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the author from whom the license was obtained has retired; the company however holds worth £ 680

ACCOUNTABLE CARE ORGANIZATION

Integrated health care association (IHA) is a national wide health organization that provides quality, improvement and accountability health care in California. IHA is a non-profit organization that has a mission to assemble other heath care organization to collaborate on health care issues. The association conducts regional and statewide programs that help to assist in promoting health care programs and projects.

P4P

Health care pay for performance rewards physicians, hospitals and providers with money and non-financial strategies based on their performance (Berenson, 2010). The financial aspects cover various issues such as quality of clinic, adoption of technology and experience of patients. The sponsors of payment of performance are government agencies, insurance plans and health care providers. Most of Payment for performance programs have demonstrated improvement of clinical quality and have encouraged health providers to use systems of clinical health. P4P programs that have encouraged use of efficiency and quality services have experienced the advantage of cost savings. In addition, P4P services have shown improvements in patients’ experience. However, there are inevitable consequences that arise because of P4P. These include avoidance of complains from patients and handling patients with more than one health condition. However, there is no evidence on the above complains.

Research has shown that P4P programs have initiated change in behavior and have engaged provides. This program has assisted in follow up of patients conditions and has encouraged providers to adopt technology in health care. The program has also encouraged providers in improvement of health care services and collaborative learning has reduced unwanted practices.

There are new medical devices that have assisted in health care improvement and reduced death rates. However, these devices have also increased cost in healthcare (Berenson, 2010). These new medical services that are used and specialty of procedures used add quality to the hospital and services provided by the medical practioners. They also encourage adoption of health care technology and improvement of heath care insurance plans. Quality and efficiency is marked by better data collection and high standard benchmark on the prices of equipment both locally and internationally. In addition, there in improved purchasing of hospital equipment with the collaboration of physicians and provision of best services in the hospital. Lastly, there is advanced methods of payments where the incentives of the physicians and hospitals are bundled together.

Episode Payment

There is growing interest world wide in method of medical care treatment in connection to heath care policies. There are proposes on whether payment should be done on basis of episode care instead of the individual test or population based care (Kocher &Sahni, 2010). Coming up with a single budget of free care that involves many providers might bring quality and efficiency problems in connection to the current payment method. This is because there is increased imbursement and increased services that need payment. Pricing methods that involves bundling of various components of services might bring issues of transparency to the consumers. It is therefore important for the teams to make informed choices on selection of the provider team. IHA is conducting bundling payment of the services offered in California. This demonstration begun with bundling payment for knee and hipbone replacement.

Efficiency Measurement

There is a national wide campaign in private and government-sponsored hospitals in measurement of efficiency and increasing transparency in use of resources and cost of medical services. This will improve the quality of medical services and enhance improvement in health care. California stakeholders have an opportunity to adopt standardized measures and ensure there is efficiency development by using a collaborative report (Lee, Casalino, Fisher, 2010). Using standardized procedures and transparency in the cost is a method of creating a balanced and fair comparison on the physician group in connection to P4P. Even though measurement of efficiency and transparency might result to apprehension to those who are measured, it is good strategy for ensuring affordability in health care programs. The main goal of P4P efficiency measurement program is for lowering medical cost without compromising the quality of medical health care. This can be achieved through the development of a reliable and valid set of efficiency measures and establishing a trusted process of data collection and analysis. In addition, it is convenient to collaborate with other heath care plans for provision of meaningful incentives for provision of efficient health care delivery.

Conclusion

Integrated health care association (IHA) is a national wide health organization that provides quality, improvement and accountability health care in California. Health care pay for performance rewards physicians, hospitals and providers with money and non-financial strategies based on their performance. Research has shown that P4P programs have initiated change in behavior and have engaged provides. There are new medical devices that have assisted in health care improvement and reduced death rates. However, these devices have also increased cost in healthcare. There is growing interest world wide in method of medical care treatment in connection to heath care policies. There is a national wide campaign in private and government-sponsored hospitals in measurement of efficiency and increasing transparency in use of resources and cost of medical services.

References

Berenson, R. A. (2010). Shared Savings Program for Accountable Care Organizations: A Bridge to Nowhere? American Journal of Managed Care, 16 (10), 721-726. Retrieved on March 2013 from,

<http://www.ajmc.com/media/pdf/AJMC_10oct_Berenson_721to726.pdf>

Kocher R. &Sahni N. R. (2010).Physicians versus Hospitals as Leaders of Accountable Care Organizations. New England Journal of Medicine, 363(27), 2579-2582. Retrieved on March 25 2013 from,

<http://www.nejm.org/doi/pdf/10.1056/NEJMp1011712>

Lee, T. H., Casalino, L. P., Fisher, E. S. &Wilensky, G. R. (2010).Creating Accountable Care Organizations.New England Journal of Medicine, 363 (15), e23. Retrieved on March 25 2013 from,

<http://www.nejm.org/doi/full/10.1056/NEJMp1009040 (video) or http://www.nejm.org/doi/media/10.1056/NEJMp1009040/NEJMp1009040.pdf>

Cannibalism Through Love

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Cannibalism Through Love

The book Perfume: the story of a murderer by Patrick Sūskind is one of its kind since it embodies a vice and a value. Both love and murder are put together, contrasted and compared and in fact with a closer look it seems like all is fine for Jean-Baptiste Grenouille to kill since he is just desperately looking for a scent from girls that he likes their scent. Cannibalism even though totally against the values of humanity and any moral principle of the time of the setting of the book is forgiven in the book when the population realizes that the young man was just desperately in love and this is mesmerizing because forgiveness and even the desire of the father of the girl to adopt jean are not expected. The final part of the novel is indeed difficult to interpret. The human beings in that time as depicted in the novel are caring and loving. However, a society that allows cannibalism and death in the name of love cannot be judged in a positive way. It is a confusing issue as death and love can never be reconciled.

Jean wants love and he does not get it. He seeks love through his special gift as a perfumer and tries to smell different girls whom he thinks are perfect for him. However, it does not end well because the more he tries to get the girls the more he continues killing. He develops an art of collecting the perfumes of girls that he likes after his first encounter that does not go so well. The first time he smells a girl who is a virgin across the city and tracks her down. He kills her in order to collect her scent and this proves to be difficult. Later he discovers another girl and tries to collect her scent as well and he kills her then holds her until the scent disappears. Finally, he realizes that he doesn’t have a scent and tries to make one for himself. These efforts are all geared towards being liked and making himself the superhuman in the human society. He wants to get attention and love but the methods he uses to attain this are very questionable. Therefore, the story of jean is a metaphor and it is a complicated one.

References

Süskind, P. (2001). Perfume: The story of a murderer. Vintage.

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Introduction

Capital punishment is an old punishment in which a person is punished for his or her crime with execution. Since the Babylonian era, death penalty laws have been in effect and several books and inscriptions make a mention of this practice. Despite education, democratic, technical, and other changes we have made as a society, this phenomenon persists even today in civilized countries such as the US. Indeed, America is the only advanced state that does not abolish the death penalty by death. Do we not display barbaric characteristics as a culture in maintaining this type of punishment? That’s what this paper talks for. The death penalty is an inhuman act precisely because the law should protect and not kill people. This paper starts out with a brief history of the US death penalty and addresses the cruel essence of and the abolishment of the death penaltyADDIN CSL_CITATION {“citationItems”:[{“id”:”ITEM-1″,”itemData”:{“ISSN”:”00389765″,”abstract”:”Cass Sunstein and Adrian Vermeule argue that, if recent empirical studies finding that capital punishment has a substantial deterrent effect are valid, consequentialists and deontologists alike should conclude that capital punishment is not merely morally permissible but actually morally required. While the empirical studies are highly suspect (as John Donohue and Justin Wolfers elaborate in a separate article in this Issue), this Article directly critiques Sunstein and Vermeule’s moral argument. Acknowledging that the government has special moral duties does not render inadequately deterred private murders the moral equivalent of government executions. Rather, executions constitute a distinctive moral wrong (purposeful as opposed to nonpurposeful killing) and a distinctive kind of injustice (unjustified punishment). Moreover, acceptance of “threshold”” deontology in no way requires a commitment to capital punishment even if substantial deterrence is proven. Rather

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According to the statement by Julianne C. and San Francisco, people consume products or services because the product or service provider might be consistent with their products. For instance, in the first statement, the narrator stops at the bakery quite often because the bakery is consistent with their star bread senorita recipe each time. It seems like they make excellent food products, including the bread, and also have good client service. This is vital in order to maintain a sale and prevent the client from leaving. It also creates trust, builds added value for the client, and guarantees customer satisfaction. Being consistent with the product or service production is a significant element in business.

In the second statement, it is evident that people buy products because they are cheap and affordable. Making quality products affordable for most people is a good start to attract more clients. Price is important to marketers because it represents marketers’ assessment of the value clients see in the product or service and are willing to pay for a product or service. The right price can positively influence sales and cash flow. Most of the time, lower prices will lead to higher sales volumes, which may make up for the lower profit margin. Selling quality products, for instance, sweet buttery bread at an affordable attracts more customers.

In the last statement, people like purchasing products that are fresh and of good quality. Most of them do not like those products that have stayed on the shelf for a long time. A fresh food product is an important part of a healthy diet. People like purchasing fresh products because they consider them to have vitamins, minerals, fiber, and nutrients that are essential for good health. Customer service also matters a lot. Customer service plays a major role in your business. Selling products with a friendly and smiley face builds trust.

SUSAN J. FRANKLIN

1555 Lake Woodlands Dr. Contact: +1 (573)-258-2584

s.franklin22@gmail.com

EDUCATION The University of Texas-Austin Masters in Arts Social Work 2/18- 6/19

Indiana University Bachelor of Science (Social Work) 9/12-12/16

EXPERIENCE High-Hope Community Mental Health Licensed Clinical Social Worker 10/19-04/21

Accomplishments:

Created 43 successful, timely discharge plans and 137 treatment plans

Helped the clinical manager to process documentation/intake for more than 50 clients

Helped provide interventions for caseloads totaling 23. Worked individually with all clients to come up with a list of personal goals with a 90% success rate.

Monroe County Home for Little Wanderers

Licensed Clinical Social Worker 08/18-09/19

Accomplishments:

Provided clients with round-the-clock crisis intervention services, plus an on-call basis

Successfully completed 20 assessments and designed more than ten treatments plans for clients.

Assigned counselor for 19 youth clients in foster and adoption care homes.

FELLOWSHIPS

-508013335

Alumni at Yale Young Global Scholars Yale Campus

Cohort 23 08/19

ADDITIONAL ACTIVITIES

-508015240

Volunteer 4x a month for American Cancer Society

Active Member, National Association of Social Workers

CERTIFICATIONS Emergency Medical Technician (EMT)

REFEREES

Jerry Scott

Manager

High-Hope Community Mental Health

Mobile: 1 (570)-110-0124

Email: jerryscott@yahoo.com

MODULE 5 ASSIGNMENT

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Introduction

Medicare is a government-sponsored health insurance program that provides health coverage to people aged 65 years and above, regardless of their health status, level of income, or medical history, and to people below the age of 65 years with certain diseases and disabilities (Sultz & Young, 2017). On the other hand, the Medicaid program is a joint state-federal program that provides health coverage to low-income earners (Mullner, 2019). Managed Care Organizations (MCO) is a health plan or health care company that provides appropriate and cost-effective medical treatment (Sultz & Young, 2017).

This essay outlines the differences and similarities of Medicare, Medicaid, and MCO based on three questions posed. The first question relates to the concept of gatekeeping, where the MCO stresses the role of the physicians to control patient access to expensive specialty and hospitalization care. According to this question, some people consider gatekeeping unethical since it introduces financial element into treatment decision. In contrast, others consider it an important factor contributing to improved care quality facilitated by the utilization of the most appropriate levels of care. The second question relates to Medicare being overlooked despite bringing financial burden to its beneficiaries and requires providing alternatives for easing the drain on Medicare resources. The third question relates to Medicaid, which is associated with a higher burden of cost for elderly’s long-term car and requires providing alternatives for easing the drain on Medicaid resources. The essay is organized into two sections, with the first section addressing each of the three questions separately. The second section summarizes the key similarities and differences of the three entities deduced from the answers presented in the first section.

Section A

Question 1

Gatekeeping in healthcare entails a patient first visiting Primary Care Physicians (PCPs) who authorize their accessibility to specialty care (Sripa et al., 2019). Usually, gatekeeping is associated with a response to specialists’ shortage and a need to minimize healthcare expenditure. Liang et al. (2019) further add that gatekeeping plays a key clinical function of protecting patients from adverse effects of unnecessary care by using PCPs as entry points to medical care. Gatekeeping is among the concepts underpinning the provider-facing strategies utilized by MCO (Barnett et al., 2018). The use of gatekeeping in MCO has received mixed reactions. Some people argue that it is unethical since it introduces financial element into treatment decisions, while others claim that gatekeeping improves the quality of care by facilitating the utilization of the most appropriate levels of care.

Despite the two contrasting views, the existing empirical evidence supporting the positive impact of gatekeeping on health outcomes is sufficient to ascertain that gatekeeping is associated with better quality of care. This is supported by various scholars such as Barnett et al. (2018), Liang et al. (2019), and Sripa et al. (2019), who have empirically proven that gatekeeping improves the quality of care, resulting in better health outcomes. Contrary, research reveals that the impact of gatekeeping on health care costs remains unclear (Engels et al., 2020; Sripa et al., 2019). Therefore, it cannot be concluded that gatekeeping has adverse effects on health care costs.

Question 2

According to the second question, Medicare has been overlooked despite it being recognized as a financial burden. Even though Medicare provides its beneficiaries with protection against the cost of many health care services, it is associated with financial hardships. Supporting this statement, Kyle et al. (2019) reveal that despite Medicare’s high beneficiary satisfaction, seriously ill Medicare beneficiaries bear a disproportionate burden of health care costs, with the prescription of drugs proving to be the most burdensome. Also, as the economic hardships cause few employers to provide supplemental coverage to their retired employees, Medicare beneficiaries with low income are suffering the most onerous annual premiums, which are more than $500 higher than Medicaid beneficiaries (Davis et al., 2019).

One of the alternatives for easing the drain on Medicare resources is encouraging people to have access to health care from a young age. Usually, the efforts of upstream procedures such as prevention will be more effective, and there will be a huge reduction in the economic burden resulting from health issues. Besides, Medicare can reduce the number of days that patients requiring long-term care stay in skilled nursing homes for conditions with few medical health benefits. For instance, Medicare can provide long-term care to people aged 65 years and above for the first 100 days of care in skilled nursing homes for some conditions with few medical health benefits and speech, occupational, and physical therapy. Another alternative for easing the drain on Medicare resources is through lessening the tax slab. Better health care can be delivered with universal health coverage with a lesser tax slab. Additionally, the government can pass a rule that health care services delivered to people above the age of 85 are not charged and minimize recommending surgeries for this group. Lastly, Medicare beneficiaries can be encouraged to obtain supplemental insurance to ease the drain on Medicare resources (Kyle et al., 2019). Fie instance, the client can opt for Managed Care Organizations services.

Question 3

The third question requires discussing the alternatives for easing the drain on Medicaid resources. One of these alternatives is using private health insurance. Notably, people should rely mostly on the private insurance market. Although private insurance costs are relatively high compared to Medicaid services, the accessibility and coverage of private insurance are higher. The majority of health care providers accept commercial insurance compared to Medicaid services. Cost-sharing by the Medicaid beneficiaries is another alternative for easing the drain on Medicaid resources. Every state can set limits for cost-sharing based on their income level, with total out-of-pocket sharing accounting for at most 5% of the income. Medicaid beneficiaries can also use co-pays for long-term care needs rather than for preventive and emergency services to reduce the cost. Beneficiaries can also reduce costs by seeking supplemental insurance from MCO. Furthermore, encouraging Medicaid beneficiaries to start health savings can help ease the drain on Medicaid resources. Here, Medicaid beneficiaries can be sensitized to the increasing cost and limited coverage of Medicaid and encouraged to start health savings. Lastly, to ease the drain on Medicaid resources, Medicaid beneficiaries should be encouraged to choose cost-effective care.

Section B

Comparison of the Entities

Similarities

Medicare, Managed Care Organizations, and Medicaid have several key similarities and differences. In terms of similarities, the ultimate goal of the three entities is to provide quality and managed care services to the enrolled clients and minimize medical costs.

Differences

These differences have been summarized in Table 1 below.

Table SEQ Table * ARABIC 1: Differences Among Medicare, Medicaid, and MCO

Medicare Medicaid Managed Care Organizations

Type of entity Federal program A joint state-federal program A health plan or health care company

Eligibility Eligible to people aged 65 years and people below the age of 65 years with certain diseases and disabilities. Eligible to low-income earners regardless of their age. Applied to both patients and doctors to select a less costly form of care

Gatekeeping No gatekeeping. No gatekeeping. There is gatekeeping where the

Coverage It covers hospital and post-hospital facility fees, outpatient care and prescription drug coverage, lab costs, and doctor fees. It covers basic health care costs such as hospital stays and visit to the doctor and covers 20% of the Medical costs not paid by Medicare. Provides coverage on economic incentives for patients and doctors.

Source: (Sultz & Young, 2017).

Conclusion

Overall, the goal of this essay was to provide similarities and differences of three entities: Medicare, Medicaid, and MCO. The three entities are similar in that their main goal is to provide quality and managed care services to the enrolled clients and minimize medical costs. However, they differ in terms of their management, coverage, eligibility, and inclusion of gatekeeping concept. While MCO is a health plan or health care company, Medicaid is a joint state-federal program, while Medicare is a federal program of medical service providers. Secondly, as evident in the first question, gatekeeping has its benefits and disadvantages. However, gatekeeping is a concept that is only present in Managed Care Organizations, but it is not present in Medicaid and Medicare programs. Furthermore, based on the three questions, it is evident that seeking medical services using Managed Care Organizations is more affordable than using Medicare and Medicaid since, in the second and third questions, Medicare and Medicaid have shown to result in a financial burden to their beneficiaries. Additionally, Medicare is eligible to people aged 65 years and above despite their health status, income level, or medical history, and to people below 65 years with certain diseases and disabilities. Contrary, Medicaid is eligible to low-income earners regardless of their age. MCO is applied to both patients and doctors to select a less costly form of care.

References

Barnett, M. L., Song, Z., Bitton, A., Rose, S., & Landon, B. E. (2018). Gatekeeping and patterns of outpatient care post healthcare reform. Am J Manag Care, 24(10), e312-e318.

Davis, K., Willink, A., & Schoen, C. (2019). How the Erosion of Employer-Sponsored Insurance Is Contributing to Medicare Beneficiaries’ Financial Burden. Issue Brief (Commonwealth Fund).

Engels, A., Reber, K. C., Magaard, J. L., Härter, M., Hawighorst-Knapstein, S., Chaudhuri, A., … & König, H. H. (2020). How does the integration of collaborative care elements in a gatekeeping system affect the costs for mental health care in Germany?. The European Journal of Health Economics, 21(5), 751-761. http://dx.doi.org/10.1136/jech.2005.038240Kyle, M. A., Blendon, R. J., Benson, J. M., Abrams, M. K., & Schneider, E. C. (2019). Financial hardships of Medicare beneficiaries with serious illness. Health Affairs, 38(11), 1801-1806. https://doi.org/10.1377/hlthaff.2019.00362Liang, C., Mei, J., Liang, Y., Hu, R., Li, L., & Kuang, L. (2019). The effects of gatekeeping on the quality of primary care in Guangdong Province, China: a cross-sectional study using primary care assessment tool-adult edition. BMC Family Practice, 20(1), 1-12. https://doi.org/10.1186/s12875-019-0982-zMullner R.M. (2019). Health Services Data: The Centers for Medicare and Medicaid Services (CMS) Claims Records. In: Levy A., Goring S., Gatsonis C., Sobolev B., van Ginneken E., Busse R. (eds) Health Services Evaluation. Health Services Research. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-8715-3_5Sripa, P., Hayhoe, B., Garg, P., Majeed, A., & Greenfield, G. (2019). Impact of GP gatekeeping on quality of care, and health outcomes, use, and expenditure: a systematic review. British Journal of General Practice, 69(682), e294-e303. https://doi.org/10.3399/bjgp19X702209Sripa, P., Hayhoe, B., Garg, P., Majeed, A., & Greenfield, G. (2019). Impact of GP gatekeeping on quality of care, and health outcomes, use, and expenditure: a systematic review. British Journal of General Practice, 69(682), e294-e303.

Sultz, H. A., & Young, K. A. (2017). Health care USA: Understanding its organization and delivery (9th ed.). Jones & Bartlett.

MODULE 6 ASSIGNMENT

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Why the Relationship Between Public Health and Private Health Medicine Has been Contentious

The relationship between public health and private health medicine has been sometimes contentious for a number of reasons. Firstly, historical boundaries, which involve division of labor, have led to the relationship between public health and private health medicines being sometimes contentious. Public health medicine focuses on treatment of diseases and provision of care. Contrary, public health focuses on health promotion and disease prevention (Sultz & Young, 2017). However, this does not mean that private health medical professionals do not employ strategies for prevention of diseases. Although they focus on disease treatment and care, they always consider the application of disease prevention strategies a fundamental part of their work. For instance, sometimes doctors may assist their patients to quit smoking in order to prevent lung cancer. Contention arises when public health and private health medicine consider their roles mutually exclusive. This results in goal conflict, as each entity strives to achieve its goals.

Secondly, the difference in who public health and private health medicines focus on sometimes makes their relationship contentious. Usually, public health addresses health issues from the perspective of the population, while private health medicine addresses health issues from an individual’s perspective. Public health providers diagnose a community health problem using disease surveillance systems and scientific research, while private health care medical providers diagnose an individual’s health problems by listening to patients as they describe their symptoms and through performing relevant medical tests. Due to the differing viewpoints, both public health and private health medicines have often expressed powerful oppositions; thus, making their relationship sometimes contentious.

The perceptions public health professionals and private health medicine have about each also result in their relationship is sometimes contentious. The public health professional has characterized private health medicine as a field dominated by self-interest where the professionals seek to gain more money. On the other hand, private health medicine professionals view private health as a politically corrupt field (Sultz & Young, 2017).

Furthermore, public health professionals argue that the quality of care should not depend on the financial resources of the patient. Instead, they believe that a patient should receive the best possible treatment despite their financial status. Contrary, private health medicine professionals believe that the quality of medical services depends on the patient’s financial resources. These different perspectives are what make their relationship sometimes contentious.

How to Deal with the Problem of Medical Errors

The first step in dealing with medical errors is identifying these errors, which can be facilitated by reporting them as they occur. However, reporting of medical errors is faced with various barriers, which result in many medical errors going unreported (Aljabari & Kadhim, 2021). To deal with the issue of medical errors, the government needs to take the necessary actions to keep track of the status of this high-risk situation as it does with other epidemics instead of continuing to trust the health care providers to deal directly with the issue. This is because, more often, medical errors are committed repeatedly by the same medical staff, but health care providers, patients, and their families are hindered from reporting these issues by several barriers, with the most common barrier being the fear of consequences. Thus, the barriers hindering reporting of these medical errors can only be solved by the government creating a platform where the errors can be safely reported and forwarded to the relevant authority.

For instance, Aljabari and Kadhim (2021) reveal that health care providers fail to report medical errors perpetuated by another health care provider due to fear of criticism by colleagues. Research reveals that some health care providers fail to report medical errors as they occur because they are afraid that they will be discriminated against by their colleagues if they report such issues (Afaya et al., 2021). Another barrier to reporting medical errors relates to the systems used for medical error reporting. There is a challenge of lack of reporting systems and lack of anonymity of the systems being used for reporting medical errors. Some of the systems used for reporting medical errors require the person reporting the error to fill in their names and other identifying details, which creates fear among health care providers; thus forcing them not to report medical errors (Soydemir et al., 2017). Research reveals that more medical errors would be reported if the reporters felt protected (Soydemir et al., 2017). Therefore, when the government takes the responsibility of monitoring the status of this high-risk situation and finding safer ways of reporting medical errors, such as creating a platform where the errors can be anonymously reported and forwarded to the relevant authorities, this will help minimize the fears of reporting medical errors and encourage health care providers, patients, and their families to report medical errors as they occur. Consequently, this will ensure that the responsible persons are held accountable for their mistakes, thus preventing similar mistakes from being repeated. Also, the federal government can easily identify the non-compliant facilities and the necessary actions taken to reduce medical errors. For these reasons, the federal government needs to take the necessary actions to keep track the status of the high-risk situation of increased medical errors.

Why Addressing Only One of the Trio of Rising Costs, Lack of Universal Access or Variable Quality of Health Care Worsens the other Two

The major issues in the US healthcare system include increased healthcare costs, variable quality of healthcare, and a lack of universal access to health care (Sultz & Young, 2017). Although the US government has gone ahead to address these issues, its efforts are yet to bear fruits. In fact, efforts to address one of these issues worsen the remaining two. For instance, legislative attempts to create universal access to health care have worsened the quality and the cost of health care. Universal access to healthcare implies that healthcare services should be availed to all people, notwithstanding their capability to pay for them. One of the legislative attempts to create universal healthcare is the provision of affordable healthcare in the form of Medicaid. However, this has been associated with increased cost, which in turn have adversely affected the quality of care. Zieff et al. (2020) reveal that universal healthcare is associated with high costs. Being a capitalist nation, it is believed that everyone in the US is capable of paying for any service. Therefore, the efforts to offer universal healthcare in the US have resulted in medical debts within the health care institutions. The increased medical debts have led to the reduced ability of health care institutions to purchase drugs and medical equipment. Consequently, this has affected the quality of care rendered as the hospitals cannot render some services. Also, legislative effort to offer universal healthcare has meant that the majority of low-income earners will free-ride, and individuals who can afford to pay for the health care services are forced to pay more. Furthermore, in an attempt to provide universal health, the government is forced to augment the cost of health care services in order to raise more health care funds. Also, the legislative attempt to improve the quality of care requires use of high quality medical equipment, which results to increased costs. Due to the increased costs, the government is forced to provide health care to a lesser number of people thus adversely affecting the provision of universal healthcare. Thus, the legislative attempt to address any of the three issues worsens the other two.

References

Afaya, A., Konlan, K. D., & Kim Do, H. (2021). Improving patient safety through identifying barriers to reporting medication administration errors among nurses: an integrative review. BMC health services research, 21(1), 1-10. https://doi.org/10.1186/s12913-021-07187-5Aljabari, S., & Kadhim, Z. (2021). Common Barriers to Reporting Medical Errors. The Scientific World Journal, 2021. https://dx.doi.org/10.1155%2F2021%2F6494889Prybil, L., P. Jarris, and J. Montero. 2015. A Perspective on Public-Private Collaboration in the Health Sector. NAM Perspectives. Discussion Paper, National Academy of Medicine, Washington, DC. https://doi.org/10.31478/201511aSoydemir, D., Seren Intepeler, S., & Mert, H. (2017). Barriers to medical error reporting for physicians and nurses. Western journal of nursing research, 39(10), 1348-1363. https://doi.org/10.1177%2F0193945916671934Sultz, H. A., & Young, K. M. (2017). Health care, USA: understanding its organization and delivery. Jones & Bartlett Learning.

Zieff, G., Kerr, Z. Y., Moore, J. B., & Stoner, L. (2020). Universal healthcare in the United States of America: a healthy debate. Medicina, 56(11), 580. https://dx.doi.org/10.3390%2Fmedicina56110580

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Monsoon Wedding, by Nair, 2001

Personal Perception of the Movie

I liked the movie because it first strikes the viewer as a very fast comedy. The easiness by which music was being efficiently woven into the narration and the deft manner in which Nair manages to make her way between the story lines evokes emotion that glues one to the screen (Barnwouw 46).The Importance and Dynamics of Punjabi Families

The importance and dynamics of Punjabi families is illustrated in the how Monsoon wedding converts Vijay Raaz, an actor with a remarkable body and face, to P.K.Dube. He is later transformed in the course of the film from a spidery joker, subject to hysterics of loneliness. He gets used to anxiety fits and unquenchable demands for money that transforms him into a sympathetic character. Viewers pity him but in the end, he is admired for his willpower to make use of his ingenious talents to win Alice. He generates a fancy world of hearts for her and steps in it as her suitor holding a massive heart shaped garland of marigolds (Nair 23).

The Monsoon Wedding in effect builds a framework of illusions and dreams in its episodes. The illusions are diaphanous, porous, and colorful like the saris that women enthusiastically maul over in a fashion shop during the selection of Aditi’s trousseau. The message conveyed from Monsoon Wedding on the importance and dynamics of Punjabi families is interesting to the casts. That things can shift in and out of the confusion apparent in the night world where obstacles are real but a route can be found around the mirrors (Bennet 57).Comparison of the Punjabi Families to the American Families

The entire Monsoon wedding film shatters most western mistaken beliefs about life in India, rather than face stark images of disease and poverty. Nair depicts a contemporary India where snobbery and social life climbing are predominant. The love life of the young protagonists in the film shows that India’s youth have undergone a revolution in as far as their love lives are concerned so that it is comparable to what goes on in the USA (Desai 35).

The love triangles that persist in the USA are also typified in the movie. The screenplay by Sabrina reinforces the negotiations between the groom and the potential bride. She was a woman on a bounce back having ended her love affair with her boss and now getting involved with a handsome young man all the way from Houston Texas. The Indian characters also speak a mixture of Hindu and English in their sentences unlike the American ones who speak fluent English (Nair 30).Other Themes and Their Interpretation

Apart from the wedding theme, Nair presents several important moments in the film. For example, the theme of mirrors and confusion which replicates the improbability felt by everyone in this rapidly dynamic world where it is increasingly becoming difficult to sort out the contemporary identities and the stark realities on the international front. This is practical because it is difficult to decide on the right path and choose the right face to flaunt in each circumstance. Just like Lalit Verma who hires a team to fix her daughter’s wedding constantly worries how she will pay them, Dubey struggles up a social ladder that has lots of tradeoffs and pains. Although he starts making it, he still leads a lonely life in his mother’s tiny house. However, he eventually marries Alice and they are permeated in the circle of Verma’s extended family (Barnwouw 50).Scenes Significant in developing Characters’ Relationships

The romance between Hemant and Aditi offers some moments of truth, particularly when they remind each other of their pasts. However, an actual heart rending moment that touches me most is when P.K.Dube falls to his knees facing a heart that is formed from marigolds in a desperate adoration gesture before Alice (Bennet 60).

Vikram and V.J. Dubey who also doubles up as the coordinator of the wedding make use of the cell phones to deceive not only their wives but also their employer and mother. As the police close in on the tryst that Vikram has with Aditi, he tells his wife that he is in the studio. Consequently, Aditi gets her revenge on Vikram’s duplicity by driving his SUV away in a bid to ensures that he is stranded in the rain as the officers ridicule him. This is about the theme of deceptive appearances that the film director uses to indulge the viewers (Desai 65).The General Theme of the Movie

The general theme of the movie is that of deceptive appearances. This theme reaches its climax in the scene where men working on the wedding pavilion decide to peep at the family maid through the window Alice (Tilotama Shone) as she fits herself the bride’s wedding jewelry, converting herself into a beautiful princess. They erroneously accuse her of stealing; however, Dubey, who has fallen in love with her acknowledges that she is only making a fuss of her right to dream (Nair 55).

Works Cited

Barnwouw, Erik. Documentary: a history of the non – fiction film. Oxford: Oxford University Press. (2010): 45-56. Print.

Bennet, David . Multicultural States: Rethinking Difference and Identity. New York: Routledge. (2009):56-67. Print.

Desai, Jigna . Beyond Bollywood: the Cultural Politics of South Asian Diasporic Film. New York: Routledge. (2007): 34-67.Print.

Nair, Mira. Create the world you know. Cinema militants Lecture, the Netherlands film festival. (2012): 23-56.Print.

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Canterbury Tales

Which member of the emerging middle class does Chaucer portray in the most favorable light? In what way does his description of this character differ from other members of this class or estate?

The member of the emerging middle class who is portrayed in the most favorable light is the Wife of Bath. She is seen as hardworking and skilled. She does not get her money from an inheritance or exploitation as the upper class and the clerical class do but from her cloth-making venture. The Wife of Bath is described as being experienced in the ways of love as she has been married five times. She is also seen as independent and brave as she travels alone. Compared to other pilgrims in the emerging middle class such as the Guildsmen and the Miller, the Wife of Bath is depicted to be more ambitious, good-natured, and honest. The Miller is, for instance, depicted as rude and dishonest. He cheats his suppliers and customers. The Guildsmen are seen to be unambitious and their success is seen to be controlled by their wives’ desire for social status rather than hard work or ambition.

Discuss Chaucer’s use of satire. In your response, cite specific text-based evidence. Your answer should be at least 250 words.

The Canterbury Tales text is a satire because it criticizes and ridicules the main social classes in the Medieval Times. The main social classes in Chaucer’s time were the Clergy, the nobility, and the peasantry. However, by the time Chaucer wrote Canterbury Tales, there was increased social mobility and people could work hard and belong to the middle class. The Monk, Friar, Pardoner, and the Summoner represent the first estate (the clergy). The latter two, rather than serve the Church, are seen to be opportunistic. Chaucer’s description of the Pardoner in the general prologue, “This pardon-seller’s hair was yellow as wax, / And sleekly hanging, like a hank of flax. / In meager clusters hung what hair he had; /Over his shoulders, a few strands were spread, / But they lay thin, in rat’s tails, one by one. / As for a hood, for comfort he wore none. (Chaucer 39). The Pardoner is involved in selling forged pardons and his opportunistic nature is compared to that of a rat. The Summoner’s description in the general prologue, “Whose face was fire-red, like the cherubim; All covered with carbuncles; his eyes narrow (Chaucer 37).” The Summoner has boils and blisters on his face. His vulgar appearance reflects his poor morals. He takes bribes, is a drunk, and is ignorant but tries to sound intelligent by frequently speaking in Latin. Despite being in the first estate, the Summoner and the Pardoner are presented as a low-class character. The Plowman is an idealized character of the working class. Chaucer depicts the Plowman’s industrious and pious nature by referring to him as a “good and true laborer.” The Plowman, who is also the Parson’s brother, threshes, carries dung, digs, and makes ditches to assist a poor neighbor. He also serves God genuinely by promptly paying his tithes to the Church. He truly follows Christ’s commandments of loving thy Lord and thy neighbor.

Work Cited

Chaucer, Geoffrey. “The Canterbury Tales.” The Norton Anthology of English Literature. Volume 1. Eighth Edition. New York: Norton, 2006. Print.