot on and I believe that anyone familiar with working with individuals with disabilities similar to Arnie’s would be proud of DiCaprio’s performance in the movie. Also, the second accuracy within the film was the way that the family sometimes treated Arnie like he was a nuisance. At times, families with a child who has a disability feel as though their child is nothing but a large burden to their life. As sad as it may sound, it is the truth in most cases; and it was very true especially with the Grape family. It was obvious at times throughout the movie that Arnie did have a negative impact on the lives of the members of the Grape family and sometimes they just did not want to be bothered because it was just too much for them. I believe that that is accurate because anyone who cares for a family member with a disability needs a break sometimes, and without the occasional break or help from another family member, it can be very strenuous to one’s own health. One of the most ridiculous inaccuracies that were stated in What’s Eating Gilbert Grape happened within the first couple minutes of the movie when Gilbert, the narrator, says that the Doctor said that Arnie would not live past the age of 10, and that he could now go any day now. Having a disability is not a death sentence, and even though the movie was set back in the early 1990’s, I don’t think doctor’s views on developmental disabilities such as Arnie’s have changed much since that time. There are many things that can be done for an individual with developmental disabilities as long as they are taken care of properly. Another inaccuracy in What’s Eating Gilbert Grape is that several times throughout the movie, Arnie’s younger sister, Ellen calls Arnie crazy. Individuals with disabilities are not crazy. Sure, they may do things out of the ordinary, or do things that we as regular people may not find acceptable to do, but that does not make them crazy, it just makes them different from us. Everyone is different from each other in one way or another, but that definitely does not make them crazy. Although, Arnie does do things over and over again, such as climbing the water tower in town, and does not learn from being reprimanded, but that in the least does not make him crazy. Also, another inaccuracy I would like to point out from the movie is when his family member’s think and say that Arnie is totally helpless. Although, in some cases, this may be a true statement, in Arnie’s case, it is not true at all. He is able to do many things on his own. He is very capable of finding the water tower on his own, he is able to speak and express his wants and needs clearly, and he is also able to communicate clearly with others. There were quite a few stereotypes in What’s Eating Gilbert Grape, and most of them were very common among people today. Like for example, when Arnie climbed the water tower and the police decided to arrest him, they thought that he should have known better. Although, he was told numerous times before not to climb the water tower, for an individual with a disability, it is not an easy concept to grasp, and individuals with developmental disabilities more often than not do not understand right from wrong. Also, when arresting Arnie, they do not take his disability into consideration whatsoever. They were very rough with him and very rude as well. Another stereotype that was cast upon Arnie in the movie was when Gilbert was with his friends as the restaurant and Arnie was playing the pinball machine. He was being very verbal while he was playing the game, and many of the other patrons eating in the restaurant were staring at him as though no one else would be excited if they won a game or upset that they lost. They sort of glance at him like he has some sort of horrible disease, but much to their dismay, he is just as normal as the common folk. Take-away Message In the movie there are quite a few negative scenarios that could leave many viewers who are unfamiliar with individuals with disabilities with a bad taste in their mouths. One of the take-away messages that one may get from What’s Eating Gilbert Grape is that it is acceptable to yell and reprimand an individual with disabilities in public. This could not be further from the truth. This could have been taken from the scene where Ellen is watching Arnie, and he is headed toward the water tower and in her attempts to stop him, she pulls him down to the ground by his shirt, and proceeds to yell and scream at him like he is an animal. She also hits and kicks him while he is lying on the ground. This is a very negative thing for anyone to witness and it could not be further from the truth. Another message that people could have taken-away from the movie is that many family members and caregivers for individuals and family members with disabilities will eventually leave the family due to frustrations, commit suicide, or hit their disabled child. This is a very untruthful statement as well. Even though Mr. Grape did commit suicide and in the movie, the children and Bonnie do casually mention that it is because of Arnie that Mr. Grape is dead, it is not said for sure. Many people choose to be caregivers for individuals with disabilities and do it for their entire lives. It takes a special person to take care of a person with disabilities, and it takes a lot of time and patience, and without that, you will most likely be an unsuccessful caregiver. There are certain characteristics that a caregiver for a person with a disability must hold, and if you lack any of those characteristics, you will most likely not be able to handle the stress of caring for a person or child who is disabled. In addition to the ones mentioned before, another common take away message is that all individuals with disabilities are â€Å"crazy†. This was covered in another part of my paper, but it applies here as well. When Ellen calls her brother â€Å"crazy† numerous times throughout the movie, it makes people who are not familiar with disabilities wonder â€Å"are people with disabilities really crazy? † and the answer is no, they are not. Although there are many different kinds of disabilities out there, the disabilities that Arnie has do not make him crazy. There is not any time during the movie where Arnie shows any signs of being â€Å"crazy†. He is just a typical teenage boy who needs a little more help than others at times. Last but not least, the last take away message from the movie is that all persons with disabilities constantly misbehave and need to be under constant 24 hour supervision. This is not true in any sense of the word. There any many independent individuals who have disabilities who have their own apartments, have jobs, pay their own bills, and do not need any help or supervision whatsoever. Just because Arnie needs to be watched closely so he does not get into trouble does not mean that every single individual with a disability needs to be supervised with a close eye at all times. Every person and every disability is unique, and every person deals with their disability in a unique way. Some individuals with disabilities are able to go out and live completely independent lives, where others may need to live with a parent, caregiver, or roommate forever. It just depends solely on the individual. Likes, Dislikes, Changes In What’s Eating Gilbert Grape, there were a lot of things that were definitely likable about the movie. For one, the reality of the family and community setting where the movie took place. Also, the acting of DiCaprio as Arnie who was a teenager with developmental disabilities was exceptionally realistic. In addition, the reactions that the people in the community had to Arnie and his sometimes impulsive and irrational behaviors were very similar to the reactions people would have to an individual with disabilities out in the community today. Another thing that was much desired about What’s Eating Gilbert Grape was the fact that it probably opened the eyes of many people who thought it was out of the ordinary for parents to keep their disabled child and care for them and not send them away and institutionalize them. I believe that it made many people realize that it is normal for families to keep and care for their child whether it has a disability or not. Lastly, the movie also sent out a very positive and important message to viewers that could make many people feel more comfortable with people who care for individuals with disabilities, individuals with disabilities themselves, and giving the people who care for such individuals more credit for the hard work that they do. Some of the dislikes in the movie What’s Eating Gilbert Grape were the way the family and the community sometimes treated Arnie. Even though, that is the way it actually is at times, it is still unnecessary to treat anyone, disabled or not, disrespectfully and rudely. Throughout the movie, there were several scenarios where Arnie was treated with much disrespect. Although, that is how many individuals who are like Arnie are treated in today’s society, it is not acceptable and very terrible. Another dislike of the movie was the part of the movie where Gilbert was so frustrated with everything in his life, and had all of his emotions built up and he took it all out on Arnie and he hit him. Although, everyone gets angry at times, it is never acceptable to hit someone else, especially someone like Arnie who is unable of properly defending themselves. It may have been a very honest and true situation to see a family member with a child or sibling with a disability struggle through; there are plenty of other ways that Gilbert could have effectively expressed his emotions without hitting Arnie. He was under a lot of stress from the rest of his family, but that was no reason for him to take it out on Arnie, when it was his mother and other siblings that were causing all of his built up frustration and anger. Lastly, a dislike was very disheartening was the fact that whenever they went somewhere with Arnie, the people in the community would point, stare, or ask â€Å"what is wrong with him? †. Although, most times in today’s society, children and even some adults will do the same things to individuals with disabilities; that is the most disrespectful thing you could ever do to a person. It is a giant reality and it happens very, very often, but it tops the list of my dislike list in the movie What’s Eating Gilbert Grape. Some of the changes that would have been ideal to the movie would to have been given the opportunity to see how Arnie performed and acted during school. It was very apparent how he acted outside of school and how he acted while around Gilbert and his other siblings, but it would have been interesting to see how he acted around his peers and other individuals who are like him. Also, another change that would be idealistic would be to have his other sister’s more involved in his care. Amy and Ellen were always too busy to care for Arnie, so all of the responsibility was always dumped completely onto Gilbert. It would have been nice to see how differently Arnie would have acted, and if he would have behaved any different if he were to be with Amy or Ellen more often than he was throughout the movie. At one point in the movie, Ellen was supposed to be watching Arnie and he ended up running towards the water tower and Ellen grabbed him and pulled him to the ground and was dragging him away from the water tower, while yelling at him and kicking him in public. Thankfully, Gilbert was there to intercede and stop Ellen from hurting Arnie anymore than she already had. It makes you wonder if Ellen showed more interest in Arnie if he would not have acted out while with her, and scenarios such as that would not have happened. Back in 1993, What’s Eating Gilbert Grape was a very controversial movie but portrayed a positive message to those families and individuals who did not understand disabilities and just how much work goes in to caring for individuals with disabilities. Many of those who did not understand before still may not completely understand and sadly, they may never. The movie does not do complete justice to all individuals with disabilities, because every individual and every disability is different and Arnie’s condition was a mild to moderate disability. From working with individuals with disabilities for the past eight years, every stereotype you can imagine was cast upon them, and many people do not take into consideration that they are people just like themselves and they have feelings too. Many people believe that individuals with disabilities do not hear or understand what is being said about them, but you would be surprised how smart some individuals with disabilities can be. It is sad that many individuals with disabilities are hardly ever recognized for their good attributes, it always seem to be the bad one’s that outshine and catch people’s attention.