Managed Health Care Delivery with Healthcare Reform Act Essay

Managed Health Care Delivery with Healthcare Reform Act - Essay Example These legislative developments will no doubt bring about tremendous changes in the managed care sector impact immensely on the system of care delivery. Studying managed healthcare relative to the Health Care Reform Act is therefore a very important topic affecting healthcare professionals, care providers, medical students, policy makers and other stakeholders. The Act will particularly have far reaching impacts on models of business for insurance providers and the Managed HealthCare Sector. Insurers and self funded care plans for instance are required to overhaul some practices of underwriting as well as structures of benefit. The act will therefore see insurers receive more customers since most Americans are expected to acquire covers or attract penal measures. Ultimately premium rates expected to hike as insurers struggle with costs of registering new clients some with very high costs of medication. Another area of concern to the Health Care Reform Act has to do with compensation for physicians especially given the amount and nature of work given the changes that will be occasioned by the reforms. The future of managed healthcare is thus going to be marred with a myriad of changes all in the best interest of the patient in America. It is important for these reasons that I believe this is as very relevant and timely topic for students in the entire medical field. In this article, the author reflects on physician compensation, cost and quality in the U.S. He also explains three ways to reimburse physicians for services rendered; the ways are salary, capitation, or fee for service. Physicians reimbursed on the basis of salary receive a certain sum at the end of every month or year worked. Those on capitation schedule receive their payments commensurate with the number of patients attended to or the number of patients placed under their responsibility. On the other hand, professionals compensated based on fee-for-service receive payment for

The History of Rock and Roll Essay Example | Topics and Well Written Essays - 1000 words

The History of Rock and Roll - Essay Example However, crossover music may also be a combination of two dominant styles that are each distinctive. Jerry Lee Lewis' "Great Balls of Fire" went to the top 3 of the C&W, R&B, and Pop charts because it had distinctive elements of all three styles. Musical styles can sometimes be combined into 'fusion' music, such as Rockabilly, that forms a new style but is still considered a form of crossover. Crossover is important because it increases the size of the available audience. This is especially true when radio stations are categorized by genre. An audience will have a loyalty to a certain station and by getting airtime on both a rock station and a country station, the artist has doubled their exposure. This phenomena was critical to 45-RPM record sales in the 1950s. Exposure to new music was through the radio and record sales were directly linked to airtime and radio station promotion. A crossover record could double their sales or as in the case of "Great Balls of Fire", sales could triple. Elvis Presley's musical career peaked in 1960 before he left for the Army. The previous 6 years had an enormous impact on rock and roll that his later career would never have been able to capture. When Elvis signed with Sun Records in 1954, he brought the right ingredients to an environment that meshed perfectly with his style (Stuessy and Lipscomb 36). Rock and Roll had been introduced to a rebellious post war youth in an affluent economy. The 45-RPM record had made music on demand accessible for everyone and it was most popular with the younger audience. To this scene, Elvis brought his unique mix of musical talents. He had a broad range of style from Gospel to hard core Rock and Roll that held a wide appeal (Stuessy and Lipscomb 40). He could successfully blend these styles or use them independently. His physical appearance and performances were just rebellious enough to mirror James Dean and entrance the emerging TV viewers. Elvis was able to dominate the youth culture and explo it the new mediums of recording and television. After his release from the Army, Rock and Roll had taken new directions and had a life of its own. Music was getting more sophisticated and the audiences had generated expectations of a continually changing sound. His 1960s hits "In the Ghetto" and "Suspicious Minds" lacked the spark that had ignited the Rock revolution (Stuessy and Lipscomb 38). They were generic sounds that could have been performed by a dozen other artists. Though he would always remain one of the most popular figures in music, without the early years he would never have reached the success that he has today. A Good 1950s Rock and Roll Song The Rock and Roll of the 1950s was a pulling away from the Big Band era and the crooners of the 1940s. It had to be counter to those sounds. Where Big Band had been highly structured, Rock was required to have little if any structure. This often resulted in songs that were simple and direct with few chords and simple progressions. This was part of Rock's appeal. A good song needed a familiar structure that the audience could immediately relate to. Buddy Holly's "Oh Boy" was built on the I IV V chord progression that had permeated Country and Blues for decades (Stuessy and Lipscomb 30). The successful song would take these familiar progressions and escalate the tempo, timbre, and volume to create a good Rock and Roll

Impact of Tourism on UK Tourist Destinations

Impact of Tourism on UK Tourist Destinations Evaluate the Nature and Extent of Tourism Impacts at a Range of Tourist Destinations The tourism and travel patterns of past decades, combined with the challenging market conditions, especially given the impacts that recent terrorist activity and natural disasters have had on the tourism market, have tended to result in short-term approaches from many organisations in travel and at destination resorts, where commercial activity has thus impacted negatively on natural or cultural environments. In historic terms, leisure travel is relatively new phenomenon, starting in the UK with the ‘Grand Tour’ journeys of the eighteenth century, when wealthy individuals chose to visit neighbouring lands to learn about politics, culture and art. By the nineteenth century, leisure travel within Britain increased, with the growing popularity and royal patronage of spa and seaside towns, and the corresponding availability of transport, which became faster and easier during the industrial revolution, with improved roads and the introduction of trains and rail travel. The we althier and aspiring middle classes popularised travel destinations that developed into resorts offering entertainment and serviced accommodation. (Global Market Information Database, May 2005) However, this rapid growth of tourism has resulted in several unforeseen impacts on destinations, which have been observed to be either beneficial or detrimental to the locality. The twentieth century inventions of the motor car and coach transport accelerated the popularity of domestic holidays, leading to the seaside holiday becoming firmly established as integral to British culture, with corresponding impacts on town such as Brighton and Blackpool, which have become strongly geared towards holidaymakers Sea travel improved and developed with the leisure traveller in mind, bringing ferry routes, luxury liners and vessels for hobbyists. The two World Wars also brought about the accelerated development of air transport, which resulted in a demand for civilian passenger planes, and thus fast overseas travel by plane opened up the world to international leisure journeys. As a result of this massive explosion in tourism, over the past three hundred years, tourism has brought prosperity to many regions of the world that would otherwise exist in abject poverty, such as the island of Bali, where living standards are considerably higher than the neighbouring islands in the Indonesian peninsula. (Friedheim, 1996) However, frequently tourism grew to suit human interests, particularly those of the tourists and businesses, and by no particular long-term plan with regards to sustainability at the local destinations. As a result, today the detrimental effects of global tourism are evident in the form of pollution, the erosion of local culture, the widening of the gap between rich and poor, a threat to survival for local economies and the spoiling of natural habitats and landscape. (Cooper et al, 2004) Indeed, whilst Friedheim (1996) mentions the strong positive impact of the tourist trade in Indonesia’s Bali Island, with the island frequently being described primarily as a popular tourist destination, Friedheim also comments on tourism’s impact on the island’s economic and social conditions for those locals not actively engaged in the trade. He also comments on how traditional skills and employments are increasingly being suborned to appeal to the tourist masses and their money, and thus the island’s culture is being eroded. Similar comments are made on the developments related to the tourist trade in Eastern Europe, following on from the collapse of the Soviet Union and the ‘Iron Curtain’, when the area’s potential as a tourist destination first began to be explored. However, in this case, there was widespread cooperation amongst the Eastern European countries for the promotion of the regions tourist trade, and tourism generally had a positive impact on the areas re-building efforts (Friedheim, 1996) due to its focus on the culture of the cities, rather than beach holidays. Lori (1998) takes a similar view, but focuses on the second annual Sustainable Tourism Conference of the Caribbean Tourism Organization in Trinidad, Spain. In the Caribbean, tourism had previously followed a quite unsustainable model; however the aim of the conference was to address this, based on the tourism strategy initiatives followed by the Dominican Republic: a model ecotourism destination in the Caribbean. Although it is wise to aim for sustainable tourism wherever possible, to reduce the negative impacts on regions wherever possible, there are often factors that work against this desire. One of these is seasonality: an integral quality of the landscape which greatly affects, informs and interweaves with many tourism factors, such as the tourism-based economies of Greek island communities, currently almost entirely dependent upon summer holiday tourism for their survival. (Terkenli, 2005) The multiple facets and impacts of seasonality produced and inscribed by tourism on the landscape, and specifically on the landscape of northern Crete, can, as with many other impacts and destinations, be both problematic and beneficial. In the case of Crete, the three different stages of the tourism destination lifecycle model used by Terkenli (2005) are roughly represented by three different zones of tourism impact in the broader region of Hersonissos in northern Crete. Here, tourism-induced changes roughly attenuate with distance from the coast, acquiring distinctive geographical patterns that follow those of spatial tourist concentration, scale of development, and incorporation of tourism into Cretan society and space, thus giving the island a seasonal economy and demography, in common with many similar regions dependent on seasonal tourism. However, there can be major negative impacts on regions with economies of this type or, indeed, any economy based on tourism. For example, in the months immediately following the 11 September 2001 terrorist attacks, there was a strong trend in many regions towards staying closer to home, with tourists being deterred from long-haul travel for several reasons, including lower incomes, the fear of further terrorist attacks, and delays at airports due to higher security. This benefited domestic travel, as well as regional travel such as travel between European destinations, travel between the US and Canada, and travel within Asia, thus helping some tourist destinations in these countries. However, it had an adverse impact on destinations such as Florida, which relies heavily on tourists from Europe, and many destinations that relied heavily on tourism from the US were particularly badly affected by the fall-off in American tourists immediately after the attacks of 11 September 2001. Thes e included destinations such as the Caribbean and Latin America, and within these regions, notably Mexico, Puerto Rico and the Bahamas. (Global Market Information Database, Sep 2005) In response to this, Latin American and Caribbean governments launched marketing campaigns and other measures to encourage tourism in the region. In Mexico, for example, which depends on the US for 85% of its tourist arrivals, measures included the elimination of sales taxes on conventions, and an increase in the promotional budget of 50% through a new public-private consortium. The Caribbean Tourism Organization (CTO) also launched an emergency joint marketing, promotion and public relations campaign at the end of 2001 to try and resurrect the failing tourism market which was pushing many of the region economies towards recession (Global Market Information Database, Sep 2005) Indeed, increasingly governments and organisations across the world are realising that travel and tourism growth cannot be left to chance, as the potential impacts on regions, and also entire nations, are just too great. As a result, in 2003 over five hundred of the world’s most influential business leaders called on the World Travel and Tourism Council (WTTC) to form a new vision and strategy for travel and tourism. This project combined the forces of stakeholders from public and private organisations, resulting in the formation of â€Å"Blueprint for New Tourism† campaigns to influence behaviour and to introduce new legislation and best practice for the industry in its quest to help governments recognise travel and tourism as a top priority, to balance economics with people’s needs, culture and environments and to share the pursuit of long-term growth and prosperity, underpinned by corporate social responsibility. Global Market Information Database (May 2005) O rganisations are now required to evidence the measures they take towards social responsibility in their annual reports, and consumers too are becoming more aware of the impact that tourism and development can have on the world, through television documentaries and media coverage of issues such as global warming, endangered species and fair trade practices. To help consumers make informed choices on their travel destinations, consumer advisory services such as the Centre for Environmentally Responsible Tourism and ecotourism.org were established, offering advice on the best destinations and most sustainable tour operators. Indeed, as with many regulatory bodies around the world, for tour operators, such an endorsement provides a promotional opportunity and can further benefit nations: for example, the dreadful and much publicised effects of the Asian tsunami awoke the UK public to the need to give and support nations in peril. Popular destinations for back-packers were literally wipe d off the map, and to support the regeneration of the tourist industry in the affected countries, volunteer holidays were offered, which helped provide useful skills and manpower to local populations, as well as helping tourists get closer to the local culture. A final impact of tourism is its tendency to skew the geographic distribution of wealth in countries that have particular tourist attractions. Egypt is a good example of this, as it is now looking into the possibilities for diversifying its tourism opportunities throughout the country, with the main target for expanding the tourism sector in nature-based tourism. The coral reefs and rich marine life in South Sinai and the Red Sea coast have made these two areas among the premier scuba diving destinations in the world, with many beach resorts are now in operation and still hundreds to be constructed. However, previous tourism development in Egypt has resulted in a series of negative environmental impacts, both to the reefs and marine life, and to the other areas of the country which have suffered a lack of funding and investment due to not being in proximity to well known tourist destinations. The ambitious development plans to receive 16 million tourists across the country by 2017 wi ll thus take into consideration sustainability and demographic concepts, with the government and developers having significant roles to play in adopting and implementing environmentally sound policies and practices to avoid the degradation of the natural heritage of Egypt for the sake of the current as well as future generations. (Shaalan, 2005) In conclusion, tourism offers some of the most impoverished regions of the globe the chance to develop their infrastructure and quality of life in ways that would otherwise be impossible in the modern world. However, frequently these developments are allowed to proceed without thought to maintaining a balanced distribution of income amongst the local inhabitants, and preserving the very attractions which bring tourists to the area. As a result, tourism can often have significant, wide ranging negative impacts as well as positive ones, such as in the case of Bali. However, with the new sustainable tourism developments helping to reduce the negative impacts, and distribute the positive ones equally across the local populations, there is evidence that tourism can, and in future increasingly will, provide beneficial and sustainable long term impacts to the communities and destinations it affects. References Cooper, C. Fletcher, J. Fyall, A, Gilbert, D. and Wanhill, S. (2004). Tourism: Principles and Practice, 3rd Ed. Prentice Hall: London. Friedheim, E. (1996) Holding on to paradise. Travel Agent; Vol. 284, Issue 1, p. 22. Global Market Information Database (Sep 2005) The World Market for Travel and Tourism. Euromonitor International. Global Market Information Database (May 2005) Travel and Tourism in the United Kingdom Euromonitor International. Shaalan, I. M. (2005) Sustainable tourism development in the Red Sea of Egypt threats and opportunities. Journal of Cleaner Production; Vol. 13, Issue 2, p. 83. Tenny, L. (1998) Second CTO conservation confab explores tourisms impacts. Travel Weekly; Vol. 57, Issue 38, p. C9. Terkenli, T. (2005) Human Activity in Landscape Seasonality: The Case of Tourism in Crete. Landscape Research; Vol. 30, Issue 2, p. 221.

Marxist Criticism Essay -- Karl Marx Marxism Essays

Marxist Criticism Introduction Marxist literary criticism is based upon the political and economic theories of the German philosopher Karl Marx. In works like The German Ideology and The Communist Manifesto, written with Frederick Engels , Marx proposes a model of history in which economic and political conditions determine social conditions. Marx and Engels were responding to social hardships stemming from the rise of capitalism. Appropriately, their theories are formulated specifically to analyze how society functions in a state of upheaval and constant change. A materialist view of history Using Hegel's theory of dialectic , which suggests that history progresses through the resolution of contradictions within a particular aspect of reality, Marx and Engels posit a materialist account of history that focuses upon the struggles and tensions within society. As society forms more complex modes of production, it becomes increasingly stratified; and the resulting tensions necessitate changes in society. For example, the introduction of heavy machinery into the feudal economic system fragmented existing social structures and necessitated a move towards capitalism. The base and superstructure model Within Marx's dialectical account of history is the idea that a given individual's social being is determined by larger political and economic forces. Marx writes that "it is not the consciousness of men that determines their being, but, on the contrary, their social being that determines consciousness." Simply stated, the social class into which a person is born determines her outlook and viewpoints. Marx then expands this concept of determination into one of the central concepts of Marxism--that of base and sup... ...with theories that focus upon how literature functions within social, political, and economic structures, than it does with theories that focus only upon the text. Marxist criticism has had an enormous influence on feminism , new historicism , and most recently, cultural studies . As a system that looks for causes beneath the surface of society, Marxist criticism has much in common with psychoanalytic criticism . In fact, it is possible to make a rough comparison between the Marxist model of base and superstructure and the Freudian model of unconscious and conscious. Works Cited Eagleton, Terry. Marxism and Literary Criticism. London: Metheun Books, 1976. Selden, Ramden. A Reader's Guide to Contemporary Literary Theory. Lexington: University Press of Kentucky, 1985. Williams, Raymond. Marxism and Literature. Oxford: Oxford University Press, 1977.

Music Piracy: Should It Be Allowed?

File sharing is when people share files on their computers with other users. This is done across the internet and made possible by peer-to-peer programs. These files can be anything: pictures, text, pornography, movies, etc. I will be focusing on music. The issue is whether or not music or file-sharing should be legalized. When I first tried Kazaa, I was absolutely amazed. With my family's terribly slow internet connection, I would download as much music as I could. I would wait patiently, sometimes 30-45 minutes, for a single song to be downloaded. Then, one day we got a ADSL connection and no one could stop me from downloading music. In a rough estimate, I must have downloaded over 30 gigabytes worth of music in the past few years. That's a lot of music, music that I would not have heard, artists I would have not discovered, if it weren't for file sharing. But all good things come to an end. After losing legal battles with the RIAA (Recording Industry Association of America) and related parties, Napster started deteriorating. Filters prevented certain artists from being listed in searches and if you had songs by certain artists on your computer, you would be banned. I once started up Napster only to be greeted with this message: â€Å"YOU HAVE BEEN BANNED BY DR. DRE†. Along with thousands of other people, I stopped using the program. So what was/is the RIAA's deal? What do they have against file-sharing? The RIAA and many artists feel that peer-to-peer file-sharing is a violation of copyright laws and is hurting music sales. Some artists feel that P2P sharing is, simply, stealing. That they feel this way is okay. However, the way they went about handling the situation is highly debatable. For the most part it shows the lack of vision and understanding the RIAA and some musicians have concerning the future of music. Why are CD sales down? In 2002, there was a 10% decline in record sales. The RIAA blame file-sharing, however, they need to consider the following possibilities†¦ (1) The state of radio. Clear Channel controls around 60% of rock radio. Ever wonder why, no matter what city you travel to, there is always a radio station with the same format as a station back home. According to Professor James Boyle's, this is an example of Clear Channels â€Å"McDonaldization† of radio. â€Å"Since Clear Channel controls the format and the play lists of the majority of radio stations across the country, the type of music that gets heard becomes limited to what Clear Channel programmers decide to include on play lists†(Boyle's). If the listeners don't like what they hear, they won't buy the music. Would the fact that almost every song on commercial radio is bought and paid for have anything to do with the narrow focus and homogeneous nature of radio? â€Å"What drives radio is advertising and money, not music. A lot of music gets left behind thanks to the current state of radio, that consumers are rejecting it shouldn't be surprising. They're creating their own MP3 play lists, and if the labels were smart, they'd be doing everything in their power to be on the play lists of radio stations. Instead, they scream copyright infringement and call their lawyers.† (Boyle's) The second possibility is price. Music is overly expensive. Sometimes, paying $15 for a CD is just not within people's budget. What file-sharing has told the recording industry is that a very large number of people are more willing to sit in front of their computer and download music, rather than pay for the ridiculously overpriced alternative. Basic economics tells us that as more alternatives become available, prices drop. The recording industry is trying to resist this. Imagine if new CD's were only 5 dollars each. Would you buy more music? I certainly would. Of course, this invites the classic argument, presented by John Syner in his essay â€Å"Many Things We Pay for Are Free†: â€Å"Why would people buy something that they can get for free?† There are dozens of companies that sell†¦water. We pay for TV when there is free programming. We buy books, when we borrow them for free at the library. Why would you pay for a song that you could get for free? For the same reason that you will buy a book that you could borrow from the public library or buy a DVD of a movie that you could watch on television or rent for the weekend. Convenience, ease-of-use, selection, ability to find what you want, and for enthusiasts, the sheer pleasure of owning something you treasure. It could be argued that MP3's are the greatest marketing tool ever to come along for the music industry. If your music is not being downloaded, then you're in trouble. If you can't give it away, you certainly can't sell it. There will always be a market for CD's because people, especially music collectors, want something tangible. Something with art and liner notes, that they can put on their shelves. I believe the Philosophy of Consumerism fits this topic to a â€Å"T†. Consumerism is the theory that an increasing consumption of goods is economically desirable. The third and final possibility is that file-sharing is helping the music industry. As I said at the beginning of the essay, file-sharing has allowed me to discover artists that I would not have discovered otherwise. Many times after discovering these new bands/artists I actually did go out and purchase some of their music. Sometimes I went to go see them play live at a local club. But even if I didn't go out and purchase a bands album, I am still benefiting them by downloading their music. If I like what I hear, they get free word of mouth.

Malaysia Chinese Culture Essay

Malaysia’s cultural mosaic is marked by many different cultures, but several in particular have had especially lasting influence on the country. Chief among these is the ancient Malay culture, and the cultures of Malaysia’s two most prominent trading partners throughout history–the Chinese, and the Indians. These three groups are joined by a dizzying array of indigenous tribes, many of which live in the forests and coastal areas of Borneo. Although each of these cultures has vigorously maintained its traditions and community structures, they have also blended together to create contemporary Malaysia’s uniquely diverse heritage. Populated by the three (3) major races found in Asia, Malaysia culture is a melange of Indian, Malay and Chinese influence The Spring Festival is the most important festival for the Chinese people and is when all family members get together, just like Christmas in the West. All people living away from home go back, becoming the busiest time for transportation systems of about half a month from the Spring Festival. Airports, railway stations and long-distance bus stations are crowded with home returnees. The Chinese character â€Å"fu† (meaning blessing or happiness) is a must. The character put on paper can be pasted normally or upside down, for in Chinese the â€Å"reversed fu† is homophonic with â€Å"fu comes†, both being pronounced as â€Å"fudaole. † What’s more, two big red lanterns can be raised on both sides of the front door. Red paper-cuttings can be seen on window glass and brightly colored New Year paintings with auspicious meanings may be put on the wall. Waking up on New Year, everybody dresses up. First they extend greetings to their parents. Then each child will get money as a New Year gift, wrapped up in red paper. People in northern China will eat jiaozi, or dumplings, for breakfast, as they think â€Å"jiaozi† in sound means â€Å"bidding farewell to the old and ushering in the new†. Also, the shape of the dumpling is like gold ingot from ancient China. So people eat them and wish for money and treasure. Burning fireworks was once the most typical custom on the Spring Festival. People thought the spluttering sound could help drive away evil spirits. However, such an activity was completely or partially forbidden in big cities once the government took security, noise and pollution factors into consideration. As a replacement, some buy tapes with firecracker sounds to listen to, some break little balloons to get the sound too, while others buy firecracker handicrafts to hang in the living room. People in different places follow various customs, but all show their love and longing for a better life. Today people will enjoy the full moon and eat moon cakes on that day. The moon looks extremely round, big and bright on the 15th day of each lunar month. People selected the August 15 to celebrate because it is a season when crops and fruits are all ripe and weather pleasant. On the Mid-Autumn Festival, all family members or friends meet outside, putting food on tables and looking up at the sky while talking about life. How splendid a moment it is! | There are many legends about the evolution of the festival, the most popular of which is in commemoration of Qu Yuan. People will dragon boat racing, eating zongzi and drinking realgar wine on that day. On Dragon Boat Festival, parents also need to dress their children up with a perfume pouch. They first sew little bags with colorful silk cloth, then fill the bags with perfumes or herbal medicines, and finally string them with silk threads. The perfume pouch will be hung around the neck or tied to the front of a garment as an ornament. They are said to be able to ward off evil. | The Qingming Festival sees a combination of sadness and happiness. This is the most important day of sacrifice. Both the Han and minority ethnic groups at this time offer sacrifices to their ancestors and sweep the tombs of the deceased. Also, they will not cook on this day and only cold food is served. On each Qingming Festival, all cemeteries are crowded with people who came to sweep tombs and offer sacrifices. Traffic on the way to the cemeteries becomes extremely jammed. The customs have been greatly simplified today. After slightly sweeping the tombs, people offer food, flowers and favorites of the dead, then burn incense and paper money and bow before the memorial tablet.