How the Affordable Care Act Changed Health Care - Free Essay Example

Sample details Pages: 3 Words: 1048 Downloads: 10 Date added: 2019/08/08 Category Health Essay Level High school Tags: Affordable Care Act Essay Did you like this example? The Affordable Care Act (ACA) was passed into law in 2010 by President Barack Obama. Provisions of the health care act were intended to extend coverage to millions of Americans that were uninsured, lower health care costs, improve efficiency of the health care system, and to eliminate denial of coverage to Americans based on pre-existing conditions (Health Insurance.org). This paper will outline the impact the ACA has had on health care organization and finance, explain how the ACA has incorporated social determinants of health into health policy, and outline the proposed changes to the ACA under our current administration. The Affordable Care Act encourages health care providers to form new organizational arrangements. According to Blumenthal, Abrams, Nuzum (2018) these arrangements are called Accountable Care Organizations (ACO) which are intended to promote integration and coordination of ambulatory, inpatient, and postacute care services and to take responsibility for the cost and quality of care for a defined population of Medicare beneficiaries (p. 2451). An incentive for physicians who create these organizations falls under the Medicare Shared Savings Program (MSSP) when providers improve or maintain the quality of care, they can share part of the savings they achieve (Blumenthal, Abrams, Nuzum, 2018). Don’t waste time! Our writers will create an original "How the Affordable Care Act Changed Health Care" essay for you Create order With the expansion of the ACA in 2014, millions of Americans were able to get health insurance through the expansion of Medicaid which increased health care costs to 5.3% from 2.9% (Weiner, Marks, Pauly, 2017). According to Abramowitz O Hara (2015) the ACA sets maximum limits on how much consumers with health insurance coverage can be required to pay out-of-pocket annually for their medical care based on their income beginning in 2014 (p. 197). In 2013, it was estimated that providers uncompensated care costs were between $74.9 billion and $84.9 billion. The amount of uncompensated costs, were offset by government payments designed to cover the costs (Coughlin, Holahan, Caswell, McGrath, 2014). According to Coughlin, Holahan, Caswell, McGrath (2014) Medicaid and Medicare were the largest sources of such government payments, providing $13.5 billion and $8.0 billion, respectively. Anticipating fewer uninsured people and lower levels of uncompensated care, the Affordable Care Act reduces certain Medicare and Medicaid payments. In states that have not adopted the Medicaid expansion, cuts in government funding could pose challenges to some providers (Coughlin, Holahan, Caswell, McGrath, 2014). Social determinants of health (SDH) are the conditions in which people are born, grow, live, and age (Leong Roberts, 2013). Leong Roberts (2013) go on to state Racism, poverty, unsafe neighborhoods, and lack of education are some of the many SDH that create health inequity through effects such as elevated stress levels, higher rate of uninsured patients, and less access to healthy foods. The ACA incorporated SDH into health policy with a two-pronged approach. First, it encourages action at an individual level with funding for public information campaigns that educate people in the community on how to make healthier diet choices with the creation of an Internet portal that allows individuals to track their own health. However, Leong Roberts (2013) recognize a downfall stating the ACA fails to recognize that many low-income neighborhoods are food deserts, where fresh fruits and vegetables are scarce and processed and shelf-stable foods are more abundant, which can lead to poor n utritional health. The ACA SDH is addressing the average American as opposed to the especially disadvantaged population (Leong Roberts, 2013). Second, the ACA created The Community Transformation Grants to serve as a tool to improve the holistic well-being of marginalized communities (Coughlin, Holahan, Caswell, McGrath, 2014). The guidelines for this grant call for neighborhood safety as well as an underlying foundation to increase healthy living. However, all cities have populations that are more susceptible to SDH than others and these grants are not created equal for all states (Leong Roberts, 2013). The Community Transformation Grants recognize SDH nationally, however, according to Leong Roberts (2013) these relatively small grants are not standard for all states and their communities; instead, communities with the resources to apply for the grants are not guaranteed to have a winning application. Which then leads one to believe that community responsibility to reduce SDH under the ACA only stretches so far. Prior to President Trump being sworn into office he stated he wanted to repeal and replace the ACA. He has been successful at making changes that will affect millions of Americans. According to Winfield (2018) The ACA created two subsidies to help low-income consumers afford marketplace plans: premium tax credits and cost-sharing reductions (CSR) to assist with deductibles and other out-of-pocket costs. In 2017, the Trump administration ended funding of the subsidies. Winfield goes on to state To offset the end of CSR reimbursements, most insurance companies raised premiums on silver plans, the only marketplace plans that offered cost-sharing reductions. According to Jaffe (2017) the ACA also forbids insurers from denying coverage to people with a history of health problems. According to PBS News Hour (2018) Trump signed an executive order aimed at giving people who buy their own insurance easier access to different types of health plans that were limited under the ACA rules (A nalysis: What you need to know about Trumps changes to the health law). According to Winfield (2018) This executive order will attract healthier people seeking to pay less for insurance due to the fact that they offer less benefits but they will have to pay more out-of-pocket while at the same time decreasing the number of Americans sharing the insurance costs of other enrollees making premiums increase (p. 23). Additionally, Trumps executive order will allow insurance companies to deny coverage to Americans with pre-existing conditions (PBS News Hour, 2018). The Trump administration also changed the 2018 annual open enrollment period, cutting it down to six weeks when enrollees previously had twelve and making it harder for people to buy insurance after the six-week open enrollment period closed (Rovner, 2018). It was stated by Rovner (2018) that, under Trumps administration, the new rules would reduce the number of people who game the system by waiting until they need care to sign up for coverage (This ACA timeline illustrates how the health law has been changed since Trump took office). Rovner (2018) also outlines an additional change made under Trumps administration the advertising budget will be cut 90% for the coming enrollment season and programs that provide help to people signing up will be cut by 41%. Officials tell reporters that the programs are ineffective and people are already aware of the health law logistics, something public opinion polls suggests is not the case.

American Gun Laws Free Essays

Gun laws in the United States of America need to be altered in order to make American society safer. The Second Amendment of the Constitution reads â€Å"A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed. † This means that from the point any American child is born they have the right to possess a gun and use it for their own safety. We will write a custom essay sample on American Gun Laws or any similar topic only for you Order Now How can a child as young as the age of ten years old know the difference between using a gun for their safety and playing with a gun putting themselves into danger? One state in America called Virgin has its very own law that every person must possess a gun. The law in the United States approves of blind men or woman having the right to possess a gun. If you are mentally affected you are also eligible to possess a gun. How can this be legal? Semi- automatic and automatic guns can be legally purchased in most US states by anyone who doesn’t have a violent criminal record. What is a violent criminal record? The law itself is not worded correctly. Semi-automatic guns are weapons which perform all steps necessary preparing the weapon to fire again after one shot. Automatic guns are firearms which keep firing bullets until the trigger is released. Why should every day American citizens need these sorts of weapons to â€Å"protect themselves†? Ammunition for guns can be purchased at nearly every store around the United States including Kmart and even in a barbers shop. Not only are you able to buy ammunition for very powerful guns but you are also legally allowed to buy as many sets of ammunition as you desire. Seventeen cents is all you need to purchase one bullet in America. If Americans wanted fewer people dying from guns every year they would change the price and the fact that guns are so easy to access dramatically. If bullets were 7,000 dollars each they would be used more carefully. This would influence a massive change in people dying per year from â€Å"gun accidents† as Americans would become very cautious in using their ammunition wisely. In 1999 two boys, Eric Harris and Dylan Klebold went on a shooting rampage at Columbine High School. They purchased their weapons legally from the local Kmart. They used semi-automatic guns, shot guns and even possessed 99 explosives and 4 knives. They shot 900 rounds of ammunitions killing a total of 12 students and one teacher and then themselves. The massacre started a debate over gun laws and the availability of firearms to high school students. It resulted in an increase emphasis on school security. Students in American schools now must go through metal detector before entering their daily lasses. Security also checks for any sharp metal such as nail clippers but they do not focusing on the fact that guns are a large cause of death. One child was suspended from his school because he was carrying around a stapler. Guns are still legally allowed in schools. 45% of US households have at least one gun. Around 59. 1 million adults in the United States own a gun. There is no law stating that you need to register your gun so it is impossible to know exactly who owns a gun and how many guns are being sold. 31,593 helpless lived were killed in 2011 by guns. This is a clear message. Guns are not doing any good. Therefore they should not be allowed. Guns should not be used to take others lives. They should be used in the military to protect the country not to kill. They should be used for people that like to go hunting. Semi-automatic and automatic guns are not used to kill a dear so why are they allowed to be sold to any civilised person in the United States? It is said that the availability of a gun makes it more likely that you will have feelings of anger or thoughts of suicide. 381 people have died from gun shooting in Germany, 255 in France, 165 in the UK, 59 in Japan and 39 in Australia. Why is it that approximately 100,000 American people die every year from guns? This is 300 people per day losing their lives because of guns. This is screaming out to Americans that they have to act now. Waiting another year is just losing 100,000 more lives. The news in America impacts greatly on the way society looks at their safety. The TV advertises violence sending a bad message across to any children in the United States. One hour before the Columbine shooting America bombed a school and a hospital in Iraq. This is not setting a good example. Changing the gun laws is a battle between freedoms and safety. It is a battle between freedom for the American people as they have lived their whole lives with the idea that they are safe as they have possession of guns. They have grown up with parents teaching them how to use a gun and in many cases this can lead to good and bad. It can be bad because a child might accidently use a gun for the wrong reasons or their parents have taught them the wrong way of using one. Putting themselves into danger and for good as some families might be smart enough to tell their children there are other ways of protection over guns. It is a battle between safety for all the reasons above. Guns have been seen to be used for nothing but bad in the past and this needs to change. 20 people in America are dying every single hour from a gun. This is not only telling us that they are not used for safety precautions but it is telling us that the American citizens are not very educated in their actions and the way they act. Most Americans might be very good at handling guns and not using them for the worse but to think that so many are dying from one machine and nothing is changing is not good at all. In Australia around about 65 people are killed by guns every year. In America around about 11,127 people are killed by guns every year. 40% of guns sold are not sold without a background check. This means that people with criminal records are easy accepted to own a gun when they are said not to be. The Law says that is you have a criminal record you are unable to possess a gun but many Americans are still easily getting one. This is a wakeup call. America should not be allowing possession of guns for the safety of their own country. Where there are more guns, there are more deaths. America has to start acting now before another 100,000 people are dead. How to cite American Gun Laws, Papers

2001 A Space Odyssey and Lost Horizon free essay sample

A comparison of 2001: A Space Odyssey by Arthur C. Clarke and Lost Horizon by James Hilton. An examination of the similarities and differences between Arthur C. Clarkes 2001: A Space Odyssey and James Hiltons Lost Horizon. The author identifies core beliefs which both novels hold including their concern with what it is to be human. However, it is also illustrated how different the novels are with regard to structure, literary techniques, and characterizations. Lost Horizon has a more traditional narrative structure, with an enclosing frame involving characters who talk about the central figure, remembering him in the past. 2001, on the other hand, at first glance seems to lack a cohesive literary structure and to be instead a series of barely related incidents at different time periods, with different characters and somewhat obscure situations. Yet, the two novels both have a core belief in the ability and innate moral sense of the human being and a belief in positive human development. We will write a custom essay sample on 2001: A Space Odyssey and Lost Horizon or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page

6 Skills you need to success free essay sample

While we all aspire to climb to the top of our respective professions, but from time to time we come up against a roadblock, a barrier that slows our climb to the top. Whether you are being consistently overlooked in favor of someone else who is a bit more productive or perhaps there is just some intangible quality that allows other people to get ahead of you, it can be immensely frustrating to be denied a job you know you could excel in. With this in mind, we decided to consider the six skills you need to succeed. It is worth noting that all of these skills are transferable and have as much relevance in your personal life as they do in your professional life. Just as importantly, these are all skills that can be learned, so no one should feel that they are at a disadvantage with any of these. We will write a custom essay sample on 6 Skills you need to success or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Work on them and you will reap the rewards accordingly. After reading this, the career ladder will suddenly seem a much easier climb than it did before. 1- Speaking skills Whether you are hustling for a promotion when you bump into a CEO in an elevator or making an important speech at an international conference, the ability to speak with a wide variety of people is an absolute essential. Good eye contact, a varied vocabulary and the ability to tailor your language to suit your audience are all essential characteristics of an artful speaker. Being a good speaker will give you presence and make you memorable to those who are listening. Practice talking with anyone and everyone you meet, look for a debating society or a Toastmasters group. The  rewards are worth it. Being more adept in social situations and being better equipped to network successfully will help you forge working relationships that could be very advantageous to you in the future. It will also be useful to you for performing duties as a best man. 2- Confidence in decision making Nothing says mediocrity like indecision. A good leader is decisive and will always back himself up when making the correct decision. If you want to be considered leadership material, you have to possess these characteristics. If you are paralyzed by the fear of getting it wrong, you will end up doing nothing, which is worse than trying something and failing. A lot of high-fliers are prepared to take risks knowing that a mistake can be corrected. Learn to evaluate different decisions for their pros and cons, and make decisions that will take you closer to completing a given task. The key is to make sure that your decisions are thought out and reasoned. Be confident in your judgment and believe in yourself to get things right. Don’t just play it safe every time — you will blend into the wallpaper and no one will notice you. Putting yourself on the line will earn you respect, and if your decisions turn out to be right, you can expect to be rewarded for your efforts. 3- Accountability Another major part of being successful is accepting responsibility, both for successes and failures. If you want other people to respect you, acknowledge your errors rather than trying to blame someone else for your shortcomings. Everyone makes mistakes, but the real test is how you react to that. Putting yourself in the firing line is the mark of a man who wants to achieve great things and is prepared to be scrutinized. It is a sign of confidence and self-belief, and is a key ingredient among men who want to be successful. Being able to admit you have made a mistake is also a sign of humility and can garner respect from your employees. A useful way to hold yourself accountable is to scrutinize your to-do lists, see what you accomplished and what you did not. Look at ways you can improve your performance and take appropriate steps to correct mistakes yourself. Three more skills you need to succeed after the jump 4- A positive attitude Being positive about work and life is also essential to success. While your colleagues may laugh at your endless cynicism and misanthropic tendencies, your boss will see you as someone who hates his job and who will never support the aims of the company. We should distinguish between the occasional bad day (although you should always try to minimize this and remain upbeat no matter how trying the circumstances) and being consistently pessimistic. The eternal pessimist will always try to drag other people down and will probably be less productive. If you can cultivate a positive outlook, you will encourage others to be more positive. Youll also be more productive and possibly more credible as someone with executive potential. A positive attitude is entirely self-determined and can be helped by accentuating the positives in any situation. Don’t see problems; see solutions. 5- Self-presentation Learning how to present yourself to others is another major aspect of being successful. Good grooming and, in particular, smart attire will project an image of success to other people — before you have even said a word. Wearing a well-cut suit, quality shoes and an elegant timepiece speak of a man who takes pride in his appearance. High sartorial standards indicate someone who has high standards generally, and this will cause people to view you favorably. A huge amount of your impact on colleagues, bosses or clients will be based on how well put together you appear. And while substance is crucial, having a great style to support it is no bad thing. Read fashion magazines and think about visiting a hairstylist rather than a barber. If you can afford it, have suits and shoes made to measure; they will fit much better than off-the-rack goods. Don’t forget that the way you look also enhances the way you feel about yourself, making you more confident. 6- Time management skills It doesn’t matter how well you dress, how positive you are or how well-spoken you are if you cannot keep everything under control. Disorganization means that you will be forever playing catch-up with your work, rushing to meet  deadlines and producing work below par. Learn to keep a detailed diary, listing deadlines and setting a schedule for your work, to ensure it is all done with time to spare. Your work will be of better quality and you will be entrusted with increased responsibility. It will also afford you additional leisure time. It is a key element to success and well worth practicing. This means overcoming procrastination (which we can all be guilty of at times), setting goals that are challenging (but realistic) and trying to use your time efficiently. Don’t check your e-mails 17 times every hour; spend that time writing up that project that is due tomorrow. Ideally, you will reach a stage when you can get ahead of the curve and start taking on additional projects and responsibilities — a surefire way of setting yourself up for that promotion. Success is simple when you follow these professional skills success is simple There you have it: An essential list to help you move up in the world and stake your claim in business. There are more, of course, but no other general guide is more comprehensive. A final word of advice: Worry not about an intangible trait you may not have. If you have not been born and raised as the best communicator or dealmaker, you can make your mark with expertise in a specific field or venture. As long as you make your mark in something, the sky is the limit. Just keep in mind that the best of the best have a wide scope of knowledge and do not focus on one area alone.

Detonation, Pre-Ignition, and Engine Knocking

Detonation, Pre-Ignition, and Engine Knocking Detonation - generally caused by fuel with a low octane rating - is the tendency for the fuel to pre-ignite or auto-ignite in an engines combustion chamber. This early (before the spark plug fires) ignition of fuel creates a shock wave throughout the cylinder as the burning and expanding fuel-air mixture collides with the piston that is still traveling towards top-dead-center. The resulting knock or ping is the sound of the pistons slamming against the cylinder walls. The effects of detonation may be anywhere from arbitrary to severe. Prolonged and intense knocking can break the piston or the engine, though it is can also endure this slight issue for thousands of miles. Similarly, overheating may cause additional wear-and-tear on the engine, be relatively harmless or cause the engine to catch on fire and break. Common Causes of  Detonation Detonation is most often caused by the use of low-grade engine fuel and its resulting deterioration of your engines parts. However, chamber design plays a key role in determining when and if an engine might detonate unexpectedly. The shape, size, spark location and geometry of the design all help determine where these detonations are likely to occur. An overheated spark plug tip can also cause pre-ignition. This may cause a pinging to occur in your vehicle when driving down a highway, but can actually be sustained in the engine for thousands of miles. If you hear a metallic clicking sound while driving long distances, you should consult your mechanic and see if your  spark plug needs to be replaced. Common Effects Detonation can cause three types of engine failure depending on source and severity: abrasion, mechanical damage and overheating. Mechanical damage happens because the heightened impact of nature can cause parts of the internal combustion engine to fracture. This can especially affect the top or second piston ring land or even the exhaust or intake valves. In  abrasion, the piston head is slowly eroded, creating a microscopic swiss-cheese effect on its surface resulting in less efficiency and eventual breakdown. Overheating, though, is a more serious issue which acts almost like a snowball effect once it starts. Caused by the boundary gas layer getting interrupted against the cylinder head and heat transferring to the coolant via the cylinder head, this overheating of the engine will continue to happen as temperatures increase causing more detonation.   Common Solutions Fortunately, there are a number of solutions to pre-ignition. The best solution is obviously to see your mechanic about the issue, but if you have experience in engine repair, you may also look to the following methods to reduce the chances of engine detonation. Switching to a higher octane fuel in order to reduce the heat of the firing chamber and burn fuel more slowly is the best way to combat false firing. Similarly, reducing engine inlet air temperatures will greatly reduce the chance of pre-ignition and detonation. As a principle, for every 10 degrees cooler the inlet air is, it produces one percent more power. Adjusting engine timing may also help solve this issue. If your engine is firing during throttle at low engine speeds, you may need to adjust the timing two to three degrees.

How Poverty Causes Crimes Essay Example | Topics and Well Written Essays - 1250 words

How Poverty Causes Crimes - Essay Example Both theories are of great significance for designing social strategies and policies to combat crime. According to the research conducted by the United States Government Accountability Office (2007), individuals living in poverty face an increased risk of adverse outcomes such as poor health and criminal activity. American healthcare system itself can be a factor that makes people vulnerable to poverty. Among the industrial nations, U.S. is the only country that does not have a universal healthcare policy for its citizens. Although American healthcare service is believed to be the best, the dramatic increase in cost, high drug prices, fraudulent activities, healthcare abuse, and unfair coalitions have left the system extremely fragmented. For the majority of the population hospital bills have become unaffordable. According to Marilyn Elias (2009), for some families, just one added stressor is enough to push them over the edge into violence. Although hospitals are highly equipped with the advanced technology and modern facilities, majority of people do not have the access to adequate healthcare service due the escalating cost of drugs and services. To illustrate, the study proves that "as many as 195,000 people may well be dying in American hospitals each year because of avoidable medical errors, and as many as 1.5 million may well be misdiagnosed" (Coates 61-62). The recent economic recession has made the situation more complex. It has contributed to more frequent violence, more violent abuse, and more deadly abuse when the domestic violence already exists. For instance, there has recently been a 25 percent increase in felony-level domestic violence crimes in Rhode Island, and a three-fold increase in domestic violence related homicides in Massachusetts during the same period (Lauby and Else, 2008). Another argument suggests that crime is being promoted by certain social

Digital revolutions (6) Essay Example | Topics and Well Written Essays - 1250 words

Digital revolutions (6) - Essay Example It has been observed that owing to implementation of advanced technology in the global market has become more effective in nature (Crown, 2015). The principle aim of the study is to describe about the positive impact of adopting digitalisation within the existing marketing process. Apart from this, the study will also describe how digitalisation can be helpful in building effective global marketing strategies. The digital revolution is recognised to be incorporated within the global marketing strategy during the third industrial revolution, which has made a positive impact over the global economic development. The business industry has become more cautious regarding the application of the same. It has been stated that by implementing the digitalisation within marketing strategy companies are more able in developing effective connection with the costumers. It has been also observed that the traditional ways of marketing are unable to create connection with its customers. In this regards the marketing practitioners have become more eager to adopt the digitalisation within their marketing strategies. Therefore, several companies have launched new strategies of handling online marketing segments, which will facilitate the companies to generate more customers as per the needs of the global marketing segments (Breene & Whipple, 2011). In this regard, the creation of electronic commerce industry has become more active participant for the development of new business circle. Most of the marketing practitioners consider e-commerce industry as a popular domain among the mass media as well as informatics circle also. It has been noted that the implication of e-commerce industry are playing an important role for developing the financial services as well as retail industry as well. Correspondingly, it can be stated that the digital revolution in the global business encourages adoption as well as practice of