Health Care System Evolution Paper - 1313 Words

Health Care System Evolution Paper This paper will discuss how HMOs have influenced current health care systems. HMOs have been able to reduce health care cost in many ways and have also faced many difficulties along the way. Many Americans years ago did not have health coverage and we are still seeing this today because of the cost of these plans. HMOs or Health Maintenance Organizations are health care plans that reduce health care cost. Members of an HMO are usually required to make a co-payment when seeing a physician. A lot of time members have a deductible they will have to pay before they are able to see their physician too. These are just some of the ways HMOs try to keep health care cost down. There are some 75 million†¦show more content†¦With a POS plan, members can use doctors who are within the network or those who are not in order to receive their care. If member do choose doctors outside their networks they will have to pay more to have those services performed. With the POS plan members must have a primary care physician. With a PPO plan members have more options over who they can see. Members do not need a primary care physician with this type of plan (What is an HMO? 2009). HMOs have been running strong for years but to remain viable they are going to have to make some changes. Considerable evidence points to physician and consumer dissatisfaction with HMO’s. Consumers are not satisfied with primary care physicians as gatekeepers, limited provider choice, physician profiling, requirement of prior approval and constraints on covered treatments (Fang, Liu, Rizzo, 2009). Studies have shown a slight decline of the insured population covered by HMOs. In 2000-2001, 55 percent of the insured population was covered and in 2003 it dropped to 51 percent (Fang, Liu, Rizzo, 2009). President Obama signed into law a new health care plan that will help many Americans. With the way things were going, many people were not able to carry health insurance and those companies that were carrying insurance had to drop coverage for many of their employees. Many doctors and big HMO companies have made a killing over the years, and want to keep doing so. That is why many did not want toShow MoreRelatedThe Evolution Of Healthcare During The United States Essay1249 Words   |  5 Pagesindustry that has representation from both public sector and private sector. The current health care system is segregated and fragmented in America. Some states have very effective and efficient healthcare system while some states lack the desired infrastructure. The evolution of healthcare system in USA can be traced back to 1750. The period from 1750 to 1849 is termed as preindustrial period where the care of sick people was primarily handled by families (Brian, 2010). 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Though there are several influences politics, finance, culture, technology, health trends, and religions they all play a majorRead MoreEssay about Health Care Systems1368 Words   |  6 PagesRunning head: HEALTH CARE SYSTEM EVOLUTION PAPER Health Care System Evolution Paper University of Phoenix Sandra Walther/ HCS 310 October 20, 2009 Understanding the roller-coaster experience with the use of market forces in health care over the past ten years provides important context for discussions of likely future developments in the nature of competition (Lesser, 2007). The period began with acceptance of managed care transforming the organization of medical care delivery and proceeded

Why Did Political Parties Spring Up in the United States in the 1790s Free Essays

Why did political parties spring up in the United States in the 1790s? Why did political parties spring up in the United States in the 1790s? On the 30th April 1789 America’s first President, George Washington was elected into office and was to stay in power until 1797. Within this time the political scope of the United States of America expanded hugely, giving birth to the politics in which we see in America even to this present day. This essay will tackle the many aspects of the development of political parties; from the economic plans adopted by Alexander Hamilton, which forged America’s first bank in 1791, to the ways in which Americans viewed the Constitution put in place in 1789 causing the birth of Federalist and Republican attitudes throughout the United States of America. We will write a custom essay sample on Why Did Political Parties Spring Up in the United States in the 1790s or any similar topic only for you Order Now A major factor in the creation of political parties came through the influence of Alexander Hamilton. During his time as Secretary of the Treasury to George Washington, Hamilton devised five economic programs as a result of his Nation Government ideology. Eric Foner argues that: ‘Political divisions first surfaced over the financial plan developed†¦ in 1790 and 1791’[1]. Hamilton’s financial models won strong support from the American financiers and manufacturers, and the models would only work if America created close links with Great Britain. This ideology sparked resistance from Jefferson and Madison, as they both believed that ‘the future lay in Westward expansion’[2] and thus, the foundations for political divisions were in place due to the ideological differences between Jefferson and Hamilton. Therefore, it can be argued that Hamilton was the main initial influence to instigate political thought in America. However, although political divisions began to emerge over Hamilton’s financial plans, it was the events that occurred in Europe that acted as a catalyst for creating two coherent political parties. At first, the French Revolution didn’t stir any conflict between Jefferson and Hamilton but after the execution of King Louis XVI, war broke out between France and Great Britain and inevitably against Jefferson and Hamilton. On the one hand, Jefferson argued that ‘Revolution marked a historic victory for the idea of popular self-government’[3] however Hamilton; as stated by Bruce Miroff, ‘set himself resolutely against the rising tide of democracy’[4] and the events of the Revolution made the links with Britain even more significant for him. Economically America was torn. Alexander Hamilton’s economic plans for the federal government to pay off the revolutionary war debts, and the creation of a national bank were vastly disputed. Thomas Jefferson expressed massive disputes with the policies, as he thought of them as unconstitutional and would create class barriers. The historian Ryan P. Randolph argued in favour of Jefferson’s views, stating, â€Å"It was not in the best interests of the landowners they represented. †[5] Jefferson’s view of a development of patriarchal society is also supported by historian John P. Kaminski who argued that â€Å"The foundation of the Bank of America would ally the federal government with wealthy shareholders†¦ the assumption of the state’s wartime debts by the federal government would also bountifully benefit this favoured class. [6] Hamilton however admired Britain’s reforms, which restored its financial health, and therefore modelled American financial policies in part on William Pitt’s in an attempt to restore America’s own finances. However the success of Hamilton’s program depended on cooperation with Britain, as duty on imports provided a major source of federal income and most imports came from Britain. Jefferson however is argued to have a deeply hostile towards Britain. His somewhat Anglophobia is argued to have played a huge part in his drifting from Hamilton and the formation of the traditional Jeffersonian viewpoints in which founded the Republican Party. However there wasn’t a complete disagreement over Britain, as Jefferson admired the technological advances in Britain, but didn’t see the US industry base in a similar manner as Americans â€Å"worked for themselves and not for others. †[7] Hamilton and Jefferson retained explicitly different opinions on economics, showing bias towards small government power, and a large, somewhat Conservative approach, using large government power to rule the entire country, causing divisions in opinions and the development of the Federalist and Republican Parties. Social divisions can also be attributed to the formation of political parties n America as the new Federalist scheme caused class barriers throughout America. This can be seen in the case of farmers who were pushed towards Republican opinion by the 1790s. In 1792 the Militia Act organised 18-24 year olds into militia units to act against Native Indians, however these were later used against farmers as a way of enforci ng the excise taxes places on items such as Whiskey (passed by congress in 1791). This caused hardship and farmers began to revolt by tarring and feathering. In 1794 the government led 1500 militia to West Pennsylvania in a similar resistance to the Stamp Act’s Boston Massacre in 1774. This as a whole caused a division between the farming community and the government, which led to further support of Jefferson and the Republican party as farmers felt like the big government leadership was only working in favour of richer classes and causing splits in society, which in turn were represented through political parties. Henceforth, following the French Revolution, the two main ideologies were established, the parties became increasingly coherent and in the mid 1790’s they developed into the Federalist and the Republicans. Therefore, it can be argued that without the French Revolution there would be no political parties because the war against France and Great Britain caused a split, not only ideologically but geographically in America. Therefore, Hamilton’s input definitely begun the era of politics but he was not the most influential factor in the overall development of the first political parties. The Constitution may also be argued to be a contributing factor in the development of political parties as some argue that Federalists ‘loosely’ followed the Constitution, whereas Jeffersonians ‘strictly’ followed it. The historian John H. Aldrich argues that â€Å"Ratification of the Constitution launched America’s â€Å"great experiment,† testing the viability of democracy. This experiment began before national political parties were invented†[8] and therefore the constitution forced Americans into a democratic society in which made it somewhat compulsory to form an opinion, which was expressed through support of political parties. However, historian Peter W. Schramm argues, â€Å"The American Founders believed that parties were antithetical to republican government. [9] This to some extent could be due to an American desire to not have political parties, and therefore be able to express personal opinions through a democracy rather than two distinctly polarized opinions. Nevertheless, it would be almost impossible to argue that the ratification of the Constitution did not have any effect on the development of political parties, and in fact one may argue that until the Const itution was implemented, Americans were unable to express their political opinions in a democratic manner, as there was no field for expression. The Constitution also had an effecting glance on the â€Å"people’s† view of Thomas Jefferson, the supposed â€Å"American founding father. If Thomas Jefferson had any authority to influence the political uprising in the States when he was in charge and seated as president, it certainly wasn’t shown when Jefferson took up the position of the secretary of state as Senator William Maclay observed, â€Å"He sits in a lounging manner†¦His whole figure has a loose and shackling air. [10] Maclay demonstrates that the role of presidency has a profound effect on the subject and ultimately Jefferson. The fact that Jefferson was seated in an important political establishment, and seated in an undignified manner, questions Jefferson’s real commitment to the political affairs happening at that time or was he biding his time, waiting for the next presidential election? The political uprising showed that presidential influence could have a massive impact on natio nal affairs. Although Thomas Jefferson was in France at the time the Federal Constitution was introduced in 1787, he was able to influence the development of the federal government through his correspondence. Jefferson played a major role in the planning, design, and construction of a national capitol and the federal district. In the various public offices he held, Jefferson sought to establish a federal government of limited powers. In the 1800 presidential election, Jefferson and Aaron Burr deadlocked, creating a constitutional crisis. However, once Jefferson received sufficient votes in the election, he and his long-term friend, John Adams, established the principle that power would be passed peacefully from losers to victors in presidential elections. Jefferson called his election triumph â€Å"the second American Revolution. † There were many problems and arguments however, confronting the Founding Fathers like, for example, slavery. The North versus the South divide was deepening. Jefferson himself was a wealthy plantation owner and owned many slaves. Although he knew it was wrong as he said it was â€Å"a moral depravity† and â€Å"a hideous blot†[11], he couldn’t give up his wealth and his earnings. Many historians have debated whether Jefferson was an actual opposition of slavery or not as he owned such a large number of slaves himself. Jefferson also commented that slavery presented the greatest threat to the survival of the â€Å"new American nation†. This â€Å"new American nation† would see these political parties spring up and finally abolish slavery in 1865 in the 13th Amendment. Nonetheless Jefferson had an impact on the political parties and their views on such subjects like slavery through his ability to become â€Å"a captivating talker and a natural leader†[12]James Madison, Jefferson’s succeeded in the presidential role, fully supported the Constitution and its values as it was a huge factor in the political restoration of society of the United States. Madison was to come into power in the 1808 election after Thomas Jefferson retired due to illness and old age. The creation of these political parties due to the Constitution being erected is an underpinning factor why Jefferson remained in power for a second term. This was due to the fact that not only did Jefferson had little opposition from Burr or Madison, but Jefferson also campaigned against the Constitution and its values as he thought that with too much power, the government would quickly become oppressive and dominant. To conclude, it would be impossible to imagine the creation of political parties in the United States without taking into account the underpinning factor that is the introduction of the Constitution in the United States of America. Without the Constitution the economic situations such as the creation of a federal bank, the implication of social barriers including those found in farming communities which essentially led to a split in opinions, and most importantly, the political divisions – most famously seen in the case of the Jeffersonian-Hamilton case would have not arose leading to the creation of the Republican and Federalist parties in America. Without the Constitution, it may be argued that America would have remained in a consensus, and therefore the Constitution itself must be seen as a trigger for the development of political parties in America. Bibliography Why Parties? : The Origin and Transformation of Political Parties in America – John H. Aldrich, University of Chicago Press, 1 Jun 1995- pg. 6 Jefferson at Monticello, Charlottesville – Bear, James, A. Jr. – University Press of Virginia, 1967. George Washington: A Life, Ron Chernow – Page 599 â€Å"Give Me Liberty! † – Eric Foner (Seagull Third Edition) (Vol. 1), W. W. Norton ; Company, 2011 Sketches of Debate in the First Senate – William Maclay et al, Lane S. Hart, Printer, 1880, Page 212 Thomas Jefferson: Philosopher and Politician – John P. Kaminski, UW-Madison Libraries Parallel Press, 1 Jan 2006 – pg. 54 A History of the United States: Inventing America – P. Maier et al, W. W. Norton ; Company Ltd. , 2002 Alexander Hamilton’s Economic Plan: Solving Problems in America’s New Economy – Ryan P. Randolph, The Rosen Publishing Group, 1 May 2003 – pg. 20. American Political Parties and Constitutional Politics – Peter W. Schramm, Bradford P. Wilson – pg. 17 ———————– [1] Eric Foner: ‘Give Me Liberty’ Page 282 [2] Eric Foner: ‘Give Me Liberty’ Page 284 3] Eric Foner: ‘Give Me Liberty’ Page 286 [4] Bruce Miroff: ‘Hamilton: The Aristocrat as Visionary’ Page 43 [5] Page 20 – Alexander Hamilton’s Economic Plan: Solving Problems in America’s New Economy – Ryan P. Randolph, The Rosen Publishing Group, 1 May 2003 [6] Page 54 – Thomas Jeff erson: Philosopher and Politician – John P. Kaminski, UW-Madison Libraries Parallel Press, 1 Jan 2006 [7] A History of the United States: Inventing America – P. Maier et al, W. W. Norton Company Ltd. , 2002 [8] Page 6 – Why Parties? The Origin and Transformation of Political Parties in America – John H. Aldrich, University of Chicago Press, 1 Jun 1995 [9] Page 17 – American Political Parties and Constitutional Politics – Peter W. Schramm, Bradford P. Wilson [10] Sketches of Debate in the First Senate – William Maclay, Lane S. Hart, Printer, 1880, Page 212 [11] Bear, James, A. Jr. – Jefferson at Monticello, Charlottesville – University Press of Virginia, 1967. [12] George Washington: A Life, Ron Chernow – Page 599 How to cite Why Did Political Parties Spring Up in the United States in the 1790s, Papers

Trust Distrust On Effort Budgetary Slack †Myassignmenthelp.Com

Question: Discuss About The Trust Distrust On Effort Budgetary Slack? Answer: Introducation Budget based standards for performance make incentives to game or sandbag the budget process, get involved in wrongful arrangement and manipulate information. Nestle Australia is also dealing with similar problem of budgetary slack wherein its branch managers are underestimating revenues and overestimating expenses as this practice helps them achieve their goals. The present report provides recommendation on how to prevent this situation and why managers should behave ethically. Meaning of Budgetary Slack Budgetary slack is over-estimating budgeted expenses or under-estimating budgeted revenue. While some cases of budgetary slack are deliberate, others are not, and many instances fall in between. Deliberate budgetary slack might take place when a manager wants to make his numbers usually to respond to earlier quarters wherein revenues were below the estimate, and failed to meet the owners expectations. Indeliberate budgetary slack can be an outcome of insufficient internal controls (Bragg, 2013). If the data to furnish suitable sales and cost projections is inadequate, managers tend to present an unrealistic budget underpinned by honest expectations which are usually not more than best guestimates, or are based imperfectly on previous quarters budgets. Consequences of Budgetary Slack for Nestle As far as Nestle is concerned, budgetary slack is likely to interfere with its effective corporate performance. This is because managers merely have the incentive of meeting their budgeted objectives, which are established very low. Evidently, such deliberate budgetary slack has been happening for consecutive years in Nestle and this may imply that the companys overall performance has plummeted as compared to its more aggressive contemporaries who employ stretch goals (Monden and Minagawa, 2015). Hence, budgetary slack is bound to have a long-run adverse impact on the competitive positioning and profitability of Nestle. Another negative implication of slack for Nestle is that it challenges the usefulness and credibility of its budget as a tool for planning and controlling. When managers include a slack, the figures in the budget no longer represent an accurate picture of future operations (Epstein and Lee, 2011). By padding the budget, the managers think that their goals are becoming achievable, which is likely to decrease the companys efficiency and restrict innovation at workplace. The senior management will also not be able to undertake an objective assessment of its managers and their subordinates performance employing this budgetary information. Budgetary slack is also likely to reduce the ability of the organization to highlight its weak areas and take corrective measures on time. It becomes quite difficult to pin point where the problem actually lies and thus leads to late recognition as well as delayed remedial actions (Schoute and Wiersma, 2011). The overall efficacy of Nestles corporate planning will diminish. Unwanted actions like reduced promotional expenditure or pricing changes might be taken due to an apparent need of improving earnings, when removing the budgetary slack can help attain the same goals without doing any marketplace changes. The senior management will also not be able to properly allocate resources to different subunits based on the actual financial performance. This is because budgetary slack will impact their decision making as the budgets will portray decreased contribution margins (higher expenses, lower sales). Decisions pertaining to the profitability of different product lines, incentives, staffing levels etc. can have a negative consequence on Nestle (Chong and Loy, 2015). Ethical concerns might emerge because of creation of budgetary slack in Nestle. The managers are engaging in intentional overstatement of expenses and understatement of revenues. This is caused by their intention and not by any unexpected mistake in the process of estimation. Instead of honestly communication the projected expenses and revenues of the department, the managers of Nestle are padding their figures to provide themselves a breathing space and evade the limits of a strict budget. Underestimated revenue numbers are simpler to achieve and are likely to result in incentives for the managers (Walker and Fleischman, 2013). The company is putting considerable trust in its managers and employees. Every staff member at every hierarchical level is responsible to behave in an ethical manner and work in the best interest of the company, keeping their interests secondary. As Nestle is linking accounting measures to performance evaluation, its managers are engaging in a range of undesirable, and usually unethical behaviors (Epstein and Lee, 2011). Majority of the ethical decisions, including that of budgetary slack, lie in a gray area wherein there is no unambiguous decision which can be taken completely through considering objective data or quantitative evaluation. Managers are required to make ethical decisions based on sound judgment and interpretation, applying a series of values to a suite of estimates and perceptions of the implications of an action. Managers at all levels in Nestle are held to a great standard of ethical conduct. Each day, these people take key decisions which impact their company, its shareholders and every other stakeholder (Kerzner, 2013). As a manager, it is important to comprehend and stick to the legal and ethical obligations of their position to satisfy the expectations of every stakeholder group, and to create an example of such moral behaviors for others to follow. Hence, it is imperative for the managers at Nestle to comprehend Codes of Ethics and Conduct, and all the other formalized rules and to obtain and keep records of relevant documentation outlining the guidelines and expectations for ethical behavior. These people are also responsible for ensuring that their subordinates also comprehend such rules. Managers of the company are also required to establish expectations that no sort of unethical practice is acceptable. Resultantly, anyone who either witnesses or conducts such an act is accountable to report it via suitable channels (Rodrguez and Gil, 2016). Ethical ambiguity is not what a manager at any level must deem acceptable. The existing performance evaluation and reward system at Nestle encourages managers to undertake budgetary slack. Promotions, salary hikes and bonuses are all impacted by a managers potential to meet or beat the budgeted targets. As a managers career and financial standing could be impacted, budgets are having considerable behavioral effect. To prevent such practice from becoming a habit, Nestle can consider some other measures to balance the dysfunctional elements promoted by the existing system. A combination of different incentive plans plus participative budgets can be used by Nestle to develop an attractive incentive scheme and prevent budgetary slack. Stock options is one of the plan that can be used by the company to motivate its branch managers to beat their goals and positively drive their companys stock value (Chen and Jones, 2004). Stock options add significant value in a designated time frame so that managers will be able to sell their stock on maturity of that time period. This can be combined with providing a bonus for any rise in sales over the 10% increase. In fact, for every 1% rise over the 10% target, the company could provide a bonus. Participative budgets will give the branch managers a feeling that their viewpoints are valued by the senior management and they will also have a better attitude toward ways of achieving the budgeted goals. In addition to this, there are high chances that such a participative approach will lead to a more accurate budget setting (Elmassri and Harris, 2011). Conclusion Hence, it can be concluded that the existing bonus and career progression system of Nestle is responsible for budgetary slack. Having said that, this does not give the managers any liberty to resort to unethical ways of padding their numbers. Budgetary slack is less likely to happen when a limited number of aggressive managers are the ones permitted input into the budgetary model, as they can establish really high expectations. It is also less likely to take place when there is no or a full-proof connection between bonus plans or performance and the budget. References Bragg, S. (2013). Budgetary Slack. [Online]. Available through: https://www.accountingtools.com/articles/what-is-budgetary-slack.html. [Accessed on 15th September 2017]. Chen, C. and Jones, K. (2004) BUDGETARY SLACK AND PERFORMANCE IN GROUP PARTICIPATIVE BUDGETING: THE EFFECTS OF INDIVIDUAL AND GROUP PERFORMANCE FEEDBACK AND TASK INTERDEPENDENCE, Advances in Management Accounting, 13, pp.183 221. Chong, V. and Loy, C. (2015) The Effect of a Leaders Reputation on Budgetary Slack, Advances in Management Accounting, 25, pp.49 102. Elmassri, M. and Harris, E. (2011) Rethinking budgetary slack as budget risk management, Journal of Applied Accounting Research, 12(3), pp.278-293. Epstein, M. and Lee, J. (2011) Advances in Management Accounting, Emerald Group Publishing. Kerzner, H. (2013) Project management: a systems approach to planning, scheduling, and controlling. John Wiley Sons. Monden, Y. and Minagawa, Y. (2015) Lean Management of Global Supply Chain. World Scientific. Rodrguez, S. and Gil, D. (2016) Effects of trust and distrust on effort and budgetary slack: an experiment, Management Decision, 54(8), pp.1908-1928. Schoute, M. and Wiersma, E. (2011) The relationship between purposes of budget use and budgetary slack, Advances in Management Accounting, 19, pp.75 107. Walker, K. and Fleischman, G. (2013) Toeing the Line: The Ethics of Manipulating Budgets and Earnings, Management Accounting Quarterly, 14(3).