From Salvation to Self-Realization - 18515 Words

0From Salvation To Self-Realization: Advertising and the Therapeutic Roots of the Consumer Culture, 1880-1930 T. J. Jackson Lears Lears, T.J. Jackson 1983. From salvation to self-realization: Advertising and the therapeutic roots of the consumer culture, 1880-1930. In The Culture of Consumption: Critical Essays in American History, 18801980, ed. by Richard Wightman Fox and T.J. Jackson Lears, New York: Pantheon Books, 1-38. Reprinted with the permission of the author. 1On or about December 1910, Virginia Woolf once said, human character changed. This hyperbole contains a kernel of truth. Around the turn of the century a fundamental cultural transformation occurred within the educated strata of Western capitalist nations. In the United†¦show more content†¦But my research in magazines, letters, and other cultural sources suggests that something was different about the latenineteenth-century United States. In earlier times and other places, the quest for health had occurred 2 within larger communal, ethical, or religious frameworks of meaning. By the late nineteenth century those frameworks were eroding. The quest for health was becoming an entirely secular and self-referential project, rooted in peculiarly modern emotional needs above all the need to renew a sense of selfhood that had grown fragmented, diffuse, and somehow unreal The coming of the therapeutic ethos was a modern historical development, shaped by the turmoil of the turn of the century. And the longings behind that ethos the fretful preoccupation with preserving secular well-being, the anxious concern with regenerating selfhood these provided fertile ground for the growth of national advertising and for the spread of a new way of life. 3 6In the emerging consumer culture, advertisers began speaking to many of the same preoccupations addressed by liberal ministers, psychologists, and other therapeutic ideologues. A dialectic developed between Americans new emotional needs and advertisers, strategies; each continually reshaped and intensified the other. Sometimes deliberately, sometimes unwittingly, advertisers and therapists responded toShow MoreRelatedHappiness State of Mind1180 Words   |  5 Pagesfreedom from mundane occurrences such as the occupation of western powers from within a country, the end of war, poverty and famine, and liberation of the false self. In contemporary times, and with the arrival of eastern philosophy, religions, and traditions in the west, many are turning inwards and using a tool believed to have more power than an atomic bomb, the human mind. In China, India and various other Asian countries, the mind has long been a powerful tool used to liberate one from sufferingRead MoreDifferences Between Islam And Hinduism1280 Words   |  6 PagesThe two major beliefs are the means of salvation and the number of Gods the followers of the religions worship and believe in. 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In the preface, Panikkar starts with a heady notion that the first steps of interreligious dialogue don’t involve seeking truth, having discussionRead MoreThe Four Noble Truths of Buddhism Essay791 Words   |  4 Pages Dukkha is the first of the four noble truths of Buddhism. The word means suffering, but just to state suffering as the entirety of the first noble truth, is not enough because the expression of dukkha is the first truth that is needed for salvation. Moreover, dukkha is the conclusion of a logical chain of ideas that explains the life and death cycle of mankind. Before a person recognizes the truth of dukkha, he lives in a space of ignorance and with ignorance he seeks the fulfillment ofRead MoreAdvertising in the 20th Century1193 Words   |  5 Pagesproduction and the lowering of prices on consumer goods meant that more items were available to more people than ever before. The construction of the transcontinental railroads provided a national market for a companys goods. 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On the following pages, I will take a closer look at Christianity and their encounter with Animism, HinduismRead MoreThe Attribute And Function Of The Satguru Essay981 Words   |  4 P agescustodian of the knowledge of, and holder of the key to, salvation. This fact resonates with the stipulation in the preamble of the Ismaili Constitution that Imam’s Ta‘lim lights the murids’ path to spiritual enlightenment and vision. Essentially, these two lines encapsulate the theme of the redemptive attribute and role of the Satguru, discussed in verses eleven, eighteen, nineteen, twenty-three and twenty-six of this granth. Apart from serving as a reminder to the believers to seek emancipation

The Sarbanes Oxley Act Of 2002 - 1356 Words

Financial Statement Fraud Over the past decade the world has been taken by surprise by the numerous accounting scandals that have occurred, for example, Enron, WorldCom, Tyco, Xerox, and Global Crossing (Suyanto, 2009, p. 118). Since those accounting scandals occurred the United States Congress passed the Sarbanes-Oxley Act of 2002 (SOX) to help improve a company’s corporate governance and help deter fraud (Chinniah, 2015, p.2). In addition to SOX, the Accounting Institute of Certified Public Accountants (AICPA) passed the Statement on Auditing Standards (SAS) No. 99 (p. 118). Both of these new accounting laws help to deter financial statement fraud from occurring. Background Suyanto noted the number of financial statement fraud†¦show more content†¦0). According to Chinniah, there has been a lot more financial statement fraud cases due to the pressures placed on managers by the shareholders, increasing competition among other companies, the significance of meeting analyst forecast for net income, and the increasing public expectations of that specific company to perform above industry standards (p. 0). Companies with the expectations of having higher standards are finding themselves facing legal and economic consequences for committing immoral and illegal activities (p. 0). Furthermore, Chinniah discusses the two principle categories of behavior committed by the employees who prepare the financial statements: macro-manipulation and micro-manipulation (p. 1). Both the macro and micro manipulation occur when the financial statement preparers are only interested in benefiting themselves (p. 1). Hogan, Rezaee, Riley, and Velury (2008) noted the development of the auditing standards created due to the financial scandals that have occurred over the years. However, the authors note even with the development of SOX and SAS No. 99 there still does not appear to be a decline in financial statement fraud (232). Purpose of Research and Research Questions The general purpose of this research is to determine the cause for financial statement fraud. In addition, the purpose is to review ways fraudulent behavior can be detected and prevented. Lastly,

Piper Alpha free essay sample

Abstract This research explains about The Disaster of Piper Alpha which occurred in the North Sea on 6 July 1988 which killed 167 people and cost billions dollars in property damage. This research report also examines about the objectives and the structures of the management of the Piper Alpha Oil Platform. This research is analyzed from both technical and organizational view. Besides that, this research report also discuss about the industrial processes and the operations of the platform. Moreover, the risk factors in all area which lead to the accident also have been explained in this research report. The organizational factor includes the flaw in the guidelines and design practices. Besides that the organizational factors includes the management of the trade-off of productivity and safety. Moreover, it also includes the management of the staffs on board. The financial pressure applied in the production sector which leads to the negligence of inspections and maintenance operations. The consequences of the effects of the disaster of Piper Alpha are also discussed in this research report. For example, this report discusses about the effects to the investors of Piper Alpha and the effects to the environment. This research report is also used to provide systematic way of identifying, the accident sequence which includes human errors and technical failure. Finally, this research report also explains the improvement strategies in the management systems to prevent the accident from occurring. 1. Introduction Piper Alpha platform was North Sea oil production platform which was operated by Occidental Petroleum (Caledonia) Ltd. The platform started its production in the year 1976. It first operates as an oil platform and then it was develop to gas production plant. A large fixed, Piper Alpha was situated on the Piper oilfield, approximately 120 miles northeast of Aberdeen and comprised four modules separated by firewalls. For safety reasons the modules were organized so that the most dangerous operations were distant from the staff areas. The conversion from oil to gas in 1980 broke this safety concept, with the result that sensitive areas were brought together. For example, the gas compression area is next to the control room, which played a role in the blast. Piper Alpha was one of the heaviest platforms operating in the North Sea at the time of the disaster in 1988. The Disaster of Piper Alpha occurred on 6th July 1988 caused by a gas leak and pumps failure which killed 167 people including two people from the rescue vessel and lost around 3. 4 billion US dollars. There were only 61 people survived from the accident. Besides that, more than 30 people couldn’t be discovered after the accident (Steve Duff,2006). This report briefly explains about the technical and organizational factors which leads the Disaster of Piper Alpha. Besides that, it also discuss about consequences of the effect of the accident. Finally, it also discuss about the improvement and prevention step to avoid this type of accident to happen in future. 2. Management and Operation 2. 1 The management and its structure Four companies that later which have transformed into the OPCAL joint venture obtained an oil exploration license in 1972 and discovered the Piper Oilfield. The Piper Alpha was started on 1973 and its start operating on the year 1976. This oil platform and Flotta Oil platform was operated by Occidental Petroleum (Caledonia) Ltd. Occidental Petroleum Corporation (OPCAL) is California based oil and gas exploration and production company. Occidental Petroleum Corporation is the largest oil and the natural gas producer in Texas (Lord Caplan,1997). The management structure of Piper Alpha Platform Figure 1: Management Structure of Piper Alpha Platform (Lord Caplan, 1997) The figure above shows the management structure of Piper Alpha platform. According to the organization structure, the highest post was held by the managing director of the OPCAL. The person who was holding this post was Mr Brading at the time of disaster. Among all the workers working on the platform there was an ultimate responsible person who took overall control on the platform called the Offshore Installation Manager (OIM). Under the OIM, there were three departments. The first department was Maintenance of Equipment Department. The hierarchy of this department is Superintendent, Deputy Maintenance Superintendent, and Lead Maintenance Hand. The technicians below the Lead Maintenance Hand are the Maintenance Technicians and other relevant staff such as electricians. Besides that, the second department under the OIM was safety department. The hierarchy of the safety department is Safety Supervisor, Lead Safety Supervisor, followed by the OPCAL’S safety operators and the Contractor’s safety operator. The most significant department under the OIM was Production personnel apart from safety they would take over if anything went wrong on the platform. Most of them were OPCAL’s own employees. Under the OIM there was an Operations Superintendent, a Deputy Operation Superintendent, Lead Production Operators and the actual Operators. There were also many employees of the various contractors on the platform under the supervision of the permanent production staff. The objective of this Piper Alpha is to produce and process crude oil and gas (Lord Caplan,1997) 3. Industrial Processes 3. 1 Operation Functions The oil production was started in 1976 with about 250,000 barrels of oil per day. Later on, it was increased to 300,000 barrels per day. In the year 1980, a gas recovery module was installed. By 1988, the production has to into half which is 125,000 barrels per day. Then, OPCAL built the Flotta Oil Terminal in the Orkney Island receive and process oil from the fields Piper, Claymore and Tartan. A main pipeline ran from 128 miles from Piper Alpha to Flotta, with a short oil pipeline from the Claymore platform to west. The main purpose of the plant is to produce crude oil and natural gas from 24 wells to deliver oil to Flotta terminal and to other installations which is Tartan and Claymore by three different pipelines. A short pipeline was joint with the pipeline of Flotta within the range of 20 miles way from Claymore. The Tartan field also runs oil to Claymore and then runs to Flotta through the main pipeline. A gas pipeline runs from Piper Alpha to Tartan. It runs from Piper Alpha to gas compressing platform MCP-01, 30 miles away to the Northwest. Piper Alpha had four transport risers in total. They are, an export oil riser, the Claymore gas riser, the Tartan gas riser and the Flotta gas riser (Risk Analysis, vol 5, No. 4, pg 277-288). Figure 2: Illustration of Piper Alpha’s Oil and Gas Risers Subsea Pipelines (Willie Scott, 2011) The 84-foot level consisted of four modules A, B, C and D. A, B and C were the main production modules. Module D was the generation and utilities module. These modules as with other structural equipment had all been fabricated onshore. The next main level up was the 107-foot level which housed the Mud Module and Storage Module on the west, and the Gas Conservation Module (also known as the GCM or Phase 2 Module) and Utilities module on the east. The 133-foot level contained the pipe deck and the 174-foot level the helideck. The accommodation modules were at the north end of the platform and were at levels ranging from 121 feet to 174 feet (Lord Caplan,1997). 4. Causes of Accident 4. 1 Human Factors One of the human factors that contribute this disaster is lack of safety training of the staffs inside the platform. Less experienced maintenance crew, personnel, operators and production workers were allowed to run Piper Alpha at a time when high-level activity should have required special care, attention, and the ability to recognize abnormal signs in order to diagnose and fix problems immediately. Besides that, less inspection of the equipment by the maintenance technicians is also a contributing factor for this disaster (Elisabeth patte-cornell, October 1991) 4. 2 Design and Process Factors There was controversy about the disaster. The controversy about whether there was sufficient time for more effective emergency evacuation. This is because; the second explosion occurs 20 minutes after the first explosion but many people couldn’t escape from the second explosion. The main problem was that most of the personnel who had the authority to order evacuation had been killed in the first explosion which destroyed the control room. This was a consequence of the platform design, which includes the absence of the blast walls (Kletz, T. ,2001). Another contributing factor, the nearby platform continues pumping oil and gas to Piper Alpha until its pipeline damaged in the heat in the second explosion. Even though after the first blast, the nearby platforms continue pumping oil and gas to Piper Alpha. Besides that, on the morning of the day of the incident, some backup propane condensate pumps in the processing area need to have its pressure safety valve check. But the work could not be complete by 6pm and the work was postponed to the next day. The tube was sealed with a plate. Later in the evening during the next shift, the primary condensate pump failed. The gas products escaped from the valve. Finally, the gas audibly leaked out at high pressure, ignited and exploded, blowing through the fire walls. Moreover, the automatic deluge system was designed to spray water to put out the fire was never activated because it had been turned off. In addition, the accommodations were also not smoke-proved. This contributes to the death of personnel inside the accommodation area. Moreover, the poor design of the emergency equipment also contributes to this disaster. When the first blast occurs, the general alarm system and the emergency lighting failed to work. The design of the platform is also a factor of this disaster. Initially, the platform was not designed for severe loads (Mannan, S,2001). . 3 External Factors The external factor of the Disaster of Piper Alpha is the organization factor. One the reason is because the management of OPCAL didn’t supervise the recruitment of the worker on board. Hence, some workers on board have less experience and knowledge in crude oil production. Besides that, the management didn’t provide safety training for most of the workers in the pl atform. Moreover, the death of the OIM is also a factor of the death of the personnel on board. This is because; the OIM is the person who gives order to evacuate when emergency. Therefore, most of the personnel could not make decision to evacuate when the incident happens (Lord Caplen,1997). 5. Consequences of the effects of the accident 5. 1 Health After the incident of Piper Alpha took place, a researcher has conducted a study into the long-term psychological and social effects of the Piper Alpha disaster. Finally, he manage to find thirty-six survivors who agreed to give interviews. Almost all of them reported psychological problem. More than 70% of those interviewed have psychological and behavioral symptoms of post traumatic stress disorder. The family members of the dead and survived victims also were reported to have psychological and social problems (Hull AM, Alexander DA, and Klein S. ,2001). 5. 2 Environmental and ecology Some documents showed that highly-toxic chemical that fell into the North Sea after the explosion destroyed the oil platform by killing 167 men would not have burned up as had been claimed by OPCAL. In addition, 5. 5 tonnes of the cooling fluid, polychlorinated bithenyl (PCB) which contain in equipment called the transformers was also destroyed during the fire. This would contribute a massive to the marine life. For example, the death of marine species. Besides that, the fish caught near the platform found to be chemical contaminated. Moreover, the release of Carbon monoxide (CO) and Sulphur Dioxide (SO2) to the air also results acid rain at some area nearby the platform (Nicola Reeves, 1991). 5. 3 Damage cost and Compensation cost The damage cost of the disaster of Piper Alpha is calculated to be around three billion US Dollars. Besides that, this disaster results in an overall reduction in insurance capacity in London. Besides that, the compensation cost of the disaster cost was around 1. billion US Dollars (Nicola Reeves, 1991). 6. Improvement and Prevention 6. 1 Design and Process As an improvement steps for a platform to avoid from disaster like Piper Alpha, a regulatory control of offshore should be implemented. An offshore installation (Safety Case) regulation is a written document where a company must demonstrate that an effective safety management system (SMS) is in place on the par ticular offshore installation. Then, the implementation of this handed over to the HSE in 1991. As a recovery of this incident, regulatory control of offshore installation has been introduced in the year 1991. Besides that, the need of safety training for the staff is given more importance. Moreover proper isolation plant is formed when a platform undergoes maintenance process. The disaster would not have occurred if the pump where work was being done had been positively isolated. Isolation is not achieved by shutting a valve but it requires the insertion of a slip plate or removal of a pipe section. Disabling of protective equipment by explosion would be one of the prevention steps from this disaster to happen. The firewalls on the Piper Alpha could have stopped the spread of fire. However, they were not built to withstand an explosion. The initial blast blew the firewalls down, and the subsequent fire spread could not be stopped (Kletz T. 2001). Besides that, the inventory should be limited on installation and in pipelines. The large inventory of the pipelines connected to the platform fed the fire. Other than technical problems, it should be a design objective to reduce the amount of hydrocarbon. In addition, emergency shutdown valves should be located in platform to prevent this type of disaster. Proper location of emergency shutdown valves and backup valves are essential to cutting off fuel supply in case of fire. Above water positioning provides testing accessibility for vigilant maintenance. Moreover, the use of wind tunnel test and explosion simulations in design could prevent the spread of fire. Wind tunnels are useful to assess the effectiveness of the ventilation and the gas detection system. The explosion simulations help to investigate effect of different layouts an explosion ans assess the effectiveness of blast walls (Kletz T,2001). 6. 2 Human resource Proper training should be given to staff in the platform by the management. For example, fire and explosion protection training should be given to employees. This is because, fire fighting are particular importance as there is no possibility to rely on outside assistance, such as the fire brigade. Besides that, proper recruitment process should be carried out to prevent this type of disaster. For example, highly experience maintenance staff could have sealed the pipeline in a proper way. Thus, the incident would not have occurred. 6. 3 Safety and Health For safety,, more than one route to helicopters and life boats must be present at any given time to ensure evacuation of the platform in crisis situation. Besides that, luminescent strips and heat shielding provide visibility in smoke and protection from flames. In addition, secondary escapes such as ropes, ladders and nets also should be provided as backup for the more sophisticated escape method (Mannan S. 2005). Conclusion Many of the events that led to the Piper Alpha accident were rooted in the culture, the structure, and the procedures of OPCAL. Safety management systems and associated safety cases can make a big difference. The systematic approach means that the hazards of the business are known, understood and demonstrably controlled. http://www. aiche. org/uploadedfiles/CCPS/resources/knowledgebase/Piper_Alpha. pdf http://www.caa.lv/ http://www. hse. gov. uk/research//rrpdf/rr089. pdf http://www.heraldscotland.com/

Medicare Fraud Scandal with the Columbia/HCA Hospitals Essay Example

Medicare Fraud Scandal with the Columbia/HCA Hospitals Paper One of the most pressing issues affecting the health sector is Medicare fraud. Based on the events that rocked the health community, which involved Columbia Health Hospitals, America has decided that it is high time to pay closer attention to one of the reasons why the Medicare is bleeding to death. This paper will try to look into the events that shaped the most controversial and biggest Medicare scandal that has awakened government to act before it is too late. To assist the readers, this paper will be divided into several parts: (a) Background of the paper where information about the case being examined will be provided. In addition, an introduction of the major issue(s) to be analyzed will also be presented; (b) Analysis Section will provide a detailed analysis of the situation(s) being examined and will outline recommendations for how the issue(s) could have been handled more effectively; finally, the (c) conclusion section where we will try to summarize the purpose of the project, the issue(s) examined and the major findings/conclusions/recommendations. II. Background For this particular paper, we will look into the kind of fraud that Columbia allegedly committed against Medicare and its members. We will write a custom essay sample on Medicare Fraud Scandal with the Columbia/HCA Hospitals specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Medicare Fraud Scandal with the Columbia/HCA Hospitals specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Medicare Fraud Scandal with the Columbia/HCA Hospitals specifically for you FOR ONLY $16.38 $13.9/page Hire Writer To do so, we will need to first define what fraud is and how it is particularly committed. More importantly, we will look into how Columbia/HCA Hospitals allegedly committed the fraud and how it ultimately affected the American public as well as the American government. One fateful day in July of 1997, a series of raid launched by the government against a particular hospital conglomerate shocked America’s health care system and brought into the nation’s attention one of the biggest scandal that involved Medicare benefits of Americans. https://healtheappointments.com/private-hospital-vs-public-hospitals-essays/ In a raid conducted by federal and state agents, the main target was Columbia/ HCA hospitals in Florida. At issue were allegations that Columbia had defrauded Medicare, the deferral health insurance for the elderly and the disabled. Medicare was created by Congress in 1965 as a means to provide health benefits to Americans over the age of 65 and for the seriously disabled. In the beginning, it was said that Medicare had no effective cost control and while it did help the people it was meant to help (i. e. the elderly and the disabled), it also cost Uncle Sam a lot of taxpayer’s money. In the beginning, hospitals were reimbursed on a cost plus basis meaning that Medicare paid for the cost of service plus a fee for administrative overhead. However, in 1983, Congress passed the first significant effort to curb the skyrocketing costs of Medicare. Congress adopted a payment system based on diagnostic related groups (DRGs). Under the DRG system, hospitals would be paid per admission with an amount determined by the diagnosis instead of per day or per service. This new system helped check increasing Medicare costs but it also hurt hospitals and made them bleed profusely –at least on financial aspect. And while many hospitals saw this new change as a disadvantage, Columbia/HCA had another vision. They saw this new change as a way to increase their profits, albeit in a more fraudulent manner. In 1997, investigations were underway with regard to the alleged fraud practices employed by Columbia against Medicare. At issue in the investigation were several possibly fraudulent practices by Columbia/HCA and its managers. Among these were upcoding, cost shifting, unethical practices to pressure acquisition targets, and financial relationships with doctors. III. Analysis First things first: what is fraud and what act or acts constitutes fraud? When does one commit fraud? According to the definition of the Department of Health and Human Services, fraud is the intentional deception or misrepresentation that an individual knows to be false or does not believe to be true and makes, knowing that the deception could result in some unauthorized benefit to himself/herself or some other person. The most frequent kind of fraud arises from a false statement or misrepresentation made, or caused to be made, that is material to entitlement or payment under the Medicare program. The violator may a physician or other practitioner, a hospital or other institutional provider, a clinical laboratory or other supplier, an employee of any provider, a billing service, beneficiary, Medicare carrier employee or any person in a position to file a claim for Medicare benefits. Under the broad definition of fraud are other violations, including: the offering or acceptance of kickbacks, and the routine waiver of co-payments. According to the Find Law website, fraud schemes range from those perpetrated by individuals acting alone to broad-based activities by institutions or groups of individuals, sometimes employing sophisticated telemarketing and other promotional techniques to lure consumers into serving as the unwitting tools in the schemes. Seldom do perpetrators target only one insurer or either the public or private sector exclusively. Rather, most are found to be defrauding several private and public sector victims, such as Medicare, simultaneously. In Medicare, the most common forms of fraud include: Billing for services not furnished Misrepresenting the diagnosis to justify payment Soliciting, offering, or receiving a kickback Unbundling or exploding charges Falsifying certificates of medical necessity, plans of treatment, and medical records to justify payment Billing for a service not furnished as billed; i. e. , upcoding (Find Law, 1998) Now that we have an idea of what constitutes fraud, particularly the kind that can be committed against Medicare, we can now look more closely into the case that involved Columbia/HCA hospitals. Unlike many hospitals, Columbia/ HCA hospitals were obviously managed by a profit-oriented leader who put more emphasis on the money-yielding power of health care instead of the healing and caring aspect of the business. One key element that could have fostered the fraudulent behavior of the Columbia/HCA management is the company’s strategy of doctor ownership. Doctors were given the opportunity to become shareholders in the company –thus giving motivations to physicians to refer patients to its hospitals instead of its competitors. Moreover, as shareholders of the hospital, doctors had more incentives to hold down costs or to comply with managerial directives. It is, thus, not surprising to see how fraud could happen in such an environment. If doctors and hospitals are in it for the money, then there is no limit as to what they can do to get more financially. Just looking at the company vision or strategy of Columbia/HCA hospitals, we will see that ethics is clearly absent in the vision of management. Instead of aiming to provide quality health care to its patients, the doctors and management of Columbia/HCA are more interested in gaining more profit for the hospital and the corporation instead of giving excellent health care. While this may not be a bad gesture in the over all scheme of things, it still says a lot about the ethics of Columbia management. It would seem that the managers and doctors have lost the essence of their profession. Let me qualify that there is nothing evil in wanting to work for money. What constitutes evil is applying fraudulent means to get more profit. Now that we have an idea of what the problem is and where it lies, one recommendation that can be forwarded is the strengthening of ethics and values formation in the medical community. Doctors as well as everyone involved in the medical profession should understand that medicine is a calling, a vocation where money should come secondary to quality health care. Second recommendation would be to pressure government into providing stricter procedure for health care, particularly for Medicare. As noted by the Concord Coalition website, wherever medical guidelines are hazy and judgment calls are required, it tries to ration claims through arbitrary rules, creating a feast-or-famine reimbursement policy. It imposes huge compliance costs and produces capricious results. Worst of all, despite the estimated 45,000 pages of regulations, the system careens toward bankruptcy as costs keep rising. (Concord Coalition, 1997) More importantly, it is important to set harsher penalties for Medicare fraud cases. This is to ensure that hospitals like Columbia/HCA will learn from their mistakes and will serve as an example to all. Penalties must send the message that fraudulent acts will not go punished and will be dealt with severely by the government. IV. Conclusion It goes without saying that the controversy surrounding Medicare, Columbia/HCA, and the health system in general is a disease that needs immediate diagnosis. The purpose of this paper is to heighten awareness of the problem affecting our health care industry with the ultimate goal of finding the perfect solution to the problem. Needless to say, Medicare fraud hurts not just the beneficiaries or the members but the taxpayers in general. In other words, it affects all Americans. The raids that took place in the hospitals of Columbia/HCA should serve as a reminder that criminal acts will, sooner or later, be revealed and perpetrators will be brought to justice. In addition, we have learned from the case presented to us, that there is still need for improvement in terms of implementing the Medicare system. More importantly, we have seen that ethics plays a huge part in the Medicare scandal. It would seem that the management behind Columbia/HCA has forgotten the real reason behind their organization. It is the belief of this author that a strengthening of ethics formation in the medical community will help in changing the tides of Medicare fraud. References: Find Law, 1998: Medicare Definition of Fraud [online] Available at: http://library. findlaw. com/1998/Feb/19/131383. html [cited on: June 14, 2006] Kansas Medicare, 2006: Medicare Fraud [online] Available at: http://www. kansasmedicare. com/policy/fraud. htm [cited on: June 14, 2006] Medicare, 2005: Medicare Fraud [online] Available at: http://www. medicare. gov/FraudAbuse/Overview. asp [cited on: June 14, 2006] Mutual Medicare, 2006: Help Reduce the Impact of Medicare Fraud [online] Available at: http://www. mutualmedicare. com/fraud/ [cited on: June 14, 2006] Senior Health, 2006: Medicare Fraud and Abuse Detection and Prevention Tips [online] Available at: http://seniorhealth. about. com/library/medicare/blfraud. htm? once=true [cited on: June 14, 2006] The Concord Coalition, 1997: Medicare Fraud: A Symptom, Not the Disease [online] Available at: http://www. concordcoalition. org/facing-facts/ff_fax42. html [cited on: June 14, 2006] The Qui Tam Online Network, 2006: Common Types of Qui Tam Fraud [online] Available at: http://www. quitamonline. com/fraud. html [cited on: June 14, 2006] United Government Services, 2006: Fraud and Abuse [online] Available at: http://www. ugsmedicare. com/about_ugs/fraud_abuse. asp [cited on: June 14, 2006]

Leadership and Organisational Change in MCFC

A Plot Summary of Our Town

A Plot Summary of Our Town Written by Thorton Wilder, Our Town is a play that  explores the lives of people living in a small, quintessentially American town. It was first produced in 1938 and received the Pulitzer Prize for Drama. The play is divided into three aspects of the human experience: Act One: Daily Life Act Two: Love / Marriage Act Three: Death / Loss Act One The Stage Manager, serving as the play’s narrator, introduces the audience to Grover’s Corners, a small town in New Hampshire. The year is 1901. In the early morning, only a few folks are about. The paperboy delivers papers. The milkman strolls by. Dr. Gibbs has just returned from delivering twins. Note: There are very few props in Our Town. Most of the objects are pantomimed. The Stage Manager arranges a few (real) chairs and tables. Two families enter and begin pantomiming breakfast. The Gibbs Family Dr. Gibbs: Hardworking, soft-spoken, disciplined.Mrs. Gibbs: The Doctor’s wife. She believes her husband is overworked and should take a vacation.George: Their son. Energetic, friendly, sincere.Rebecca: George’s little sister. The Webb Family Mr. Webb: Runs the town’s newspaper.Mrs. Webb: Strict but loving to her children.Emily Webb: Their daughter. Bright, hopeful and idealistic.Wally Webb: Her younger brother. Throughout the morning and the rest of the day, the townspeople of Grover’s Corner eat breakfast, work in town, do household chores, garden, gossip, go to school, attend choir practice, and admire the moonlight. Some of Act One’s More Compelling Moments Dr. Gibbs calmly chastises his son for forgetting to chop firewood. When George has tears in his eyes, he hands him a handkerchief and the matter is resolved.Simon Stimson, the church organist, leads the church choir while intoxicated. He staggers home drunk and deeply troubled. The constable and Mr. Webb try to assist him, but Stimson wanders away.  Webb wonders how the man’s sorry situation will end, but decided there is nothing to be done about it.Emily Webb and George Gibbs sit at their windows (according to the stage directions, they are perched on ladders). They talk about algebra and the moonlight. Their words are mundane, perhaps, but their fondness for each other is obvious.Rebecca tells her brother a funny story about a letter Jane Crofut received from a minister. It was addressed: Jane Crofut; The Crofut Farm; Grover’s Corners; Sutton County; New Hampshire; United States of America; North America; Western Hemisphere; the Earth; the Solar System; the Univers e; the Mind of God. Act Two The Stage Manager explains that three years have passed. It is the wedding day of George and Emily. The Webb and Gibbs parents lament how their children have grown so quickly. George and Mr. Webb, his soon-to-be father-in-law, awkwardly converse about the futility of marital advice. Before the wedding commences, the Stage Manager wonders how it all began, both this specific romance of George and Emily, as well as the origins of marriage in general. He takes the audience back in time a bit, to when George and Emily’s romantic relationship began. In this flashback, George is the captain of the baseball team. Emily has just been elected as the student body treasurer and secretary. After school, he offers to carry her books home. She accepts but suddenly reveals how she does not like the change in his character. She claims that George has become arrogant. This seems to be a false accusation, however, because George immediately apologizes. He is very grateful to have such an honest friend as Emily. He takes her to the soda shop, where the Stage Manager pretends to be the store owner. There, the boy and girl reveal their devotion to one another. The Stage Manager segues back to the wedding ceremony. Both the young bride and groom are scared about getting married and growing up. Mrs. Gibbs snaps her son out of his jitters. Mr. Webb calms his daughter’s fears. The Stage Manager plays the role of the minister. In his sermon, he says of the countless who have gotten married, â€Å"Once in a thousand times it’s interesting.† Act Three The final act takes place in a cemetery in 1913. It is set upon a hill overlooking Grover’s Corner. About a dozen people sit in several rows of chairs. They have patient and somber faces. The Stage Manager tells us that these are the dead citizens of the town. Among the recent arrivals are: Mrs. Gibbs: Died of pneumonia while visiting her daughter.Wally Webb: Died young. His appendix burst during a Boy Scout trip.Simon Stimson: Facing troubles the audience never understands, he hangs himself. A funeral procession approaches. The dead characters comment nonchalantly about the new arrival: Emily Webb. She died while giving birth to her second child. The spirit of Emily walks away from the living and joins the dead, sitting next to Mrs. Gibbs. Emily is pleased to see her. She talks about the farm. She is distracted by the living as they grieve. She wonders how long the sensation of feeling alive will last; she is anxious to feel like the others do. Mrs. Gibbs tells her to wait, that it is best to be quiet and patient. The dead seem to be looking to the future, waiting for something. They are no longer emotionally connected to the troubles of the living. Emily senses that one can return to the world of the living, that one can revisit and re-experience the past. With the help of the Stage Manager, and against the advice of Mrs. Gibbs, Emily returns to her 12th birthday. However, everything is too beautiful, too emotionally intense. She chooses to go back to the numbing comfort of the grave. The world, she says, is too wonderful for anyone to truly realize it. Some of the dead, such as Stimson, express bitterness to the ignorance of the living. However, Mrs. Gibbs and the others believe that life was both painful and wonderful. They take comfort and companionship in the starlight above them. In the last moments of the play, George returns to weep at Emily’s grave. EMILY: Mother Gibbs? MRS. GIBBS: Yes, Emily? EMILY: They don’t understand, do they? MRS. GIBBS: No, dear. They don’t understand. The Stage Manager then reflects upon how, throughout the universe, it may be that only the inhabitants of the earth are straining away. He tells the audience to get a good night’s rest. The play ends.

2 essay exam questions Example | Topics and Well Written Essays - 250 words

2 exam questions - Essay Example When this production run is optimized within the current output level, the total average cost per unit produces will decrease based on the simple fact that fixed cost per unit produced decreases as the number of output increases. Investopedia (n.d.) explains that â€Å"the purpose of analyzing marginal cost is to determine at what point an organization can achieve economies of scale. The calculation is most often used among manufacturers as a means of isolating an optimum production level. The benefit of producing one additional unit and generating revenue from that item will bring the overall cost of producing the product line down. The key to optimizing manufacturing costs is to find that point or level as quickly as possible.† Various reasons can be considered. For a monopolistic business, keeping the product’s presence in the market is necessary while waiting for the product’s improvements or innovations from the Research and Development department. Once these product improvement or innovation is achieved, the turn of events may become more profitable and may even achieve new heights of business success. Product substitutes may have caused the business to deteriorate. But as long as it is evident that product improvements or innovation will turn the tides of business back to original profitable track, it is worth keeping the business going. Otherwise, when there is no more prospects on the business line, continuing operation will just drain resources. (John Wiley & Sons, Inc , n.d.) states that â€Å"if the firms average variable costs are less than its marginal revenue at the profit maximizing level of output, the firm will not shut down in the short-run. The firm is better off continuing its operations because it can cover its variable costs and use any remaining revenues to pay off some of its fixed costs.† Demand curve for IPOD may rise with this increase on income level of young professionals.