The Role of France in the American Revolutionary War

After years of spiraling tensions in Britain’s American colonies, the American Revolutionary War began in 1775. The revolutionary colonists faced a war against one of the world’s major powers, one with an empire that spanned the globe. To help counter Britains formidable position, the Continental Congress created the Secret Committee of Correspondence to publicize the aims and actions of the rebels in Europe. They then drafted the Model Treaty to guide negotiations of alliance with foreign nations. Once the Congress had declared independence in 1776, it sent a party that included Benjamin Franklin to negotiate with Britain’s rival: France. Why France Was Interested France initially sent agents to observe the war, organized secret supplies, and began preparations for war against Britain in support of the rebels. France might seem an odd choice for the revolutionaries to work with. The nation was ruled by an absolutist monarch who was not sympathetic to the principle of no taxation without representation, even if the plight of the colonists and their perceived fight against a domineering empire excited idealistic Frenchmen like the Marquis de Lafayette. In addition, France was Catholic and the colonies were Protestant, a difference that was a major and contentious issue at the time and one that had colored several centuries of foreign relations. But France was a colonial rival of Britain. While it was arguably Europe’s most prestigious nation, France had suffered humiliating defeats to the British in the Seven Years War—especially its American theater, the French-Indian War—several years earlier. France was looking for any way to boost its own reputation while undermining Britains, and helping the colonists to independence looked like a perfect way of doing this. The fact that some of the revolutionaries had fought France in the French-Indian War was expediently overlooked. In fact, the French Duc de Choiseul had outlined how France would restore their prestige from the Seven Years War as early as 1765 by saying the colonists would soon throw the British out, and that France and Spain had to unite and fight Britain for naval dominance. Covert Assistance Franklin’s diplomatic overtures helped prompt a wave of sympathy across France for the revolutionary cause, and a fashion for all things American took hold. Franklin used this popular support to help in negotiations with French Foreign Minister Vergennes, who was initially keen on a full alliance, especially after the British were forced to abandon their base in Boston. Then news arrived of defeats suffered by Washington and his Continental Army in New York. With Britain seemingly on the rise, Vergennes wavered, hesitating over a full alliance, though he sent a secret loan and other aid anyway. Meanwhile, the French entered negotiations with the Spanish. Spain was also a threat to Britain, but it was worried about supporting colonial independence. Saratoga Leads to Full Alliance In December 1777, news reached France of the British surrender at Saratoga, a victory that convinced the French to make a full alliance with the revolutionaries and to enter the war with troops. On February 6, 1778, Franklin and two other American commissioners signed the Treaty of Alliance and a Treaty of Amity and Commerce with France. This contained a clause banning both Congress and France from making a separate peace with Britain and a commitment to keep fighting until the independence of the United States was recognized. Spain entered the war on the revolutionary side later that year. The French Foreign Office had trouble pinning down â€Å"legitimate† reasons for France’s entry into the war; they found almost none. France couldn’t argue for the rights that the Americans claimed without damaging their own political system. Indeed, their report could only stress Frances disputes with Britain; it avoided discussion in favor of simply acting. Legitimate reasons were not terribly important in this epoch and the French joined the fight anyway. 1778 to 1783 Now fully committed to the war, France supplied arms, munitions, supplies, and uniforms. French troops and naval power were also sent to America, reinforcing and protecting Washington’s Continental Army. The decision to send troops was taken carefully, as France was not sure how the Americans would react to a foreign army. The number of soldiers was carefully chosen, striking a balance that allowed them to be effective, while not being so large as to anger the Americans. The commanders were also carefully selected—men who could work effectively with the other French commanders and the American commanders. The leader of the French army, Count Rochambeau, however, did not speak English. The troops sent to America were not, as has sometimes been reported, the very cream of the French army. They were, however, as one historian has commented, for 1780...probably the most sophisticated military instrument ever dispatched to the New World.† There were problems in working together at first, as American General John Sullivan discovered at Newport when French ships pulled away from a siege to deal with British ships, before being damaged and having to retreat. But overall, the American and French forces cooperated well, although they were often kept separate. The French and Americans certainly were quite effective when compared to the incessant problems experienced in the British high command. French forces attempted to buy everything from the locals that they couldn’t ship in, rather than requisition it. They spent an estimated $4 million worth of precious metal in doing so, further endearing themselves to the Americans. Arguably the key French contribution to the war came during the Yorktown campaign. French forces under Rochambeau landed at Rhode Island in 1780, which they fortified before linking up with Washington in 1781. Later that year, the Franco-American army marched 700 miles south to besiege Gen. Charles Cornwallis’ British army at Yorktown, while the French navy cut the British off from desperately needed naval supplies, reinforcements, and complete evacuation to New York. Cornwallis was forced to surrender to Washington and Rochambeau. This proved to be the last major engagement of the war, as Britain opened peace discussions soon after rather than continue a global war. Global Threat From France America wasn’t the only theater in a war which, with France’s entrance, had turned global. France threatened British shipping and territory around the globe, preventing their rival from focusing fully on the conflict in the Americas. Part of the impetus behind Britain’s surrender after Yorktown was the need to hold the remainder of their colonial empire from attack by other European nations, such as France. There were battles outside America in 1782 and 1783 as peace negotiations took place. Many in Britain felt that France was their primary enemy and should be the focus; some even suggested pulling out of the American colonies entirely to focus on their neighbor across the English Channel. Peace Despite British attempts to divide France and Congress during peace negotiations, the allies remained firm—aided by a further French loan—and peace was reached in the Treaty of Paris in 1783 between Britain, France, and the United States. Britain had to sign further treaties with other European powers who had become involved. Consequences Britain quit the American Revolutionary War rather than fight another global war with France. This might seem like a triumph for France, but in truth, it was a disaster. The financial pressures France faced at the time were only made worse by the cost of aiding the Americans. These fiscal troubles soon spiraled out of control and played a large role in the start of the French Revolution in 1789. The French government thought it was harming Britain by acting in the New World, but just a few years later, it was itself harmed by the financial costs of the war. Sources Kennett, Lee. The French Forces in America, 1780–1783. Greenwood Press, 1977.Mackesy, Piers. The War for America 1775–1783. Harvard University Press, 1964.

Disputes with the Native Americans from the Beginning

Since the first arrival of colonists to America in 1607, disputes between the Native Americans and the colonist began arousing. In the years following the first arrival of the colonist, numerous outburst of war and treaties were made. Many of these treaties between the US and the natives were broken and by 1830, many Native American tribes found themselves being confined in reservations. During the second latter of the 19th century the US began to become industrialized and expand westward to fulfill the ultimate manifest destiny. The plains Indians, specifically found themselves begin affected by the various technologic developments and government action during the second half of the 19th century due to the completion of the trans continental railroad , gun invention, and broken treaties In order connect both East and West coast, the US passed the construction of the transcontinental rail road (1863), which would provide easier trade and transportation routes between the east and we st coast. This railroad although not thought of at first would undeliberately pass through Plain Indian territory, which was no good for these plains Indians. With the railroad passing directly through plain Indian territory, it would immediately attract white settlement. Soon after an influx of these white settlers began settling in. These white men not only brought families, but as well as diseases something tremendously foreign to these Indians. 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English Home Reading Project Free Essays

Todd Bowden is a boy who wants to be a detective when he gets older. He has been doing good in school and in his free time he runs background checks on people he sees. His neighbor Mr. We will write a custom essay sample on English Home Reading Project or any similar topic only for you Order Now Dussander was one of the people he did this too. He found out that he was using a fake name and was once referred to as the blood fiend of patin the only true thing about his life was that he was very old. When Todd confronts him about it he realizes that this secret is bigger than he thought. Todd soon starts to wonder about why he was called blood fiend so he started to ask some questions about it. When Dussander refuses, Todd black-males him into giving the stories. Todd starting to let his grades drop and when his first high school report card comes home he tries to change his grades with ink remover. He does this several times thought the novella. As the story’s get more and more graphic Todd begins to come almost psychopathic. He starts to make Dussander wear these awful Nazi suits and recite saying that he used to say during the war. Dussander starts to have nightmares about the war and find a gruesome way to cope with the stress. Because he used to work in one of the crematoriums, Dussander starts to find stray cats and put them in his kitchen oven. He would soon become worse and â€Å"rescue† dogs from a shelter to burn. ( worst part of book. too many details. ) As Todd grades drop further his guidance counselor try’s to set up a meeting between him and his parents. Todd black-males Dussander into pretending that he is his grandfather and proceeds with the meeting without his real parents. Todd is told that if he gets another flunk card that he will have to repeat this grade . One night after having listened too so many of the horrible stories he has a nightmare. These dreams persist for weeks and eventually Todd comes up with a plan to kill dussander. When nightmares continue to get worse Todd stabs a homeless man to death and realizes that murder helps with his stress and the dreams start to go away . he continues to commit murder whenever the dreams get too bad. Dussander starts too do the same as Todd and buries his victims in his basement. towards the end of the story the guidance counselor meets Todd’s real grandfather and starts too talk about the meeting they had and when the grandfather dident remember the conversation he puts the pieces together. CLIMAX chapter 17. his is the climax of the story because at this point the entire story changes. Dussander had a heart attack and this leads to new situations that completely change the story. The resolution of this story is that todd bowden is questrioned by the police. After this he goes to a secret spto on the highway. Gets a gun, and goes on a rampage. Only to end in his own dea th. I think this was a great ending to the story. If fit perfect with all the little details that were put into the book. It all fits together at the end. Characterization Todd Bowden: Main character of the book. He is shown as decieving and mean. Througout the novella todd tricks and manipulated people into doing things that could help himself and hurt others. He is important to the story because without him nothing would have happened and it wouldent be a good book. Arthur Denker AKA Mr. Dussander: main character. Shown as a nice man but forceful when need be and his past shows him as a monster. He is important to the story because he feeds all of todds rage to him and is an antagonist to the story. Todds personality chapter 6. this shows Todds evil side and proves just how much of a monster he can be to put an old man throug this rough time again. Todd is not the kind of person I would like to be friends with. He is a lieing kid who is extremly mean. And throughout the book he is seen by his peers as a loser. Conflict One main conflict in this story is when Todds grades start too fall. He constantly changes them to deceive his parents and when he is confronted by his guidance counselor about it he decides to lie about his situation in hopes to fix it. Todd has Dussander go to the school and talk to the counselor instead of his parent to â€Å" sweep the problem under the rug†. This fixes one of his problems but makes life much more difficult in the rest of the story. I can relate to some of todds problems like falling grades sometimes and feeling like your stuck in a place that your know wont lead anywhere good. But as for the rest of his problems like where to bury his victims I cannot say that I have any experience in. Theme one main theme of this novella is deception and black-male can only get you so far, because when the time comes for the truth it will only bring you down. This is shown when todds grandfather meets the counselor and realizes that todd lied to his parents about his grades and the whole situation unfolds. How to cite English Home Reading Project, Papers

this is wierd Essay Example For Students

this is wierd Essay We say Now that we know Dave is staying at CBS, its time to ask the question: Why do more viewers watch Lenos Tonight Show when Lettermans Late Show is so clearly superior? Maybe its a lowest-common-denominator thing: Leno goes for only the most obvious gags, so he makes people feel smarter because they can guess the punchlines. And dont give us that old Daves-too-cranky argument. In the aftermath of his heart surgery and Sept. 11, Dave has radiated a hell of a lot more warmth than NBCs animatronic joke machine. So go ahead, America stay with Jay. Daves still our fave. Winner LettermanWe say Now that we know Dave is staying at CBS, its time to ask the question: Why do more viewers watch Lenos Tonight Show when Lettermans Late Show is so clearly superior? Maybe its a lowest-common-denominator thing: Leno goes for only the most obvious gags, so he makes people feel smarter because they can guess the punchlines. And dont give us that old Daves-too-cranky argument. In the aftermath of h is heart surgery and Sept. 11, Dave has radiated a hell of a lot more warmth than NBCs animatronic joke machine. So go ahead, America stay with Jay. Daves still our fave. Winner LettermanWe say Now that we know Dave is staying at CBS, its time to ask the question: Why do more viewers watch Lenos Tonight Show when Lettermans Late Show is so clearly superior? Maybe its a lowest-common-denominator thing: Leno goes for only the most obvious gags, so he makes people feel smarter because they can guess the punchlines. And dont give us that old Daves-too-cranky argument. In the aftermath of his heart surgery and Sept. 11, Dave has radiated a hell of a lot more warmth than NBCs animatronic joke machine. So go ahead, America stay with Jay. Daves still our fave. Winner Letterman

Multidatabase Query Processing, Introduction to Transaction Management, Distributed Concurrency Control, Distributed DBMS Reliability Essay Example

Multidatabase Query Processing, Introduction to Transaction Management, Distributed Concurrency Control, Distributed DBMS Reliability Essay Introduction to Transaction Management Name: Course: Lecturer: We will write a custom essay sample on Multidatabase Query Processing, Introduction to Transaction Management, Distributed Concurrency Control, Distributed DBMS Reliability specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Multidatabase Query Processing, Introduction to Transaction Management, Distributed Concurrency Control, Distributed DBMS Reliability specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Multidatabase Query Processing, Introduction to Transaction Management, Distributed Concurrency Control, Distributed DBMS Reliability specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Date: Introduction to Transaction Management A transaction is a sequence of operations of the database that are organized in a basic unit where databases are kept reliable and consistent. A database is said to be consistent when it has the following features; it has referential integrity, it maintains entity integrity and if it remains within the constraints set by the domain values. Moreover, a database should remain consistent before the execution of a transaction and after. During the execution of a transaction, a database should be in an inconsistent state where no other transaction should be exposed to it. Regardless of the number of transactions accessing the database, it should always remain in a consistent state[1]. The reliability of a database is determined by its capability to recover and its resiliency. A transaction is a sequence of operations involving the commands of reading and writing on a database. For instance an SQL statement is regarded as a transaction, a program that is enclosed by the commands ‘Begin-transaction’ and ‘end’ is also a transaction. A transaction can be terminated by commands of committing it or rolling it back. If a transaction is committed, it has been successfully completed and if it is rolled back, it has been aborted. The commit command makes the effect of the operations of the database permanent and the results can be viewed by all other transactions. The rollback command on the other hand has the effect of undoing the operations and restoring the database to the state it was before the transaction was executed[2]. Transactions can fail to complete for three reasons. They could be aborted by the management system, either if the system crashes or if the transaction aborts itself. When this occurs, the effects of the transaction should be undone. This helps the user to forget about the undone transaction as it has already been taken care of. However, if a transaction is completed it should be durable and its effects should last. The database management system log ensures the undoing of incomplete transactions where necessary. A database must ensure that four very important qualities of a transaction are fulfilled. These are atomicity, consistency, isolation and durability. All transactions should be atomic, meaning that they are supposed to either happen or not. All transactions should run by themselves and should be consistent. By default, the database management system assumes that the transactions are consistent. Transactions should be isolated from the effects of other transactions that are executable concurrently. The effects of the transaction should be consistent once the user is notified of their success even in the event of the crashing of the system. A user is usually responsible for the consistency of their transaction. If a database is in a consistent state when the transaction is beginning, the database should remain in the same state after the transaction is over. The management system for the database does the work of enforcing the commands and other constraints that the transactions should operate on. Every transaction sees the database as consistent. The user issues commands that prompt transactions and assume that each transaction shall be executed by itself; however, the management system of the database arranges the actions to be performed concurrently. The total effect shows the user that the many transactions that they have tasked the system to perform have been executed one after the other[3]. Since transactions are seen as series of read and write commands by the management system, a list of actions is developed. The management system also specifies if the transaction is to be committed or aborted. A schedule is created by the management system for transactions. The schedule is a list of actions, whether read, commit, write or abort that are attributed to a set of transactions. The order in which they happen in the schedule is similar to how they occur in the transaction. The schedule is also seen as an execution sequence of a set of transactions. The schedule describes actions as they are seen by the management system. Transactions are of different types and can be classified according to different classifications. By applications, transactions can be regular or distributed transactions. The transactions can also be compensating or heterogeneous. A compensating transaction has the purpose of undoing the effects of previous transactions. A heterogeneous transaction on the other hand has the runs in a heterogeneous database. By duration, transactions can be classified as short-life or on-line transactions or as Batch or long-life transactions. By structure, there are nested transactions and traditional flat structured transactions[4]. There are other types of transactions, for instance, a sub-transaction is a transaction that must begin after its parent transaction and end before its parent transaction. This means that the commit or abort command of this kind of transaction depends on its parent. The sub-transactions that exist within one parent are executable in parallel. The sub transactions have a special feature of recovering from failures independently without affecting the rest of the database and other transactions. Bibliography Chorafas, Dimitris. Transaction management: managing complex transactions and sharing distributed databases. New York, NY: Palgrave Macmillan, 1998. Gray, Jim and Andreas Reuter. Transaction processing: concepts and techniques. New York, NY: Morgan Kaufmann, 1993. Ozsu, Tamer, and Patrick Valduriez. Principles of Distributed Database Systems. New York, NY: Springer, 2011. Saake, Gunter and Kerstin Schwarz. Transactions and database dynamics. New York, NY: Springer, 2000. [1] Dimitris Chorafas, Transaction management: managing complex transactions and sharing distributed databases (New York, NY: Palgrave Macmillan, 1998), 98.

Oedipus the King Essay Example

Oedipus the King Essay Example Oedipus the King Essay Oedipus the King Essay When given a prophecy, most accept it and live their lives accordingly. From day one everyone did all possible to prove Oedipus’s prophesy wrong, and did all possible to prevent it. Oedipus left his family in route for a new fresh life. Oedipus was naive in disregarding his prophecy, proving that the human race is sheltered from what they see and what they chose to believe. Despite knowing of his prophecy since birth, Oedipus lives his life naive of his foreshadowed destiny. Though countless hints and warnings, Oedipus continues to see past the truth of his prophecy, and only believes what benefits him directly. Oedipus summoned Teiresia to come to Thebes, to help Oedipus solve the mystery of Laius, but ends up setting himself up for his own demise. Teiresia tries to evade telling Oedipus who was responsible, but found himself unable. Though Oedipus knew of his fate and was being told of his past, he still was horrified that someone could accuse him of such a crime. Oedipus was unable to see the reality of this situation; instead he created his own fantasy about prevailing situation. By moving away from his, or what he though was his, family, Oedipus thought he was debunking his prophecy and fate. Feeling so mighty in saving the city and dodging his fate, Oedipus actually made himself small and blind and imperceptive, to what a real man would see and accept. But by, attempting to prove his innocence he actually bought about his own fall. Jocasta to gives Oedipus hints to his true past, but because he is unable to comprehend anything but his idea of the truth, he continues his search of the murderer. Oedipus brings on his own demise by being blinded to what everyone is clearly drawing for him. He is not ready to accept fate or his role in the murder, for he is still in a sense blind to reality. Oedipus, fearing he has murdered a king and his own father, suddenly begins to put the puzzle pieces together, revealing that he indeed murdered his father, Laius. Gorging his eyeballs out and blinding himself was the only way for Oedipus to have a clear vision of reality. Oedipus could not grasp sleeping with his wife and mother, fathering his children and siblings, and murdering his father and king; therefore he had to abandon his resurrected â€Å"life†. Oedipus begged Creon to â€Å"Get rid of me quickly. Deport me To some empty waste land†¦Ã¢â‚¬  Finally excepting his fate, Oedipus wants to go into the mountains where he can die, as he was supposed to do. By blinding himself to the truth for so long, he made it impossible for Jocasta to live, and his children to live normally. By being naive to his fate, Oedipus not only found his demise but compromised the life of the three closest to him. This shows the human race’s refusal to believe anything that would hinder there well being. Oedipus felt superior to the gods, to the oracles, and to fate leading to him overall failure. By being blind, to all that is not rationally seen, we close our minds to the world. Oedipus lived his life closed minded to any thought other than his successful avoidance of his prophecy, therefore missing all the clues that led him straight to it. When we close our minds to anything out of the ordinary, or any thought unlike the desired belief, we create a jaded and fictional reality. If Oedipus had initially accepted his fate, or listened to the truth of Laius’s death, he would have saved the life of his wife and the humility of his two children. Being naive to what is destined to happen causes Oedipus to be blind to what was made very obvious to him. Ironically, he needed to be blinded to see and understand what was so clearly drawn out in front of him.

Describe the tradeoffs of business in a borderless world Assignment

Describe the tradeoffs of business in a borderless world - Assignment Example e need of social interaction, giving low consideration to the slow rate of revenue generation plus the fact that competition is getting far more serious. This situation is what we may call as an unsatisfactory compromise, a business tradeoff, as we may commonly call it. Cambridge International Dictionary of English explains â€Å"trade-off† as â€Å"a balancing of two opposing situations or qualities, both of which are desired. There is a trade-off between doing the job accurately and doing it quickly†¦A trade-off is also something that you do not really want but you accept, in order to have something else that you do want.† (Cambridge International Dictionary of English) In the world of business decision-making, tradeoffs are essential and vital. Applying the same to social networking sites, such as Twitter, tradeoffs play an important role in major business decisions wherein it calls for the need of monetizing its business and generative revenues without sacrific ing the infectious attraction and ease of its features of microblogging. A borderless world signifies a global integration of world economies. A network of partnerships, collaborative joint ventures, business relationships and alliances are formed giving rise to diffusion of new technology and a more open world economy. In a speech given by Everett M. Ehrlich, he envisioned a global marketplace – a borderless economy – wherein epochal information technologies have disintegrated our firms and led to a restructuring of the economic market. (Ehrlich, 2007) What once was an economic setup once barred with walls preventing the sharing of information and strategic solutions is now a solely integrated and symbiotic venture where an exchange of fast and accessible information through various open networks facilitate distribution and action leading to wise business decision-making. In other words, modern companies now demand the highest level of competitiveness in every activity, rather than introducing new

Criminal Justice System Essay Example | Topics and Well Written Essays - 500 words

Criminal Justice System - Essay Example Otherwise, the people would lose confidence in their capacity to protect the people and keep them safe. The most insistent factors that must be considered in the case given are first, the protocol of the police station or simply the rules that they must follow, second, the rights of the suspects and third, upholding justice for the victim. It may seem that all these are very distinct and therefore uncorrelated at first glimpse, but a thorough study will show that they are very much consistent with each other. Given the situation, what I would probably do is to insist to my partner that we redo the interview with me in the room and the same being videotaped. I would make an effort to notify accordingly that affirmative action must be done. This would assert a number of the major things that must be considered in an ethical decision. It would not be far fetch to consider that the confession was coerced. Not to mention that both are minors aged only at 14 years old. â€Å"The ethical t reatment of others requires that we treat them as rational agents who are authors of their own decisions, and not as tools that we may use or manipulate as we like† (Kleinig, 2008). It is by duty that I uphold that justice is served. The mandate for interviews was established for a reason.

Chevy Silverado advertisement, Essay Example | Topics and Well Written Essays - 500 words

Chevy Silverado advertisement, - Essay Example Luther king Jnr in the commercial as the theme song progresses with the words â€Å"I believe there is a dream for everyone† is aimed at provoking the mind of the potential customer that the Silverado is their dream car. It is also a car for the entire American population; black or white. The use of the images of Armstrong on the moon shows it can be viewed as a truck of prestige. The landing of man on the moon was a prestigious occasion for America. The technology involved in doing it could also suggest that the Chevy is a technologically advanced truck. There are images of the hurricane’s devastating effects with an older make of the Chevy being used for the reconstruction. This portrays the Chevy brand as reliable trucks. The three historical events have all brought the American people together. It could be in different fronts but their happening has brought a sense of unity to the country. The Martin Luther King brought the fight for civil rights and won the fight against racial segregation. This united the American races. The landing on the moon for the first time also brought Americans together in pride. The hurricanes that have devastated the people of America have also seen the country unite in agony and gloom. The larger picture is that the car is a unifying factor. They show the Silverado as a car with rich history and indispensible value. Chevy has used these events in their commercial effectively but not accurately. If the events were to compel the buyers, they should have had more emphasis laid on them. The events should have been played slowly. The commercial is very fast paced and has a very busy theme with so many clips flashing by. However, the average American should understand the context. Apart from the used historical events, Chevy could have considered the use of the bombing of the W.T.O. It would have portrayed the vehicle as a strong truck against the background of the falling houses. This would not be any different from the Hurricane

Debate Of Whether Psychology Is A Science

Debate Of Whether Psychology Is A Science Empiricism and Positivism are the two major philosophical influences on psychology; the empiricists brought the concept that all ideas are derived from experience. Experience is the basis of all knowledge. And the positivists further explained that sensory experience which can be shared with others can be objectively studied by observing their overt behavior. Determinism, indeterminism and nondeterminism hold different view on whether psychology is a science. Some aspects of psychology are scientific and some are not. Behaviorist, for example, used scientific method to understand human, while humanists do not used this kind of methodology. It is clearly that psychology is not a pure science instead it scientifically studies the nature of human and animals. Introduction In trying to answer the important and complex question of whether psychology is a science, we will first take a brief look at two major philosophical influences that help to create psychology- Empiricism and Positivism. Then study the view of determinism, indeterminism and nondeterminism of different psychologists to discuss the mind and subject matter of psychology. And finally, try to compare determinism and free will and conclude writers view on this original question Is psychology a science?. Empiricism John Locke, David Hume and David Hartley etc were the British empiricists who stressed that the important of experience in the attainment of knowledge. And the only source of true knowledge about the world is sensory experience which is information that comes to our senses or our inferences between the relationships of sensory facts. The word empirical is often used with the concept of science which implies that science used observation, measurement of the world and collecting data in the environment. This view is contrast with the Rationalists who believed that knowledge is innate and inborn. Locke maintained that the mind at birth was purely nothing, but experiences color it. This idea built into the behaviorist view of learning, like children can be made into anything that environment want it to be. The implication of empiricism on psychology include, firstly, the idea of conscious mind into simple ideas or overt behavior into stimuli response behavior and secondly, provided us the theory of association for explaining how simple elements can be combined to form complex elements or compounds. Thus the empiricist provided for psychology both a theory and methodology that most behaviorists made used of and is still influence todays psychology. Positivism Comte, the positivist, claimed that the only things we can be sure of is thing that can publicly observable. That is, sense experience that can be shared with other people. The data of science is observable and therefore can be trusted and only scientific information can be considered valid. Anything that is not publicly observable is suspect and is rejected because it is not a proper object to study. He did not believe psychology could not become a science because the only way to study the mind is using unreliable method of introspection. To study individual, it can be objectively studied by observing their overt behavior or through phrenological analysis. There are two significant impact of positivism on psychology: firstly, Darwins evolution theory enabled psychology to be placed in field of biological science. Secondly, psychology can be treated experimentally under Wundts psychology laboratory. Determinism All determinists believe that all behavior is caused and there are three kinds of determinism: the first one is biological determinism which emphasizes that behavior can be caused by physiological conditions or genetic predisposition, for example, mental illness was caused because of the lack of neurotransmitter, dopamine, in the brain. And that people will suffer abnormal behavior. Most human behavior is genetically inherited. The second one is environmental determinism, stressed that the environmental stimulus as the determinants of human behavior. For example, behavior theory emphasizes that environmental stimulus determine our behavior. The third determinism is sociocultural determinism, it is a form of environmental determinism, but emphasizes on the cultural factors like rules, regulations and beliefs that govern human behavior. For example, everyone keep quite in the library automatically because the social norm of our culture is no talking in the library. So, the environment factor guides our behaviors. Freud and Skinner, who are both determinists, agreed with the view that human behavior is caused. The neo-behaviorist B. F. Skinner held the view that the person is not free. In his book Beyond freedom and Dignity (1971), he argues that behavioral freedom is an illusion. His famous concept of operant conditioning, suggested that when negative reinforcers are consider along with rewards, then almost all behavior is controlled by association of reinforcement which occur constantly in the environment. What we think that we are behaving freely is not accurate because we are merely free of negative reinforcement or its threat; our behavior is still determined by the pursuit of things that have been positively reinforcing in the past, and consists of responses that have previously been positively reinforced. When we perceive others as behaving freely we are merely unaware of their reinforcement histories and the association that govern their behavior. So, Skinner concluded that behavioral freedom is an illusion. Other determinist, Freud, also rejects the possibility of free will. Every cause of humans behavior comes from within the individuals own unconscious mind; for Skinners view, they are external. However, from the view of inductive nature of science, it is clear that total predictability is impossible. The past does not logically predict the future, if it is true for physics, does it still true for human behavior? And how much more true it is? So if the main requirement of determinism is that behavior should be completely predictable, it does not seem to bring the same reason to the free will view after all. Indeterminism Some psychologists believe that human behavior is determined but since the universe is complex, we cannot accurately measure all the cause of our behavior. As Heisnberg said, despite human behavior is determined, we cannot know at least some of causes of behavior because we change that behavior when we are attempting to observe them. Psychologists who accepted this view believing that there are some specific causes of behavior but that we cannot accurately known. For example, when studying humans thought and behavior, just like social psychologists does in their experiment; one dependent variable can be caused by many independent variables. The problem of youngsters drug abuse can be caused by peer influence, family problem, personal attitudes or others factors. The drug abuse behavior is determined, but we cannot accurately measure or discover all the causes. Determinism versus Nondeterminism (Free will) Our everyday common sense understanding is that people have the ability to choose their own course of action, to determine their lives and, to this extent, have free will. Free will could be exercised within physical, political, environmental and other sociological factors. Sometimes, when we think about the concept of free will, it is also linked to the concept of responsibility; we normally think that people are responsible for what they do since they are the cause of what they do, that is they are not driven by any outsides factors. Most humanists or existentialists, like Carl Rogers, Rollo May and George Kelly etc assume that human behaviors are freely chosen and therefore cannot be tested by scientific method. This belief in free will is contrary to the view of determinism. Therefore, these psychologists are considered nonscientific. These psychologists are strongly influenced by the concept that our nature of experience and our knowledge of the external world are determined on how we interpret and define it. The universe is occupied only by the minds, and physical objects depend on and exist in individuals mind. But the view of positivism in the nature of scientific psychology is different. They imply that behavior is determined by external events or stimuli and that people response to it passively and, to this extent, are not free. Determinism also implies that behavior is totally predictable, as they occur in a regular, orderly manner. And every human action has a cause. An important distinction can be made between compulsion on the one hand and determinism on the other hand. Free actions are free from compulsion, but this is consistent with them being determined. The view which William James proposed called soft determinism. He argued that the question of free action is depending on the type of cause our behavior has. If our actions have as their proximate cause something like conscious mind, we can see them as free, rational, voluntary, purposive actions. Is psychology a science? Is psychology science? Some aspects of psychology are scientific and some are not. The psychologist used scientific method have provided very much useful information in every major area of psychology, for example, memory, personality, learning, perception, intelligence, motivation and psychotherapy. Structuralism, behaviorism and cognitive psychology used scientific method to study the nature of human being. In structuralism, psychologists try to identify the elements of the humans conscious thoughts and feelings. Then, its work is replaced by behaviorism which its emphasis on the objective observation of the behaviors of adults, children and animals. While cognitive psychologists recognize that cognitive process can be inferred from observable behavior and be studied under experimental setting. And these three aspects have a clear definition of subject-matter, a fundamental assumption of learning, it allows prediction and control and it is a methodology, with the controlled experiment. Psychology cannot be concluded as a totally science, some even said that psychology is rather a pseudo-science or it is still in a pre-scientific stage. Since some aspects of psychology, for example the subjective mind cannot be tested scientifically as it can change from time to time. When answering the question Is psychology a science? It can be concluded that psychology is not a normal science. Whether or not we consider psychology as a science depend on which aspect of psychology we are focusing on. Clearly that not all psychologists are methodological, for example, psychoanalytic and humanistic psychologists. If we change the question to Is psychology science? It is surely answered that psychology is scientific. Conclusion

Superstitious :: Free Essay Writer

Superstitious R.L. Stine who is one of America’s best-selling authors and the devilish creator of the Fear Street and Goosebumps series of horror stories for kids. Stine is who wrote the book I read, but he came back with a book for the older generation. All of Stines ideas in his books are suggested from real life. Most of his ideas came from his imagination and his memory. He now lives in New York City with his wife Jane, and teenage son, Matthew. The story took place on a small Pennsylvania College campus. Numerous of murders had taken place. Every murder was much more gruesome than the first. The detectives didn't know what had happened. The victims looked like an out of control animal rather than a human killed them. One of the main characters in this was Sara Morgan. She had just moved to Pennsylvania or school. Everything was going just fine until she met a professor named Liam O'Connor; he was another main character. Liam had a dashing romantic figure with a Irish accent, good looks, sweet charm, and a host of Old World superstitious-all of which dazzled Sara. Plunging headlong into a sudden love affair, Sara barely had time to notice the horrible events taking place on the campus. Liam was extremely close to his sister Margaret. A little too close that is. Sara and Liam soon got married after a couple of dates. Everyone said it was strange, yet, too soon for him or her. But she claimed she was in love with him. She started receiving crank phone calls, warning her to stay away from Liam. Then she received two bloody rabbit feet in the mail saying " If you’re going to marry Liam, you’re gonna need all the luck you can get." That scared her to death. When she told Liam about it, he acted like he didn’t care. Instead he blew all up in her face because she left out the front door and came in through the back door. Lately his superstitions had been getting out of hand. And he had been getting real mad at Sara. On their wedding night they made love by the light of sixteen candles, which was one of his superstitions. They were going on, non-stop. Then he whispered in her ear that he wanted to impregnate her. She accepted the offer without really thinking.

Rousseau as Totalitarian?

ROUSSEAU AS TOTALITARIAN? Rousseau, known as â€Å"Father of Modern Democratic Theory†, was being accused by other people as a â€Å"Father of Totalitarianism†. This is one of the contentious issues which attack Rousseau’s social contract; he is seen to be advocating totalitarian solution rather democratic. Others may have only misunderstood the concept of totalitarianism but I tell you there is no clear evidence showing he is in favor of totalitarian. Why, then, some considered Rousseau as a totalitarian? Maybe it goes with his controversial concept of general will.The general will can be perceived as an objective truth to which every citizen must conform. Therefore everybody was under the control of the general will. Since totalitarianism is defined as a  political system  where the state holds total authority over the society and seeks to control all aspects of public and private life whenever necessary; this means that the general will can be use as a tot alitarian device. But the methods suggested for discovering the general will were basically democratic.This concept was introduced to prevent exploitation and this will only take effect if it is willed by the citizens. In this case, we can see that Rousseau was proposing that the best way for a community to make decisions was really to use democratic procedures. Hence, we cannot condemn him being a totalitarian advocate just because general will reigns. After all, even if it controls every citizen, it still comes from all and it tends always to the preservation and welfare of the whole and every associate.Another thing that can probably make people thinks of Rousseau’s social contract as a totalitarian is due to his view of â€Å"majority binds the rest†. Rousseau was aware that no particular human being knows what the general will truly is that is why he proposes that what the majority has voted, it is the general will, assuming that everybody is thinking for the comm on good of the community and not for his own self-interest. Now problem the decision of the majority is what rules the community and we don’t even know if they are really thinking for the common good of everybody.They maybe considered as one political group who reigns over the community. This cannot be a valid reason for saying that Rousseau was after a totalitarian government. Remember Rousseau has insisted that the sovereign is the people and not a particular group only. And at the start of the compact, before they have voted for what they think is general will; the people should give their consent to all the laws that will be passed even in their opposition.Despite that the decision of the majority wins, the people still has participated in determining that certain law. Rousseau was merely proposing measures aimed at creating community cohesion and preserving democracy. We can now say that his proposal was really an authentic attempt of finding a form of association which will defend and protect with the whole common force the person and goods of each associate, and in which each, while uniting himself with all, may still obey himself alone, and remain as free as before.

Definition and Examples of Tautologies in English

Definition and Examples of Tautologies in English   In grammar, a tautology is a  redundancy,  in particular, the needless repetition of an idea using different words. Repetition of the same sense is tautology. Repetition of the same sound is tautophony. In rhetoric and  logic, a tautology is a statement that is unconditionally true by virtue of its form alonefor example, Youre either lying or youre not. Adjective: tautologous or tautological. Examples and Observations Here are examples of tautology in use by famous authors in their work: It took only as many minutes to find the following half-dozen examples in one days crop of papers: A major nuclear disaster could have been sparked off . . .. . . who died of a fatal dose of heroin. . . equalized the game to a 2-2 draw. . . kept it from his friends that he was a secret drinkerDirty Den has made up his mind never to go back to EastEnders, finally severing his connection with the soap . . . a group for one-parent single mothers Tautology is either unnecessary elaboration (the Inland Revenues white-collar workers), pointless repetition (pair of twins), superfluous description (Europes huge butter mountain), a needless appendage (weather conditions) or a self-cancelling proposition (He is either guilty or not guilty). (Keith Waterhouse, Waterhouse on Newspaper Style, rev. ed. Revel Barker, 2010)At the risk of being redundant and repetitive, and redundant, let me say that tautology is the last thing children need from their parents, especially when they are in trouble.Whatever you have to say, whatever you do, avoid tautology. Try to say it only once! (Tom Sturges, Parking Lot Rules 75 Other Ideas for Raising Amazing Children. Ballantine, 2009)The new public management has brought new ailments, particularly tautology. You often see such phrases as first class organizations are those that perform excellently. (David Walker, Mind Your Language. The Guardian, Sep. 27, 2006) Mark Twain on Tautological Repetition I do not find that the repetition of an important word a few timessay, three or four timesin a paragraph troubles my ear if clearness of meaning is best secured thereby. But tautological repetition which has no justifying object, but merely exposes the fact that the writers balance at the vocabulary bank has run short and that he is too lazy to replenish it from the thesaurusthat is another matter. It makes me feel like calling the writer to account. (Mark Twain, Autobiography of Mark Twain. University of California Press, 2010) Tautologies in Logic In common parlance, an utterance is usually said to be tautologous if it contains a redundancy and says the same thing twice over in different wordse.g., John is the father of Charles and Charles is a son of John. In logic, however, a tautology is defined as a statement that excludes no logical possibilitiesEither it is raining or it is not raining. Another way of putting this is to say that a tautology is true in all possible worlds. No one will doubt that, irrespective of the actual state of the weather (i.e., regardless of whether the statement that it is raining is true or false), the statement Either it is raining or it is not raining is necessarily true.(E. Nagel and J. R. Newman, Gà ¶dels Proof, 1958  A  tautology is  a statement that is logically, or necessarily, true or is so devoid of content as to be practically empty (and thus true because completely empty statements, making no claim, cannot be false). Example: Scott Peterson did it or he didnt.  (Howard Kahane and Nancy Cavender,  Logic and Contemporary Rhetoric, 10th ed. Thomson Wadsworth, 2006) Tautology. Yes, I know, its an ugly word. But so is the thing. Tautology is this verbal device which consists in defining like by like . . .. Since it is magical, it can of course only take refuge behind the argument of authority: thus do parents at the end of their tether reply to the child who keeps on asking for explanations: because thats how it is, or even better: just because, thats all. (Roland Barthes, Mythologies. Macmillan, 1972) Tautology as a Logical Fallacy One of the most boring fallacies, the tautology, basically just repeats the premise. FAN: The Cowboys are favored to win since theyre the better team.​  (Jay Heinrichs, Thank You for Arguing: What Aristotle, Lincoln, and Homer Simpson Can Teach Us About the Art of Persuasion. Three Rivers Press, 2007) Pronunciation: taw-TOL-eh-jee Also Known As: pleonasm EtymologyFrom the Greek, redundant

The Discovering of Puerto RIco Essay Example

The Discovering of Puerto RIco Essay Example The Discovering of Puerto RIco Essay The Discovering of Puerto RIco Essay The Discovering of Puerto Rico?Can this be any be more ironic. Boriquen was the name given to what we today call Puerto Rico and it was already discovered by Arawak Indians.So why do we date the discovery only when the Europeans came into the picture, 1493.Most of us are aware of what the European did to the native Indians and how the brought over the Africans and inslaved them.Ifwe could go back time we would have wished things had been dault in a different, more peaceful way.But since we cant go back in time we have to accept that now we are who we are because of those events.And since we cant change the past we should try our best to change the future by not being prejudice. On Christopher Columbus 2nd voyage he brought 17 ships, about 1200 men, stores for round trip voyage of 6 months.Also seeds, plants, animals, tools for agriculture and construction.Obvious that Spain intended to colonize not just explore.But the most important things they brought was language th at today is still spoke, religion that is still practice and a way of remembering this of years and years gone by, written history.When he sailed out of Cadiz September 1493, and made a stop at the Canary Islands in October, those who joined him on the second voyage probably had no idea how they would change, andthere great great grandkids would be part Dominica was thefirst of many island that would be discovered found for thefirst time by European.Followed by Mariegalante, Les Saintes, Desirade, Guadeloupe, Monserrat, Antigua, St. Martin, St. Croix, and the Virgin Islands name after the mythical story ofSt. Ursula and the 11,000 virgins that were killed by the Hauns when they were visiting the holy shrines of France, Spain, and, Portugal.Thefirst sign for a what we

FIXED-PRICING CONTRACTING Essay Example | Topics and Well Written Essays - 250 words

FIXED-PRICING CONTRACTING - Essay Example labor and materials. Therefore, by using these indices the profitability and going concern of small businesses is shield from fluctuating economic conditions. Thus, when there are serious doubts about the economic environment’s stability for prices of labor and materials used by small contracting firms during the period of performance of contract, it is eminent all pre-defined contingencies subject to fluctuations are measured and determined (Stanberry, 2012). Therefore, the fixed-price contracts EPA are the most appropriate type of contacts for small businesses not enjoying any economies of scale and having the desire to grow and expand in a hostile environment where rivalry between firms for the limited market share is intense. Thus, small business owners can take advantage of favorable economic conditions to make supernormal profits when price adjusts upward by negotiating high terms for the ceiling of contract price and negotiating low base level prices during adverse economic

ITM 501 Mgt. Information. System. and Bus. Strategy SESSION LONG Essay

ITM 501 Mgt. Information. System. and Bus. Strategy SESSION LONG PROJECT 1 FRITO-LAY, NASA & GOOGLE - Essay Example The definition of Knowledge management is similar in the three cases and there is a clear focus on accumulating all the knowledge that is available across the organization to build one strong and effective knowledge database. The three companies have faced several problems. Taking the case of Frito Lays, it is clear that the company faced the issue of working unnecessarily to find customers and for sales. It is noted that all the employees worked on the same processes to gain the same information. In the case of NASA, the problem that the organization faces is that it needed a central point for all the information to be provided so all employees in the organization can learn and benefit from the previous mistakes and experiments of others in the organization (DowJones). Also the issue is the amount of risk involved in the space exploration and the human space flights which indeed need a through and well designed and implemented work to ensure that all the NASA employees have the specialized knowledge and are in track with all the events that occur within the company. The lack of centralized point was the main issue of NASA (Murphy and Holm). In the case of Dow Jones, the company has a wide range of data and knowledge and is spread across the over 157 countries with over 23 languages. Hence again the company lacks a well designed and centralized place for all information. The solution implemented by each of the companies is very similar and there is a main idea of developing a centralized control for the company employees to easily access and use to work more effectively (Murphy and Holm). One of the only major differences that is present is that NASA has a more developed and has used higher technology to develop a more complex system, this however is simply due to the nature of the business. The solutions have been

Career management in business Essay Example | Topics and Well Written Essays - 1000 words - 1

Career management in business - Essay Example In the changing demands by businesses in the modern era, career management is a necessity to adapt to the changing environmental demands. The mode in which careers are studied in the organizational context take the form whereby careers are shaped by organizations and they as well shape themselves up through both theoretical and systematic approaches (Denison, 1996). It is often interesting to realize how the day to day work around companies and businesses are based on technology hence the way in which work is conducted around such work places is highly altered. It is also worthwhile to realize how scientists are on the rise in terms of numbers hence the crop of modernization is likely to go up. To cope up with all theses changes at the work place it is advisable to therefore be necessary to keep our knowledge current and skills (Arthur, Inkson & Pringle, 1999). II. The Career Management Practices in use today To mange an employee’s career plan successfully so as to achieve the necessary development some of the following practices may be adopted. First, provide the employees with career planning workshops while conducting constant assessment on them. The managers should be placed under career workshops. Employee career centers can be created within the organizations to encourage employees to constantly go for performance check (Fombrun, Tichy & Devanna, 1984). The management can also give open career briefing to enable the employees have a chance of planning their careers. These can be within a defined timeframe or through the relevant media to ensure that there is no lapse at all. Furthermore, a team of internal network of information providers so that information can always reach the parties concerned of for example the nature of work and their job qualifications. The internal job and talent banks ought to be maintained since it enables employees to frequently peruse through which employees learn about open positions and the skills required from them. O ther practices include: - establishment of individual learning accounts, starting a mentoring program formally as they are effective in ensuring employee retention by quite a big percentage (Ghoshal & Bartlett, 1997). III. Why organizations should implement supportive career management practices There are numerous reasons as to why it is appropriate for organizations to adopt and implement career management practices most so due to the changing work environment and dynamic workforce. Firstly, such practices enable the employees take charge of their careers by in the first instance assessing their abilities, interests and values. Such practices will enable the employees engage in planning process where they dig deep into the organizations needs hence determining the future options for the organizations and how to prepare for them. Secondly, through the career management practices, managers in many business organizations are able to learn how to support and reward employee efforts thr ough becoming familiar with their career assessment and planning process hence practicing vital techniques of career planning. Thirdly, career management practices can create a situation in the organization where services become automated and modernized hence able to incorporate all round feedbacks, competency assessment, confidential counseling, career management and resilience training (Gratton, 2000). Furthermore, career management

Ophelia can be viewed as an insignificant minor character Essay Example for Free

Ophelia can be viewed as an insignificant minor character Essay Ophelia can be viewed as an insignificant minor character in the play through the way she is used as an unwitting pawn in schemes of those who have control over her, as revealed in Act 2 Scene 2 where Polonius says I will loose my daughter to him when he and Claudius plan how they will test Hamlets madness. The word loose objectifies Ophelia, portraying her as an animal used as bait for Claudiuss own objectives; spying on Hamlet. Ophelias character does not have a say in the matter, and through her absence in this particular scene, Shakespeare is able to emphasise her insignificance in the play. Ophelias lack of appearance in the play also portrays her character as minor and insignificant, as Shakespeare only uses her character in 5 scenes. For the majority of these scenes, Ophelia has little contribution to the dialogue and her spoken lines are often responses to questions and commands by others who dominate the play, for example in Act 1 Scene 3 Ophelias responses are short in comparison to her fathers and brothers dialogue, most of which contains instructions on how Ophelia is expected to act; Do not believe his vows Look tot I charge you. Come your ways. The use of imperatives in this scene show how Ophelia is dominated by others and is therefore highlight her insignificance in the play. This is further portrayed in Ophelias responses, such as I shall obey, my Lord. The use of my Lord reveals her inferior status and through minimalistic speech we are able to gain a sense of her unimportance to the action of the play. Another way in which Ophelia may be viewed as insignificant is in her marriage prospects. Her brother Laertes, who suggests that she is not good enough for Hamlet, condemns her relationship with Hamlet, who tells her to regard Hamlets love as something unlikely to last and potentially dangerous: Fear it my dear sister. Hamlet is a prince and therefore Ophelias status makes her inferior in comparison and as a result, an unsuitable wife. Both her brother and father tell Ophelia how to behave, for example Polonius instructs Ophelia to spend less time with Hamlet; Be something scanter of your maiden presence. This dominance over Ophelia, as well as her subservience, again presents her of an insignificant status in the play. Ophelia does not say or do anything to indicate she is unhappy about the instructions given to her by her brother or father. However, another interpretation of Ophelias subservience is that obedience is a role she plays. She is expected to act as a loyal daughter and responses such as But as you did command suggest she is carrying out orders to keep her father content. Shakespeare reveals a weak Ophelia in Act 4 Scene 5 in which she is in a state of madness, through her songs about death, chaos and unrequited love. The poignancy of her songs (He is dead and gone lady, he is dead and gone) as well as the reactions of other characters (Alas sweet lady), induce a piteous reactions, allowing the audience to sympathise with a character who has become so weak it has led to madness. In contrast to her minimalistic speech, in Act 1 Scene 3, Ophelia has dominated the speech. This may suggest that Ophelias character is only of significance when she is in a state of madness. The taboo nature of her songs reveals a character stepping out of the bounds of her social status and this contrasts to how her father has ordered her to act. The death of Polonius may be a cause of Ophelias madness and this is evident when Claudius says Oh this is the poison of deep grief; it springs all from her fathers death. This may suggest that Ophelia becomes weak without the presence of the dominant male authority. Her father is dead, her brother is absent from the country and she has been rejected by Hamlet; without them Ophelia collapses. Shakespeare presents Ophelia as weak in Act 4 Scene 7 where she is unable to save herself: As one incapable of her own distress. The suggestion that Ophelia has committed suicide may have been used by Shakespeare to imply that Ophelias weak state did not allow her to go on living. Shakespeare uses Ophelias character to portray many aspects of Hamlets character, for example Shakespeare is able to reveal Hamlets capability of staggering cruelty through his treatment of Ophelia in the nunnery scene. Shakespeare presents this cruelty through the use of brutal commands and insults such as Get thee to a nunnery. In Act 2 Scene 1 Ophelia presents herself as a victim of Hamlets rough treatment; He took me by the wrist, and held me hard, revealing Hamlets capability of cruelty. There is also evidence of Hamlets cruelty when he embarrasses Ophelia in public, asking her Do you think I meant country matters? Hamlets wit enables him to belittle or mock other characters and the fact that there is little sign of Ophelias character reinforces the idea that she is a minor character. Another thing that is revealed about Hamlet through Ophelia is Hamlets judgment of women. In the nunnery scene, Hamlet accuses Ophelia; You jig, you amble, and you lisp, you nickname Gods creatures, and your make your wantonness your ignorance, revealing his disgust towards women. Shakespeare lists the deceptions to reinforce Hamlets repugnance towards the women in his life. Once again Shakespeare has revealed Hamlets feelings through his words to Ophelia. Ophelias character is also used to portray ideas about other characters, for example when handing out flowers to other characters, Shakespeare develops ideas about the nature of other characters through the type of flower that Ophelia gives to them. For example, one of the flowers she gives out is a daisy, which represents deception an act that could be linked to Claudiuss character. By doing this, Shakespeare is using Ophelia in this scene to indirectly criticise the characters, and the connotations associated with the various flowers would be widely understood by the audience in Shakespeares day. It could be argued that Ophelia is chiefly interesting for reasons other than what she reveals about Hamlet, for example Ophelia is important in the manner in which she illuminates discussion of some of the plays central themes, one of which is the oppression of women in society. Shakespeare presents Ophelia as oppressed through her lack of opinion and contribution in the play. The mere fact that she can be viewed as insignificant shows the audience that Ophelia is oppressed by male authority in the family. Polonius tells Ophelia that she speaks like a green girl, implying that she is nai ve, and this comes across to the audience as patronising. The alliteration of green girl emphasises Poloniuss condescending tone. By belittling Ophelia, he is able to gain control of the conversation. Ophelia is told to think herself a baby, suggesting that she is constrained from using her own mind and must follow the orders given to her. Ophelias character is presented as one with no point of view; as she says I do not know my Lord what I should think. Through statements such as this, Shakespeare reveals an oppressed Ophelia who is unable to think for herself due to the strict control by men in her life. The fact that Ophelia is being used as a pawn in mens political affairs is also a sign that she is being oppressed. When Polonius offers to loose Ophelia, he is taking advantage of her by offering her as a service without her consent. This also portrays Ophelia as a possession that belongs to Polonius. On the other hand, it could be argued that Ophelias character is not oppressed, but in fact in need of male control. In Act 1 Scene 3 Ophelia says I shall theffect of this good lesson keep as watchman to my heart. The use of good implies that the advice is necessary for Ophelias well being and is taken on by her with a positive attitude. When asked by Laertes to remember what she has been told, Ophelia responds by saying Tis in my memory locked, and you yourself shall keep the key of it. This statement also shows Ophelia is willing to take on her brothers advice. This argument can be supported by the idea that Ophelia collapses without her father or brother, and that she in fact benefits by being in their command. Ophelia is also significant as her character is crucial for the plot and setting the scene in the play, for example, in part it is her death that motivates Laertes to take revenge on Hamlet. Another example of the importance of Ophelia in the plot is that her death is used by Shakespeare as a catalyst for confrontation between Hamlet and Laertes.

Essay --

Tooth and Claw, by T.C Boyle, is a short story about the main character, Junior, a man who only depends on others to get by, and struggles in life because of it. In life, we all find ourselves searching for alternative reasons as to why things don’t always workout the way we hoped they would; however, more often than not, the real reason lies within ourselves, no one or nothing else. It is up to that person to make something happen, and junior fails to do this, always relying on others. As if the title wasn’t enough, the short story is packed with symbolism, one of which being that, like the wild cat he had won, Junior is nothing without someone to take care of him, and he fails to be the change he wishes to see in the world. This is displayed in multiple Scenarios throughout the short story. From the start it is clear that Junior is confused when his boss calls him and tells him not to come in for the day, but instead â€Å"take a couple days off and enjoy yourself†(Boyle 62).Without the direction of his boss and his job, Junior doesn’t know what it is he should do with himself for the day and he seems lost and turns to the comfort of drinking it away at his favorite bar, Daggett’s. Junior acts as if he needs direction of someone else, as pet would, to function. While drinking at the bar, in a haze, Junior wins a wild several that I man were trying to get rid of. This draws the attention of a waitress at the bar he has had his eyes on, Daria. When they get the cat home, they confine it to juniors bedroom, and he claims it hadn’t made a noise yet, but â€Å"†¦It’s existence communicated to me, it was there, I could feel it† (Boyle 72), showing that he connected with the animal and perhaps relates to it. Junior appears to worry greatly ab... ...egins to think of how far away and lost the cat must be, and without being certain that it had escaped, throws himself into the enclosed bedroom and shuts the door behind him, he explains â€Å"And then-and I don’t know why-I pulled the door shut behind me† (Boyle 83), in the instance, severely risking his life; however, like the several, feeling helpless and lost, he seems to be acting on impulse and not bothered by it. The title of the short story, Tooth and Claw, demonstrates the basic needs of survival in the wild, as most animals in the wild have both. While also tying into the symbolic several and metaphorically relating to Juniors life as well because he does not have the necessities to live on his own. The story has a hidden message, which portrays junior’s life lacking â€Å"Tooth, and Claw†, or necessities for survival, proving that it was eventually his downfall. Essay -- Tooth and Claw, by T.C Boyle, is a short story about the main character, Junior, a man who only depends on others to get by, and struggles in life because of it. In life, we all find ourselves searching for alternative reasons as to why things don’t always workout the way we hoped they would; however, more often than not, the real reason lies within ourselves, no one or nothing else. It is up to that person to make something happen, and junior fails to do this, always relying on others. As if the title wasn’t enough, the short story is packed with symbolism, one of which being that, like the wild cat he had won, Junior is nothing without someone to take care of him, and he fails to be the change he wishes to see in the world. This is displayed in multiple Scenarios throughout the short story. From the start it is clear that Junior is confused when his boss calls him and tells him not to come in for the day, but instead â€Å"take a couple days off and enjoy yourself†(Boyle 62).Without the direction of his boss and his job, Junior doesn’t know what it is he should do with himself for the day and he seems lost and turns to the comfort of drinking it away at his favorite bar, Daggett’s. Junior acts as if he needs direction of someone else, as pet would, to function. While drinking at the bar, in a haze, Junior wins a wild several that I man were trying to get rid of. This draws the attention of a waitress at the bar he has had his eyes on, Daria. When they get the cat home, they confine it to juniors bedroom, and he claims it hadn’t made a noise yet, but â€Å"†¦It’s existence communicated to me, it was there, I could feel it† (Boyle 72), showing that he connected with the animal and perhaps relates to it. Junior appears to worry greatly ab... ...egins to think of how far away and lost the cat must be, and without being certain that it had escaped, throws himself into the enclosed bedroom and shuts the door behind him, he explains â€Å"And then-and I don’t know why-I pulled the door shut behind me† (Boyle 83), in the instance, severely risking his life; however, like the several, feeling helpless and lost, he seems to be acting on impulse and not bothered by it. The title of the short story, Tooth and Claw, demonstrates the basic needs of survival in the wild, as most animals in the wild have both. While also tying into the symbolic several and metaphorically relating to Juniors life as well because he does not have the necessities to live on his own. The story has a hidden message, which portrays junior’s life lacking â€Å"Tooth, and Claw†, or necessities for survival, proving that it was eventually his downfall.

Biography John F. Kennedy :: essays research papers

May, 29, 1917, in the wooden three-story house in Brookline, Massachusetts, John Fitzgerald Kennedy became the second child in the Kennedy family. Joe Jr. is his two-year older brother. In all, Rose Fitzgerald and Joseph Patrick Kennedy would have nine children, four boys and five girls. Before long, family and friends called the blue-eyed baby, Jack. When Jack was three, the family moved to a twelve-room house just outside of Boston. Joseph Kennedy was running his own stock trading business and was working hard to ensure his family a wealthy life. The Kennedys had everything they needed and more; Jack could enjoy a very comfortable life. He was sent to Choate, boarding school in Connecticut, where he was very popular and had many friends. He played tennis basketball, football and golf. Jack graduated from Choate, and in 1936 he started his first year at Harvard, where Joe was already a student. In 1937, Mr. Kennedy was appointed U.S. Ambassador to England. The family, with exception Joe and Jack, who were still in Harvard, moved to England. Jack became even more interested in politics, world affairs and also visited Europe a couple times. World War 2 began and John Kennedy wrote a thesis why England was not ready for the war against Germany, which was so good that it was later published as a book. After graduating Joe and Jack joined the Navy. Jack became the Lieutenant of a torpedo boat in the South Pacific. On a dark night in 1943 the boat collided with a Japanese destroyer and sank. In the cold water Lt. Kennedy managed to gather his men around a piece of boat. At sunrise he led them toward a small island several miles away. He was awarded with the Navy and Marine Corps Medal for his leadership and courage. His brother though, was not that lucky; he died a year later when his plane blew up on a mission in Europe. After the war Jack was uncertain what kind of work he wanted to do. He had considered becoming a teacher or a writer, but the death of his brother changed everything. His father finally convinced him that he should run for a seat in the House of Representatives, which he won in 1946. This was the beginning of his political career. After serving three years, he was elected to the U.S. Senate in 1952.

Health Financing in India

Institute for Financial Management and Research Centre for Insurance and Risk Management Delivering Micro Health Insurance Through the National Rural Health Mission A Strategy Paper Rupalee Ruchismita, Imtiaz Ahmed and Suyash Rai August 2007 Rupalee Ruchismita (rupalee. [email  protected] ac. in) and Imtiaz Ahmed ([email  protected] ac. in) are with the Centre for Insurance and Risk Management at IFMR, Chennai (http://ifmr. ac. in/cirm). Suyash Rai is with the ICICI Centre for Child Health and Nutrition, Pune. The views expressed in this note are entirely those of the authors and do not in any way re? ct the views of the Institutions with which they are associated. . Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission Contents 1 Introduction 2 Health Financing in India 3 Key issues in Health Financing 4 Exploring Risk Transfer and Pooling Strategies 5 Proposal for a National Apex Body 6 Conclusion 7 Annexures 7. 1 ANNEXURE I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. 2 ANNEXURE II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. 3 Objectives, Activities, and Services . . . . . . . . . . . . . . . . . . . . . . . 1 1 3 4 8 13 14 14 19 22 0 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission 1 Introduction The Indian health scenario is fairly complex and challenging with successful reductions in fertility and mortality offset by a signi? cant and growing communicable as well noncommunicable disease burden1 , persistently high levels of child undernutrition2 , increasing polarisation in the health status of the rich and the poor3 and inadequate primary health care coexisting with burgeoning medical tourism! This situation is further complicated by the presence and practice of multiple systems of medicine and medical practitioners (several of whom are not formally certi? ed and recognised) and very limited regulation. In such a context, this paper highlights the challenges in ? nancing health in India and examines the role of health insurance in addressing these. It proposes an operational framework for developing sustainable health insurance models under the National Rural Health Mission, responding to the contextual needs of different states. 2 Health Financing in India The total spending on the health sector in India is not low. According to the National Health Accounts 2001-02, the total health expenditure in India for the year was Rs. 1,057,341 million, which accounted for 4. 6 percent of the Gross Domestic Product (GDP). The concern lies in the fact that households are the major ? nancing sources, accounting for 72 percent of the total health expenditure incurred in India. State Governments contribute 12. 6 percent of the total health expenditure, Central Government 6. 4 percent and the public and private ? rms 5. 3 percent. External support from bilateral and multilateral agencies accounts for 2. percent of health expenditure in India, a majority coming in as grant to the Central Government. So, only about 20% of the overall funding comes from India accounts for only 16. 5% of the global population, it contributes to approximately a ? fth of the world’s share of diseases: a third of the diarrheal diseases, tuberculosis, respiratory and other infections, parasitic infestations and perinatal conditi ons; a quarter of maternal conditions; a ? fth of nutritional de? ciencies, diabetes, cardiovascular diseases, and the second largest number of HIV/AIDS cases in the world. Report of the National Commission on Macreconomics and Health. 2005. New Delhi: Ministry of Health and family Welfare. ) 2 National Family Health Survey III, 2005-06. Mumbai: International Institute of Population Sciences. 3 The poorest 20 percent of Indians have more than twice the rates of mortality, malnutrition, and fertility of the richest 20 percent. (Peters DH et al. Better Health Systems for India’s Poor. 2002. New Delhi: World Bank. 1 Although 1 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission he government, which is one of the lowest in the world. This is a signi? cant problem in a country where the government has mandated itself to provide comprehensive quality health care to all. The problem of household expenditure for health care is compounde d by the fact that 98 percent of this is â€Å"out-of-pocket†, which is fundamentally regressive and burdens the poor more. Also, the absence of proper pooling and collective purchasing mechanisms for the households’ money further worsens the situation because of the resulting inef? ciencies. Most of the household expenditure on health goes to the fee-levying and largely unregulated private providers. The share of household consumption expenditure devoted to health care has also been increasing over time, especially in rural areas where it now accounts for nearly 7 per cent of the household budget4 . This situation is not surprising since public and private expenditure on health are closely linked. Given that government spending on health stands at less than 1 per cent of the GDP, which is very low by international standards, the need for private out-ofpocket expenditure increases. Seventy percent of the total ? nancial resources ? ow to health care providers in the for pro? t private sector. Only 23 percent are spent on public providers. In an environment of minimal regulation, this provides signi? cant opportunity for the exploitation of health care seekers. In addition, there are signi? cant inter-state differences in health ? nancing. Among the major states, Himachal Pradesh ranks highest in terms of per capita public spending on health (Rs. 493 per year) and also has the highest public expenditure as percentage of total expenditure (37. 8%). On both these parameters, Uttar Pradesh is the lowest ranking state, with a per capita public spending on health of Rs. 84 per year, and only 7. 5% of the total health expenditure is public expenditure. All India per capita expenditure on health is Rs. 997 (207 from public and 790 from private)5 . There are also indications of declining state government spending in crucial areas. Overall health spending declined over the decade 1993-94 to 2002-03 in 3 states, and declined between 1998-99 and 2002-03 in 6 4 Government Health Expenditure in India: A Benchmark Study. 2006. New Delhi: Economic Research Foundation. All India public expenditure including expenditure by the Ministry of Health and Family Welfare, Central Ministries and local bodies, while private expenditure includes health expenditure by NGOs, ? rms and households. 2 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission states6 . There are also sharp and generally growing rural- urban disparities in spending in most states. 3 Key issues in Health Financing Drawing from the above analysis and other related literature, the following emerge as the key issues in reforming health ? ancing in India. Increasing government spending on public and more speci? cally, primary health care As discussed earlier, the government spending on public health in India, constituting about 4% of its total expenditure and less than 1% of the GDP, is very low. In per capita terms, the government spends only USD 4 annually on public health. According to the World Health Report (2000), only twelve other countries spend less than India on public health, most of them in Africa. For most other nations, government spending on health is more than 10 percent of the total government expenditure. The Commission on Macroeconomics and Health has estimated that public spending in low income countries should be within the range of $30-$45 per capita to ensure achievement of public health goals. In India, most of the government spending is on medical colleges, into tertiary centres, and very little trickles down to the primary and secondary levels. There is therefore a strong case for increasing government spending across the board, with a much higher focus on primary care services. This will reduce the need for spending by the poor and also improve the overall health status. The options for increasing public ? ancing of health include reallocation of the government budget (possibly by re-routing other direct and indirect subsidies) and earmarked taxes (such as the taxes levied for ? nancing the Sarva Shiksha Abhiyan). Addressing the supply and demand-side factors that prevent the poor from bene? ting from the health sector In general the poor bene? t much less from the health sec tor than the rich do largely because of their inability to seek timely and adequate health care. The poorest quintile of Indians are 2. 6 times more likely than the richest to forgo medical treatment when ill7 . Government Health Expenditure in India: A Benchmark Study. 2006. New Delhi: Economic Research Foundation. 7 Peters, D. et al. Better Health Systems for IndiaSs Poor: Findings, Analysis, and Options. 2002. Washington 3 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission However, whatever care they do access, the poor are found to rely signi? cantly on the public system for preventive and inpatient care including 93 percent of immunizations, 74 percent of antenatal care, 66 percent of inpatient bed days, and 63 percent of delivery related inpatient bed days. Improvements in the public system through increased and more effective spending would therefore bene? t the poor signi? cantly. Increasing the effectiveness of public health spending would require attention to supply side factors such as facility location, availability of staff, medicines, equipment and quality of care as well as demand-side factors such as indirect costs (travel, wage loss), non formal charges, awareness levels, perception of quality and uncertainty about payment. Mitigating risks due to out-of-pocket expenditure, particularly catastrophic expenditure for the oor At least 24 per cent of all Indians fall below the poverty line because they are hospitalised8 . It is estimated that out-of-pocket spending on hospital care might have raised the proportion of the population in poverty by 2 per cent. Risk-pooling and collective purchasing mechanisms could increase the ef? ciency and equity with which the households’ money is collected, managed and used, so that the households’ burden is reduced. 4 Exploring Risk Transfer and Pooling Strategies Exploring Risk Transfer and Pooling Strategies in the context of the NRHM In attempting to understand the potential of risk pooling or risk transfer mechanisms such as insurance (which immediately addresses the cost which a household spends on hospitalization) in achieving public health goals within the overall NRHM mandate, the following issues become relevant: 1. The potential value addition that insurance could provide 2. The various models of health insurance for the poor 3. Implementation of the insurance programme in the context of the NRHM D. C. : The World Bank. 8 Ibid 4 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission 1. Health Insurance leads to: †¢ Risk pooling for in patient care (hospitalization): As discussed, one of the major causes of poor households slipping into the poverty cycle is out of pocket expenditure incurred for hospitalization. In such a scenario, insurance, which allows for risk pooling, helps in making available additional source of ? nancing for the household thereby reducing overall vulnerability and smoothening expenditure shocks for larger unpredictable catastrophic health events. Increased utilisation of health services: It is expected that the introduction of health insurance will lead to greater utilisation of health care services. Across the world it has been found that the overall use of curative services for adults and children was up to ? ve times higher for members of health insurance programmes than non-members9,10 . †¢ Standardization and cost effective q uality health care: Insurance as a mechanism attempts to standardize protocols, procedures and bring down cost through rate negotiations. This ensures the availability of cheaper healthcare, controlling fraud and possibility of rent seeking behaviour which is high in the case of the poor who have comparatively lesser knowledge about their health status or possible treatment required. Further due to Health Insurance, the out of pocket expenditures per episode of illness are signi? cantly lower for members as compared with those for non-members11 . Under the NRHM it is hoped that a national level expert committee will play a pivotal role in standardizing treatment protocol and rates. Presently such an activity has been undertaken by World Health Organisation (WHO), India-Of? e, in collaboration with Armed Forces Medical College (AFMC). †¢ Cover for access barriers (loss of wage, transportation cost) and new and emerging diseases: It has been seen that since most of the micro insurance models evolved from community institutions and NGOs, they packaged critical P. , and F. Diop. Synopsis of Results on the Community â €“ Based Health Insurance (CBHI) on Financial Accessibility to Healthcare in Rwanda. HNP Discussion Paper. 2001. Washington, D. C: World Bank. 10 Preker, A. S, Carrin, G. SHealth Financing for Poor People – Resource Mobilisation and Risk Sharing. T 2004. ? ? Washington D. C. : World Bank. 11 Preker, A. S and G Carrin. Health Financing for Poor People – Resource Mobilisation and Risk Sharing. 2004. Washington D. C. : World Bank. 9 Schneider 5 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission access barriers as part of their insurance cover. Also, insurance as a concept works on the principle of risk pooling and cross subsidization for low frequency events. The cost of healthcare for life style diseases like diabetes or critical illnesses and HIV/AIDS, is very high. Community Insurance models delivered at a large aggregation can cover for these rare events and ensure that the poor do not fall back into poverty in the process for paying for this high cost event. This has been tried in some schemes like the Arogya Raksha Yojna (ARY)12 . †¢ Development of stronger referral linkages: Insurance as a mechanism to be sustainable requires developing strong upward as well as downward referral mechanisms. Strong referrals ensure non escalation of cases, thus ensuring ‘right care at the right time’, reducing possibilities of collusion and fraud. †¢ Ef? ciency in the health system in terms of: – Allocative ef? iency in addressing the most risky event a household faces i. e. hospitalisation and by diverting the surplus premium to strengthen the health infrastructure and incentivise manpower. – Value for money: Presently the expenditure on health by the poor includes leakages such as transport costs, spurious drugs, unlice nsed medical practitioners who offer health care of sub optimal quality. 2. Various Models of Health Insurance for the Poor Models of micro health insurance may be categorized into the following: †¢ Social Health insurance: Such insurance models are found in about 8 countries across the world. The overall model works with a differential premium payment mechanism where the economically secure pays a relatively higher premium than what their risk pro? le dictates and the poor pay a comparatively lower premium commensurate with their income. This leads to cross subsidization across the rich and poor category. In India it is mostly seen in the formal sector in the form of ESIS and the CGHS scheme. 12 With Narayana Hrudayalaya, Biocon and ICICI Lombard in Anekal Taluka of Bangalore district of Karnataka. 6 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission Community Based Health Insurance (CBHI): There are three basic designs of CBHI, depending on who the insurer is. In Type I (or HMO design), the hospital plays the dual role of providing health care and running the insurance programme. In Type II (or Insurer design), the voluntary organisation is the insurer, while purchasing care from independent providers and ? nally in Type I II (or Intermediate design), the voluntary organisation (NGO/CBO) plays the role of an agent, purchasing care from providers and insurance from insurance companies. This seems to be a popular design, especially among the recent CBHIs13 . The merit14 of the last model is the aggregating role and the context speci? city that the NGO/CBO assumes. Since the NGO has systematically addressed information asymmetry, and also shares the community’s trust, these initiatives show better results (as seen in case of Dhramasthala insurance programme). In the case of a national roll out this can be the best model as it will capture the diverse nature of health requirements in the different NRHM states. The provider model or insurer model may not work out as customisation to local condition becomes the main crux of success or failure of the scheme. Further an NGO along with an insurer will be in a better position to retain the large risk of the community as compared to an individual entity like a provider or an NGO alone. It is crucial to ? nd NGOs that have a long term stake and therefore would act as ‘conscientious players’ who will ensure that the insurance programme, generates long term positive impact on the health system of the speci? c geography. 3. Some suggestions for the proposed Health Insurance Programme As discussed earlier, the health system in India is characterised by grave inequities leading to a political economy that makes health care access income and classdependent. This creates the need to explore various types of innovations and changes that could improve this unacceptable situation. Insurance is potentially one such et al. Community-based Health Insurance in India: An Overview. July 10, 2004. Economic and Political Weekly. New Delhi. 14 The Yeshaswani insurance programme (the large health insurance programme in the country) follows this model through the various cooperatives facilitated by the department of cooperatives. Other example is the Dharamasthala insurance programme where the NGO (Dharmastahala trust) is the aggregator and has about 1 million insured under its scheme. 3 Devadasan 7 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission innovation. However, for health insurance to effectively improve the ef? ciency of health spending and ultimately improve health status, it would need to be conceptualised as a part of a larger effort to improve the accessibility and quality of health care s ervices, especially for the poor. In the Indian context, any health insurance programme will have to take into account the plural nature of the health system, especially the presence of a large fee-levying, unregulated and ill understood private sector. It will have to explore synergies and integration with the widespread public health system and its current ? nancing mechanisms. Questions such as who should pay the premiums for the poor and how should incentives be aligned will have to be carefully thought through to ensure the management of problems such as adverse selection, inadequate monitoring and moral hazard, exacerbated because of extreme information asymmetries inherent in health services and goods. Internationally and within India, there is a signi? ant body of literature regarding the impact of different health insurance programmes on the health system. For the Indian context, it would be important to learn from these various experiences, develop a theory about the mechanisms through which insurance can contribute to public health goals, run pilots in different contexts within India to understand feasibility and impact, and determine the ? nal programme based on these learnings. 5 Proposal for a National Apex Body Proposal for a National Apex Body Working as a Coordinating Centre for Micro Health Insurance: It is proposed that a National Apex Body, ideally placed within the Insurance Regulatory and Development Authority (IRDA), be established to monitor and coordinate the implementation of the micro health insurance operations in the country (see ANNEXURE 2). The Apex body should have capacity in the areas of public health and insurance, host national and state-level dialogues on the idea of insurance in the context of health systems, implement pilots in speci? geographies and take forward the learning, and ensure knowledge sharing so that progressively larger regions can be covered under the micro 8 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission insurance scheme. ANNEXURE 2 provides details of potential roles this apex body (tentatively named Micro-insurance Coordinating Centre) could play in taking forward the agenda of usefully employing the strategy of insurance to get closer to the public health goals of the country, focusing on the vulnerable. It is envisaged that this body should play a knowledge-building, technical advisory, policy advisory, facilitative coordination role with a long-term aim of achieving universal health insurance coverage by an optimal combination of social and micro health insurance mechanisms, in a manner that it integrates seamlessly with the overall health system. The proposed apex body should host a process that ‘arrives’ at a framework of implementing health insurance under NRHM. Based on our understanding, the following emerge as important aspects of any national level health insurance programme developed under the NRHM. The health insurance model under the NRHM should explore the Partner-Agent approach which includes both the insurance partner (risk partner) and the agent (NGO). Based on experiences from the pilots, the insurance cover could be a compulsory, cash less health insurance product with a family ? oater with minimum initial deductibles. Depending on the availability and quality of providers, the insured should have the choice to access the nearest (private or public) health care facility and should be allowed to choose between any provider within a given geographical parameter. The client could be issued a biometric ID card which is updated with diagnostic information and refers her/ him to the desired care provider to control overcrowding at the tertiary facility. 1. Product Cover: To begin with, the product should cover basic hospitalisation at the secondary care level (either at the cluster of village, block or district level). It should include the cost of: †¢ Hospitalisation †¢ Diagnostic services †¢ Medicine and consumables †¢ Consultation and nursing charges †¢ Operative charges 9 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission The product should also try to cover for access barriers like transportation cost (with a initial deductible to control frauds and limited to only the cheapest mode of transport available, customized according to the district), loss of wage (in case of the male or female member of the household as de? ned by the state according to the minimum wage guaranteed by the state government. This could be done in tandem with the National Rural Employment Guarantee Scheme (NREGS). In geographies where investment in directed preventive and promotive services can bring down the need for seeking in-patient care, directed primary care primary level care can be provided by the insurance programme. For example, Directed preventive promotive community health education could lead to reduction in the frequency of inpatient care due to vector borne diseases in several geographies15 . Thus based on the speci? location package of additional community health intervention will be developed, which can be paid from the insurance model The insurance programme can work with District Health Societies to offer rehabilitative care and ? nancial help to patients who have recovered but are disabled due to diseases like leprosy or polio. It can also help the People Living with HIV/AIDS (PLHIV) by providing additional services like providing nutritional supplement and other additional services wh ich will supplement the current care being provided by the national programme for control of HIV/AIDS. 2. Health providers: Both private and public facilities at the secondary care level could be empanelled as providers. Private care hospitals could include nursing homes or 20 bedded medical facilities as seen in the Missionary hospitals as well as entrepreneur led inpatient care. For the government hospitals such as the district hospital, the difference in rates could be used for improving infrastructure and incentivising staff. 3. Building information systems: There is a need for a reliable transparent MIS sys15 For Insurance covering hospitalization due to events that can be impacted by Sspeci? S preventive promo? tive health education, it makes economic sense to proactively invest in Community Health Education, which will reduce the probability of hospitalization due to the event. Vector borne diseases show a high degree of sensitivity to such Community Health Education programmes. 10 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission tem to improve the overall ef? ciency of the system. This would reduce paper work, streamline referral linkages and aggregate data helpful for product customization. The community health insurance model could generate a much needed Electronic Health Records (EHR) system. This would imply that as per commonly agreed terms all health related information of an individual (parameters like diagnostic test results (blood pressure, body temperature, pulse rate, ECG), diseases to which he/she is prone; past illnesses etc) is stored onto a system or a database. This database can be accessed by all ensuring anonymity and therefore all insurers, health workers and policy makers can access and interpret the health data to be able to conduct community risk assessment. This will encourage insurers to compete for risk pricing of the community in the said geography and lead to cheaper insurance premiums. The focus of the EHR system would be to ensure – Universality, Consistency, Open Standards, Non-Proprietary, and Acceptability. To institutionalize a reliable EHR system it should be made compulsory that any treatment/diagnosis/medical intervention be updated into the individual’s EHR, such that the EHR is the most authentic source of health information about an individual. The other challenge that needs to be addressed for development of better health insurance products as well as better health care delivery is the challenge of targeting and uniquely identifying the individual. Such identi? cation could be achieved through a biometric identi? cation smart card. The smart card can be used to not only help in identi? cation, but also for storing of? ine health information With an EHR and smart card system, the insured can freely access b oth the public and private health care facilities available in the geography. This helps the insured as well as the medical practitioners and improves diagnosis and response time. The Smart Card can also be used to store health insurance related information of the client. The health provider can thus check the eligibility of the individual in terms of insurance before delivering treatment. The same card can also be used as a payment instrument to capture the payments that need to be made to the health providers. The card can be used to pass 11 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission n incentives to clients as well as the hospital to keep using the card. The biometric card will have terminals (which can upload data of? ine) in the various network hospitals to upgrade data whenever the insured avail care. 4. Formative Research: a Community Needs Assessment (CNA) will need to be done to list down the health needs and the willingness to pay, a mapping of the healthcare facilities in the geography, an unde rstanding about the type of premium and payout that the community are expecting from the insurance scheme and the broad range of social protection measures that they want the insurance to take up. Based on the information provided above the product and the EHR can be developed. Initially, it is advisable to undertake health insurance pilots in different contexts to develop and ? nalise the health insurance programme. 5. Implementation and monitoring: The proposed National Apex body, should monitor and coordinate the implementation of the micro health insurance operations in the country (see Annexure- 2). The following ideas can potentially strengthen the monitoring and implementation of the programme: †¢ The District Health Accounting System and the proposed ombudsman (to be created under NRHM to monitor the District Health Fund Management) will work closely with the NGO and the insurer to ensure the smooth running and monitoring of the programme. †¢ At the backend, the insurance programme with the EHR system will develop a rich data source and act as a Fraud control mechanism. This data will help in identifying disease patterns for the community and could be a critical tool for the NRHM team to de? e ? nancial allocations, target services and make evidence based policy recommendations. (While developing this EHR we should ensure that we are following international standards to be able to be coded properly and stored in a card). In the long run, this apex body should aim at achieving universal health insurance coverage by combination of social and community based health ins urance mechanisms. There is a case for building facilitative institutional arrangements of the ‘right’ stakehold12 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission rs who will pursue this goal. The learning from the challenges and processes involved in implementing Universal Health Insurance Scheme (UHIS) will be very valuable. 6 Conclusion Promoting health and confronting disease requires action across a range of challenges in the health system. These include improvements in the policy making and stewardship role of the government; better access to human resources, drugs, medical equipment, and consumables; and a greater engagement of both public and private provider of services. Insurance has a limited but important role to play in solving some of the health ? nancing challenges. Innovative pilots of partner agent model led micro health insurance could giver useful insights for designing a national level programme, led by an apex body. Such a programme could systematically impact the health system in the country. 13 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission 7 Annexures 7. 1 ANNEXURE I Beyond the pilot, the initial cover will be modi? ed to cover primary and tertiary tier of the health systems in the country. . Primary level: The Insurance will cover: †¢ Diagnostic charges incurred on low and high end diagnostic16 †¢ Medications including expensive medication (like life saving drugs, higher antibiotics etc), injectibles and other consumables not usually available in the primary health centre †¢ Based on the recommendation given in the NRHM document, practitioners of AYUSH and other speci alties can be roped in to act as the Primary Physician †¢ Based on the scale and/or the insurance experience in 1st year, further social security bene? s can be added as follows: †¢ Reimbursement of transportation charges, wage loss, ? nancial compensation for attendant, compensation for disability and subsequent rehabilitation. 2. Impacting infrastructure and Manpower: †¢ Depending on the claims experience and the volume, some monies can be utilized to purchase new or replace old goods/equipment at the Primary Health Centre (PHC) and such activity monitored by District Health Mission through district health accounting system and the proposed ombudsman under NRHM. Besides there is a need for 5-10 bedded hospitals to come up at the taluka or clusters of village level in severely resource constrained area for which emerging entrepreneurs like the Vatsalaya hospitals who have already set up such hospitals elsewhere in the country (especially in Karnataka in this case). L ocal doctors looking at running hospitals can set up such hospital and run it on a franchise model. in this realm may lead to cost effective and customised diagnostic solution. in this regard ICICI Knowledge Park is involved in coming out with such customised solution for the rural poor 16 Innovation 14 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission †¢ There is also a need for high end diagnostic chain to come in to the rural space with similar franchise model of commercial diagnostic companies17 . Standardization of all the services will be done by a committee of experts in each state. These services will include outpatient, in-patient, laboratory and surgical interventions. †¢ Manpower: The ANMs/CHWs/ASHA/MPWs can be incentivised to provide their services more ef? ciently and quickly from such fund given to the Panchayat either from the government or from the insurance fund. It is assumed that with the introduction of ICT component (EHR and biometric cards) like smart card, the 40% of time wasted by ANM on documentation will be saved18 . – To incentivise the doctors to work in the PHC: – Posting of quali? ed graduate doctors in PHCs can be made mandatory and also made necessary pre-requisite for eligibility to sit for Post Graduate Medical Entrance Examination. – Top 10 or 20 high performing PHC doctors in the entire state might be allowed to join specialty of their choice in P. G courses directly or some higher percentage of quotas may be assigned to them which will facilitate them to get admission. Transparency and accountability in the whole service delivery can be brought about by making the health manpower within the PHCs and other levels accountable to the PRIs and the Village Health Committee through a rigorous and scienti? c accountability system19 . †¢ Additional Services: De? ned amounts of fund can be made available to the local Panchayat or a certain percentage of premium collected be allowed to remain with them and be spent for these purposes according to their discretion 17 This entity can set up satellite diagnostic centre at the taluka or district level. They can have sample collection unit which collects the pathological samples from the villages and brings it to the satellite centre where it is examined. The report is either passed on to the patient the next day when the sampling collection team goes to the villages or can be sent directly to the referred doctor under the health insurance scheme. 18 This will give her more time to cover more villages, services and bring about ef? ciency in the overall healthcare delivery. It will also reduce paper work and make information easily accessible at each level. 9 Smart card technology will be used to increase transparency and accountability of the health staff bringing about good people governance. In this the gram Panchayat and the Village Health Committee will completely evaluate the work of ANM and other staffs (including the doctor). Their performance will be graded in a scale devised in consultation with the representatives of the PRIs and the District Health Mission and accordingly incentive/disincentive can be given based on the score. This information can be made available online for access to the general public. 5 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission and mutual decision (It can also cover other expenses like loss of wage and destitute supports). †¢ Health Database management system: ICT component in the form of smart card technology (in the form of a biometric card) be introduced which will ensure the capturing of health and insurance data of the population and minimize fraud. †¢ It requires a decoder cum uploading device which will be portable and hand held. This can be used by ANM/Health staff/PRI/Hospitals to upload or read information starting from the primary to tertiary level †¢ Will be able to transmit images and radiographic reports (X-ray and ultrasound, CT scan) apart from other routine test results. This can be done of? ine (Because in villages, the power supply is erratic or absent and the internet connectivity is lacking) and can be the precursor of telemedicine20 . 3. Tertiary level: It will cover all high cost, sophisticated care which may not be available at the secondary level. The diseases that can be covered are as follows: †¢ Cancer †¢ Myocardial infarction †¢ Major organ transplant †¢ Paralysis †¢ Multiple sclerosis †¢ Bypass surgery †¢ Kidney failure †¢ Stroke †¢ Heart valve replacement 20 With internet connectivity through satellite (which are now provided free of cost by ISRO to interested NGOs and CBOs) which will mean that the patient will not have to travel to district level or tertiary level care and can walk in to such tele-consulting centre within the village where his diagnostic reports are accessed by punching in the unique I. D number of the patient on the smart card. The specialist sitting at the district level can then assess the prognosis of the case and decide whether the patient needs to travel or else advices the local doctor on what is the line of treatment for the patient which then can be carried out locally. This will save a lot of money (on traveling and loss of wages), time and resources which the patient would have spent otherwise. 16 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission 4. Impacting infrastructure, Manpower and Services: †¢ It is envisaged that the government medical college hospitals, other government health institutions, central or regional health institution operating in the state can act as the tertiary care provider. †¢ Insurance can start paying for upgrading these infrastructures and incentivising the medical work force in a similar way as was explained under primary level care. Besides private healthcare who will start the franchise model or other wise interested (and agreeable to the negotiated rate for the insured) will act as the tertiary care providers21 . The government should play a central and leading role in developing a strong referral linkage in the state. †¢ As most high level tertiary care hospital are charitable trust hospital and get substantial subsidies and exemption from the government in return for providing subsidized services for the poor (but in reality a very few actually provide such services) it should be made mandatory and compulsory for these hospitals to treat the insured poor. 5. Health Database Management: †¢ There will be a Central Data Warehouse which will develop from the EHR integrate all the information collected from the primary level upwards, making it accessible to each level and hence acting as a central store house of information. †¢ Additionally it will have personnel(s) who will analyse such data. Such analysis will be invaluable for monitoring, evaluation and mid-course correction. This will help in achieving the following: – Help revise insurance premium – Incentivise and monitor providers 21 The bene? will be two fold – it will provide quality care to the poor (through a TPA and the District Health Mission and Rogi Kalyan Samiti which will empanel hospital) which will ensure compliance to a particular standard of care) and will also help reduce crowding in the government hospital. At the tertiary level, a working arrangement should be made with national level government hospital (like AIIMS,CMC etc), regional ins titutes, post graduate medical institutes (JIPMER) and large private/corporate hospital (Apollo, Wockhardt, Fortis etc) so that patient requiring advanced critical care can be referred to them. 7 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission – Control fraud The developing of referral linkages is very much possible with insurance playing a central role and ICT in the form of smart card technology will ensure equity, ef? ciency and quality in healthcare delivery at each level. The coupling of the whole machinery with tele-medicine will bring about synergy and help the poor in terms of saving money on traveling and also loss of wages. It has to be always borne in mind by all the stakeholders that all component of health care i. . preventive, promotive, curative and rehabilitative care as emphasized under National Rural Health Mission as well as the coming of all stakeholders to work together will ensure harmonious and ef? cie nt delivery of quality healthcare with insurance playing a vital role. None of the components or stakeholders can be undermined as each will ensure that we will be able to see demonstrable impact in the health indicators of the community in days to come. 18 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission 7. 2 ANNEXURE II Setting up of a national coordinating and development entity: One of the key issues recognised by many is that increased coordination as well as sharing of knowledge and resources among the various actors in the sector would greatly stimulate success of NRHM as well as micro insurance development. This is especially true of health micro insurance for which few (if any) truly successful and sustainable programs have been observed to date. Hence it is felt that there has to be an apex body in the form of a coordinating centre which will initiate, regulate and monitor these activities. Following is a matrix which delineates the various stakeholder who will be represented in such a supra structure. 19 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission Stakeholders Stakeholder Needs Coordinating Centre’s Criteria for Success 1. Bene? ciaries * Simpli? ed claims procedures with minimal bureaucracy * Solutions that result in fast claims payment 1. 1 BPL families * Timely payments of * Service satisfaction from bene? ciaries * Solutions leading to affordable insurance products with quality servicing promised bene? s * Systematic increase in product coverage to ensure reduction of access barriers * Access to health services and health risk protection services 2 Microinsurers, Insurers, reinsurers * Access to technical assistance, actuarial studies, EHR records and the Centralized Data Warehouse reports, exposure to international innovations * Long term sustainability of microinsurance programs servicing the poor * E ffective, broad-based microinsurance delivery channels * Microinsurance pro? ts commensurate to investment risk * Competent pool of microhealth experts insurance technical Service packages developed and patronized * Service satisfaction from micro-insurers * Insurers aggressively competing to offer superior products and services to MICC client governments * Investment and ? nancial support from insurers 20 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission Stakeholders Stakeholder Needs Coordinating Centre’s Criteria for Success 3 NGOs, MFIs, trade unions, employer grassroots organizations, organizations, * Strong partnerships with hospitals, diagnostic players, NRHM team, AYUSH, ASHA workers and insurers Satisfaction with the coordinating agency’s ability represents all stakeholders’ interest and re? ected by strong involvement and support and investment through time in the centres work corporate sector, co-opera tive sector, etc. * Successful delivery of risk protection services to their memberships and clientele 4 Insurance Regulatory Development Authority * Robust, vibrant health microinsurance industry * Insurance regulations followed * Robust and vibrant network of micro-insurer clientele * Mandate and support from the IRDA * Achievements towards supportive and enabling policy 5 Health Providers * Timely payment from insurers * Reliable stream of BPL clients utilizing their services * Reasonable pro? tability * Positive ratings from health providers * Service satisfaction of BPL clients * Minimal problems with * Fast claims turnaround Solutions that result in: fraud and overcharging, etc. 6 TPAs Innovative and effective collection, distribution, and servicing channel 21 Sharing best practices Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission Stakeholders Stakeholder Needs Coordinating Centre’s Criteria for Success 7 State Governments * BPL population covered Support and mandates from governments * Ef? cient utilisation of resources and resources leveraged through a resource center * Moving closer to the goals stated under NRHM 8 Government of India * Access to comprehensive and quality health care for all * Improvement in national statistics on accessibility of health care services 8. 1 Ministry of Health and Family Welfare 8. Department of Insurance, Ministry of Finance * In synergy with existing programmes and structures * Proper utilization of departmental funds * National statistics on health insurance penetration * Increase in the number of legalized community health insurance programmes * Moving towards universal coverage * Regularising illegal community health insurance programmes Other major stakeholders that will have to be consulted are the likes of Indian Medical Association (IMA), Institute of Public H ealth (IPH), Federation of Obstetric and Gynecological Societies of India (FOGSI) and Institute of Health Management Research (IHMR). . 3 Objectives, Activities, and Services The stakeholders and clients of the Microinsurance Coordinating Centre envision a network of professionally-managed micro-insurers and accredited service providers offering 22 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission affordable, comprehensive, quality risk protection to the majority of poor people in India. Similarly, the Mission Statement may read as follows: The Microinsurance Coordinating Centre aspires to facilitate delivery of innovative health ? ancing and health insurance solutions in the country and improve the health indicators. It also aims to improve the capacity of insurance providers to provide risk protection services on a sustainable basis. The Centre is committed to building a vibrant health ? nancing and risk pooling sector through coll ective advocacy and through concentration, leveraging, and focusing on resources and knowledge towards developing innovative technologies. More speci? cally, activities and services of the MCC may include the following: †¢ To diagnose the feasibility and requirements of proposed micro-insurance projects in speci? districts of the identi? ed NRHM states; †¢ To develop and offer comprehensive, feasible, customized technical solutions complete with onsite guidance and implementation assistance; †¢ To facilitate strengthening the technical and cost effective management capacities of the NRHM team at the district level; †¢ To analyze and document the leading and best practices in the health microinsurance industry; †¢ To provide a forum for regular exchange and dissemination of ideas, innovations, lessons learned, achievements, and international best ractices; †¢ To develop and support EHR central data warehousing and tools; †¢ To develop health microin surance performance standards and prudential indicators, and the supporting technologies and tools that will enable micro-insurers to meet these standards; †¢ To provide a rating service of NRHM districts with micro health insurance pilots micro-insurers with respect to the standards and indicators; 23 Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission To facilitate and strengthen collaboration and partnerships among the various microinsurance providers and Health Ecosystem partners †¢ To establish linkages between insurers and resource institutions such as funding agencies, ? nancial institutions, and research institutions; †¢ To accredit a network of providers delivering affordable, quality health care through use of clinical protocols and negotiated tariff schedules; †¢ To provide and manage a data repository and also a national helpline for query redressal. To conduct industry experience studies and share resul ts for use in pricing and management purposes; †¢ To represent the health microinsurance sector to the Government of India and lobby for favorable and enabling policy; †¢ To identify and facilitate networking and business opportunities among the various stakeholders; and †¢ To elevate the insurance consciousness through awareness campaigns and education. Some of the activities such as product design are already being carried out by insurance companies. However, since microinsurance differs greatly from commercial insurance it requires unique design, marketing, and distribution strategies and skills. The MICC, with its personnel focused and specializing in micro insurance and health (health economists), with access to current data, and with concentration of knowledge about the industry would be positioned to facilitate superior solutions in these areas. 24