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But however, may be for this reason, many Americans turn a critical eye on these pharmaceutical companies, thinking that these companies have been profiteering from the peoples for years illegally. One of the reasons is that, they have to pay over twice as much as their European counterparts for the same prescription drugs. This fact has led many to complain against United States for subsidizing European health care.

The increased inability of a growing number of patients to pay for prescribed drugs has important effect for population health care and health system costs. Prescription noncompliance is relevant to upper levels of emergency department admissions. Failure to get prescribed drugs can have serious health consequences for the people and substantial economic consequences for society.

An estimated 16.6 million Americans reported being unable to purchase a prescribed medication in 2002 (WSU Magazine, 2004). So, this number has a great political significance as well as economical significance. If such prescription noncompliance leads to undesirable health outcomes and unaffordable health service cost, then surely the economic effect would be substantial. So, from the social, political and economical point of view it is to be said as one of the most controversial problem for general American population.

What is the overall economic effect of this situation it represents? High price of new prescription drugs is the cheapest against rising overall medical expenses. The correlation between change in drug use and costs and other medical services and costs needs to be realized.

During the period of 1990-1998, real per capita expenditure on prescription drugs in the U.S. increased by 84% (Okunade, 2002). In the beginning of 1993, average annual percentage increase in prescription drug spending exceeded the overall percentage increase in national health expenditure (Okunade, 2002). According to estimation, prescription drug spending by the Medicare population is increasing and will be $445 billion by 2012. In 1990, only $40.3 billion was spent on prescription drugs, compared to these large amounts. In 2000, $140.8 billion was spent by both public consumers and private consumers. In 2001 it increases by 21 billion more to $161.8 billion. In 2002, the consumption on prescription drugs jumped to $179.2 billion. But by the time of 2015, it would be $720 billion.

 

So, it’s a huge cost for any sector and government is concern for increasing prescription drug costs. Because from the economic perspective, it can be said that inadequate drug coverage can lead to financial destruction for individuals. The report surveyed by the Kaiser family foundation and the Harvard school of public health, says that 1 out of 10 Americans has spent $1000 or more direct out of pocket on prescription drugs. But, by 2010, more than 15% of annual expenditure on personal health care will be spent only on prescription drugs. This percentage was 9% in the year 1999 (Berger, et al., 2001) 9.4% in 2000 (Cowper, et. al., 2004).

Since the drug cost has been increased, it is affecting the health care as well as economy of the country. The high cost of prescription drugs has made it difficult for many low-earned people to afford medications their doctors recommend though they deserve an affordable drug benefits. There is lack of correlation between population’s ability to pay and the price of prescribed drugs, though U.S. is the biggest economy in the world.

The Americans are paying much more for less benefits and that is the concern for the low-income levels public. The system the Americans got is not working and day by day they are facing a nationwide economic healthcare crisis. Certainly, increase in prescription drug price is the reason behind it. It seems to be the over-price of prescription drugs is bankrupting the healthcare process of the United States.

The people are spending a lot of money only for purchasing prescription drugs which sometimes costs out of his or her ability. For example, in a family where there are 4 members. If each person spends $800 every month, then the annual spending for the whole family would be $38400. But they are spending half of the amount more than the Europeans. It is because; the price of the same drugs is half of the Americans market price. Thus, the surplus spending is affecting the family expenditure as well as the economy.

A large portion income is abusing for the American people due to increase in prescription drugs. This cost consumes the rapidly rising share of people’s income. This share varies a lot among the states, a new study finds. From the economic point of view in future it would be worse than current situation. The burden heaviest in sicker, poorer, older states and where more people are out of insured. According to a report by Health Reform Program at the Boston University School of Public Health, the burden were greatest in Tennessee, West Virginia, Kentucky, Mississippi, Louisiana in 2002.

The prescription drug spending cost reflects average prescription prices filled per person. The total spending is divided by total income to compute the drug cost burden in a state.

Those states are suffering heavy drug cost burden where burden is increasing fastest and are likely to feel to act politically to lower drug prices. The prescription drug cost is appeared as ticking time bomb. The taxpayers and patients, particularly in these high burden states, cannot afford to spend more. Therefore, the report concludes, “cutting drug prices is the only way to lower drug cost burden and expand use” of needed medicine.

Overall through country, many people still lack of needed prescribed drugs

A large portion of American people are unable to afford for medications they are prescribed for and this medication costs are not only problem for elderly patients. A recent data shows that the number of Americans unable to take their medications as prescribed due to cost grew from 12.6 million in 1997 to 16.6 million in 2002 (WSU Magazine, 2004).

The economic system of medical products and services are different from other products and services in the market. When health care costs fall then consumers use more of it. In 1980, around 66 percent of spending on drugs came out from patient’s pocket. Now that percentage is 30. Actually rising drug costs are driven by increases in the volume of drugs consumed by the consumers, not always by rising drug costs. A key feature of the pharmaceutical companies is that drugs can be produced at a variable cost of pennies per pill. But what they do? They incur high-fixed R&D costs to bring new drugs into the market. But however, if these manufactures were paid prices that returned their variable cost, then the average cost of a drug would not be covered and as a result the company would certainly lose money. It implies that fixing lower price will diminish company profits and R&D efforts may be reduced. Then it would result a diminished flow of new drugs. What are the reasons behind increasing drug consumption rapidly is very important to understand. One reason of growth is the progress of new drugs which is consumers demand. From 1997 to 2000, costs on new drugs accounted for over 40 percent of the growth in spending on medicines (Bond, 2003).

Economic effect of increasing prescription drug usage

United States spends almost 15 percent of its GDP on health care system, which is highest rate among the OECD countries (Okunade, 2002). U.S. elderly are het highest per capita users of prescribed medicine (Okunade, 2002). However, as the elderly population increases, drug costs continue to rise unabated with the use of new and expensive prescriptions. Therefore, rising prescription drug costs are a major concern for running health care system smoothly.

In United States, the consumers experienced to pay for the prescription drugs 400% than the other counterparts in Europe. In some drugs the price is 10 times more than the others. It is recommended that the pharmaceutical companies should charge high price for those consumers whose valuation of product is high than whose valuation of product is low. The logic behind this pricing strategy is that the consumer who values a product highly will pay more than the consumers who remains indifferent to the product.

Prescription drug has become an essential component of health care. Millions of Americans are in need for prescription therapies for their health. The growing rate is almost twice as fast as other medical service in recent years. Recently, public attention has grown and their focus is on the pharmaceutical industry and prescription drugs. It is because the drug costs have rapidly increased and a significant portion of entire population lacks insurance to face the drug costs they need.

Summary case – part 2

Posted by admin in Art Essays

The problem with this state of the art K’Netix system, however, is directly connected with its tremendously high costs or funning. This condition, coupled with the changing business environment of the 21-st century and increasing competition made Bob Buckman and other company directors start questioning the effectiveness and validity of K’Netix. First, the forum usage (one of the backbones’ of Buckamn Lab’s knowledge management) dropped by over 30% after the K’Netix launch in October 1998. Second, “Bob wondered if it made sense to continue to budget 3.5% to 4.5% of revenues each year” (Fulmer 11). Finally, it became strictly unclear how to build and promote employees’ trust in a virtual world.

2. Problem solution

To encourage wide participation, seven sysops offer on- and off-line help to employees and act as traffic cops in the forums. Sysops, a word from the very early years of the Internet, is short for system operators and they were essentially the prototypes for today’s Webmasters. Together, they act as traffic cops for the forums, directing unanswered questions to the right people inside or outside the company and archiving discussions that lead to effective solutions.

The program took time to implement, and is still evolving. One project underway is to bring suppliers more actively into the virtual teams and forums, widening the circle and expanding the network. The program also faced some internal opposition, particularly from middle managers who worried that being tapped as mentors could ultimately threaten their positions. But once they saw how much time they saved by putting their sales staff closer to the customer, they were converted (Fulmer 10-11).

There are ways to encourage cooperation; one is simply to put staff closer together. People working nearer to each other are more likely to share knowledge than those further apart. Obviously daily face-to-face contact makes cooperation more likely, but building knowledge sharing is possible even in the virtual environment. Workers in the same continent, same country, same city and same office are increasingly likely to cooperate as they move along this scale. Cooperation can also be triggered by other similarities such as the same functional expertise.

3. System and decisions evaluation

Buckman succeeded in making communication and knowledge sharing a cornerstone of the corporation’s culture. With this success came many questions, answers, and, most importantly, solutions to customer problems. Buckman’s understanding of the strength of knowledge brings results. “65% of Buckman’s associates were out selling, compared to 16% in 1979; 33% of sales were from products less than five years old, compared to 22% prior to K’Netix; 72% of associates were college graduates, compared to 39% in 1979” (Fulmer 9). This is not just a statistical win, but a bottom-line win as well. In 1998 Buckman won a contract from a cardboard-making company partly because it was able quickly to answer complex questions about old equipment. Within hours of posting their questions, the local Buckman sales team received 10 responses from three continents.

Alphabet organizations generally fail to function as responsible parties because they have been used mainly as campaign vehicles by candidates who act as independents when elected. Faced with an overwhelming majority of Ontario residents opposed to local party politics, members of electoral slates have been extremely reluctant to impose bloc voting on council. A candidate in one of the elections stated that his party’s nominees "would work as a team although occasionally there would be differences of opinion and they would be on opposing sides." (Nossal 1989) Alphabet organizations’ loose structure and lack of sanctions preclude the exercise of party discipline.

Alphabet organizations usually languish after each election, only to revive just before the next, when they often either splinter, with dissidents initiating yet another electoral organization, or adopt another name, possibly that of a defunct party. Another factor weakening local parties is that they seldom run enough candidates to capture a majority of council seats, let alone a full slate. In the last decades support for local party politics has declined in the province’s largest cities. A shift in the ideological position of a city’s political opponents has taken place so that they no longer fit neatly along a classic left/right political continuum. Just emerging in Ontario is a new politics based on environmentalism. As environmental and related growth issues become increasingly important, one can predict that once again local political parties will appear to clarify these new issues for the electorate.

In an ideal democratic voting system, each person has one vote and the candidate who receives a majority of the votes cast in the election wins. Simple as it may sound, few municipalities achieve this ideal. The system of representation employed in a municipality can be structured to accomplish certain ends. A ward system is generally most advantageous to those at the margins of society; an at-large system of representation favours the middle and professional classes. However, the wards that eventually replaced at-large representation in Ontario were far too big to represent minorities adequately, and the middle and professional classes soon learned how to manipulate ward representation to their own advantage.

Although many communities have attempted electoral reform, most reform measures have been either diluted or totally eliminated. The municipal voting system in Ontario seems to be straightforward, simple, and unbiased; the candidate with the most votes wins. The "plurality formula" ratifies the election of the candidate who receives more votes than any other single candidate, but the successful candidate need not have a higher total than all other candidates combined. (Atkinson 1993) The plurality system falls short of being an ideal system since it allows candidates who do not have a majority of the vote to win and it does not necessarily produce a truly representative council. The principal advantages of the plurality system are that it is simple and it seems to be very democratic. However, when people are elected to office who receive the most votes rather than a majority of votes, their legitimate right to hold office can be, and sometimes is, questioned. This, definitely, was not the case with Progressive Conservative party rule in Ontario, as their support was so overwhelming, that no one could even theoretically question the legitimacy of their rule in the post war period.

BENEFITS OF LITURE CIRCLES

Motivation of students
Promotion of elaborate of discussion
An encouragement students among them and interested to learn from another
One way of help to the teachers that they need to extend much explanation about the topic

K-16 education

The kindergartens are part of the K-12 educational system. The children who are under the age of 5-6 will attend the kindergarten. It is a formal education and no grade consideration at this stage. In this level, it is more important what the children doing rather the time spent on school. The children’s interests must be noted. The high/scope learning is being used in may kindergarten schools. The learning style is interactive by employing a plan, do and review.  The teacher provides choice of activities for the children according to their age level. The activities may water table, building blocks etc. the majority of the children’s time is spent on the activity performance. K-12 is a traditional practice and reformation is started with K-16 (Kindergarten-16).

The goal of K-16 education to develop the education from Kindergarten to Four-year degree. The student able to have perfect education addressing the several factors by different authorities. The factors include state leadership, teacher quality, retention and education, data and accountability systems, curriculum development early outreach, student financial aid, graduation and post-secondary admission standards etc. the K-16 system requires ongoing organization structure by providing sufficient resources so that K-12 and higher education stakeholders combine together. The K-16 system requires improved teaching. At least 20 states in United States are started to address teacher quality issues and raised the standards for teachers.

The teacher should a form a group of students consists 4 to 6 persons. Individual tasks should be given to each person. The member of group will collect material including class books and outside material. Then the member makes reference of all material used and make a report of the given task.  On the particular day, the member supposed to give presentation in the classroom. The other members of the group and class members will see the presentation and pose questions. The member will clarify the doubts. All such information recorded by other members which is separate task of such group. The teachers of the class makes corrections and give instructions. With such literature circles the group and entire class will be benefited with advanced knowledge on the particular topic.

The students will select the material according to choice and the teacher will accept the task according to ability of student. Each member of the group will play different roles like discussion facilitator, passage picker, Illustrator, Connector, Summarizer, Vocabulary Enricher, Travel Tracer, Investigator and Figurative Language Finder. The brief analysis of every word in the task can be addressed, analyzed and able to be provided with meaningful work. After completion of presentation, the teachers evaluate in order to know that the student’s worth in the Literature Circles. The assessments include self assessment, peer assessment, observation etc. The literature circle enables the students to complete various jobs with increasing skills in questioning, vocabulary development and writing.

Summary case – part 1

Posted by admin in Art Essays

1. Problem summary

Buckman Laboratories, a leading producer of the specialty chemicals for aqueous industrial systems, attributes much of its success to the knowledge management practices implemented in this organization. Robert Buckman, company’s chairman and CEO, argues that the success is founded on innovation strengthened by a corporate culture that welcomes and rewards knowledge sharing.

The main ingredient is a culture of trust, asserts Buckman (Fulmer 2-3).

Founded in 1945, Buckman Labs is one of the market leaders, heavily relying on the new technologies such as K’Netix. This privately held company has 1,300 employees in 22 countries, and in 1998 had sales of over $300 million (Fulmer 1). While serving many industry sectors, its primary focus is the water treatment, pulp and paper mills, and leather markets.

The heavy lifting to create knowledge pull began in 1989, when Buckman changed the corporation’s structure and started promoting a company-wide open-door policy. From a business perspective, the goal was to create a better organization that would respond quickly to customer demands. Buckman created a framework of values based on open communication.

To encourage knowledge sharing, Buckman created a system, “to which all general managers were connected using IBM’s network for email” (Fulmer 3). He also opened a general forum to everyone in the company and created restricted-access forums for project teams and industry specialists, where experts could chat about everything from whitening paper to treating leather. For the fastest results, Buckman looked for the common principles among the company’s IT infrastructure. He created the K’Netix system built around Lotus Notes, the Compuserve computer network’s forum system and standard software to facilitate newsgroups. The system focuses on allowing quick and simple downloads and easy participation by the company’s many employees (Fulmer 5-6).

But IT alone is unlikely to have succeeded without a strong effort to create knowledge pull. For instance, the team leading the knowledge management operates under the title “Knowledge Transfer Department” to emphasize the importance of sharing. Buckman also promoted frequent contributors to the knowledge network, called in-house experts as “gurus” in their field and privately talked to those who didn’t participate in online chat groups and other forums. Buckman even opened a Spanish-language version of the forum to encourage participation of the company’s Latino employees.

The proponents of nonpartisan politics argue that their position has been misrepresented by the advocates of partisan politics. David Siegel explains that one of the proponents’ favourite arguments "is that those who oppose party politics are like the turn of the century reformers who see local government as pure administration and refuse to admit that it has a political element.” (Nossal 1989) He argues that modern proponents of nonpartisanship have never been so naive and that such an argument is "guilt by association" which must be rejected. (Nossal 1989) He then presents a reasoned set of arguments for nonpartisanship. First, he maintains that unlike a party system with disciplined party voting, with nonpartisanship, individual councillors are directly responsible to their electors. In addition, in a nonpartisan system councillors are able to work together, since they are not forced into council combat because they openly wear party labels. Finally, he argues that intergovernmental relations may break down if the provincial government is controlled by one party and a municipal council by another. (Graham 1986)

On balance, the rationale for nonpartisan local political systems does not seem to be as persuasive as that for partisan systems. First, few if any Canadian municipalities have been afflicted by "bossism" and political corruption. Second, in a nonpartisan system decision making tends to be more dispersed since power generally is more dispersed, while in a partisan system power tends to be concentrated, which enables the public to pinpoint political responsibility. Finally, in a nonpartisan system there is a tendency to maintain that political decisions are made in the public’s interest, while in a partisan party system politicians are more likely to publicize who benefits and who pays.

Although there are examples of municipal nonpartisanship in other western industrialized democracies, concerted efforts to foster nonpartisanship have been made only in Canada and the United States. In both countries, its strongest advocates tend to be established political leaders and rural voters who fear that partisan government would erode their control over the political establishment. In a few Ontario communities the political campaign for nonpartisan local elections has been opposed by a militant labour movement. Labour made a concerted effort to gain a foothold in Ontario cities in which some candidates sponsored by provincial parties had been elected to municipal office. However, more common were local parties with limited durability that were spawned by a business community fearful of labour’s potential power and determined to instill and reinforce an ethos of civic and business boosterism in city hall. (Banting 1994)

The labour movement in Ontario was deeply divided between radical unskilled and semi-skilled workers anxious to improve working conditions on the railroads and in the coal mines, and moderately skilled workers in the trades. Control of the movement seesawed between the two; however, both groups knew that success depended on electing labour members to municipal councils and the provincial legislature.