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FIN 324 Final Exam Answer

Week One – Accounting Principles

 

  1. Please explain the following accounting concepts and give an example of how they relate to accounting information: Materiality, Consistency, and Full Disclosure.

 

Materiality principle. Accountants follow the materiality principle, which states that the requirements of any accounting principle may be ignored when there is no effect on the users of financial information. Certainly, tracking individual paper clips or pieces of paper is immaterial and excessively burdensome to any company’s accounting department. Although there is no definitive measure of materiality, the accountant’s judgment on such matters must be sound. For example, several thousand dollars may not be material to an entity such as Microsoft, but that same figure is quite material to a small, family-owned business.

 

To be useful, financial information must be relevant, reliable, and prepared in a consistent manner.   Consistent information is prepared using the same methods each accounting period, which allows meaningful comparisons to be made between different accounting periods and between the financial statements of different companies that use the same methods.

 

Full disclosure principle. Financial statements

 

normally provide information about a company’s past performance. However, pending lawsuits, incomplete transactions, or other conditions may have imminent and significant effects on the company’s financial status. The full disclosure principle requires that financial statements include disclosure of such information. Examples are footnotes supplement financial statements to convey this information and to describe the policies the company uses to record and report business transactions.

 

  1. What would happen if all of the steps of the accounting cycle were not completed in a specific accounting period? What would be the impact on the company’s balance sheet and net income if a company did not set up a necessary receivable at the end of the accounting period?

 

Step one of the accounting cycle is to analyze transactions and determine how those transactions affect the accounting equation. Accountants analyze transactions using debits and credits.   The second step is record the effects of transactions using journal entries Journal entries are the accountant’s way of recording the debit and credit effects of both simple and complex business transactions.   The third step is summarizing the resulting journal entries through posting and prepares a trial balance. Once journal entries are made, their effects must be sorted and copied, or posted, to the individual accounts. The fourth step is to prepare the report.   Accounting is designed to accumulate

 

and report in summary form the results of a company’s transactions, thereby transforming the financial data into useful information for decision making.

 

Some economic activities, such as the growth in the amount of interest a company owes, happen gradually. Without special adjustments, the accounting records would not reflect the impact of these gradual activities. Adjusting entries must be made at the end of each accounting period to ensure that all balance sheet and income statement items are stated at the correct amount.

 

All businesses, periodically issue their financial statements so that users can make sound economic decisions. Current owners, investors, and bankers, and need up-to-date reports in order to compare and judge a company’s financial position and operating results on a continuing, timely basis. They need to know the financial position of a company (from the balance sheet), the relative success or failure of current operations (from the income statement), and the nature and extent of cash flows (from the statement of cash flows).   Delays would be in violation of reporting guidelines and may carry substantial costs.

 

Week Two – Principles of Financial Statement Preparation

 

  1. What at the primary financial statements and how do the statements tie together?

 

Primary financial statements are income statement, balance sheet, and cash flow statements.   The income statements’ revenue and expense illustrate

 

the changes in assets and liabilities on the balance sheet. Cash assets and cash and cash equivalents on a balance sheet are reflected on the statements of cash flows. Also, the statements of cash flows present additional data on cash assets displayed on the balance sheet.

Managers use a few significant ratios to summarize the firm’s leverage, liquidity, efficiency, and profitability. They may also combine accounting data with other data to measure the esteem in which investors hold the company or the efficiency with which the firm uses its resources.

 

  1. What is the basic accounting equation? How is equilibrium maintained if overall liabilities decrease (what has to happen to assets or equity)?

 

Assets – Liabilities = Equity.   This equation is the basis for the most basic of accounting reports, the suitably named balance sheet. A balance sheet reports what a business have possession of (assets), what is in debt (liabilities) and what the remainder is for the owners (equity) as of a definite date. This equation should be in balance.

 

Week Three – Financial Statement Analysis

 

  1. What types of ratios would a credit analyst at a bank tend to focus on when deciding whether to give a company a loan (name a specific ratio)? What ratios would a financial manager focus on in order to manage a company (name at least two specific ratios)?

 

I would use debt ratio by comparing the amount of liabilities with the amount of assets

 

indicates the extent to which a company has borrowed money to leverage the owners’ investments and increase the size of the company. As a frequently used measure of leverage, debt ratio computes the total liabilities divided by total assets. A perceptive interpretation of the debt ratio is that it represents the proportion of borrowed funds used to acquire the company’s assets.

 

Price-earnings ratio is a measure of growth potential, earnings stability, and management capabilities; computed by dividing market value of a company by net income and current ratio, a measure of the liquidity of a business; equal to current assets divided by current liabilities.

 

  1. How can operating leverage be used to increase a company’s profitability?

 

A measurement of the degree to which a firm or project incurs a combination of fixed and variable costs. A company that makes few sales is highly leveraged.   A business that makes many sales is less leveraged.   As the volume of sales in a business increase, each new sale contributes less to fixed costs and more to profitability.

 

Week Four – Managerial Accounting

 

  1. Why is good working capital management important? What are some working capital strategies used in your organization (or an organization you’ve worked for in the past)?

 

A measure of a company’s efficiency and short-term financial health; a company’s working capital an d calculated as Working capital = Current Assets – Current Liabilities

 

 

 

Positive working capital means that the company is able to pay off its short-term liabilities, whereas negative working capital means that a company is unable to meet its short-term liabilities out of its current assets (cash, accounts receivable, and inventory). Working capital also is referred to as net working capital.

 

Ongoing improvements include Online Paying and Collection (OPAC OPAC – Online Public Access Catalog ), which was implemented at all DFAS locations, with authorization from the Department of the Treasury where needed. The implementation resulted in a 50 percent reduction in manual billings produced by GSA for the FTS area. The reduction in manual billings and the use of OPAC decreased the GSA accounts receivables from $192.4 million in July 2000 to $103.3 million in September 2001. Delinquent Department of Defense (DoD) bills were reduced by 44 percent, which increased GSA’S working capital fund and increased GSA’S ability to reimburse its vendors. Along with this increase in electronic commerce, the chargeback percentage of OPAC transactions decreased from 22 percent in January 2001 to 3 percent by July 2001.

 

  1. How is a car loan an example of the time value of money? Under what circumstances should an individual take out a loan versus pay all cash?

 

Time value of money (TVM) is the process of calculating the value of an asset in the past, present or future. It is based on the premise that the original

 

principal will increase in value over time by interest. This means that a dollar invested today is going to be worth more tomorrow. Principal is the amount of money borrowed today. You buy a car today for $10,000 of which you borrow $8,000.00 from the bank and pay $2,000.00 of your own money: the $8,000.00 is the principal of the car loan. The $2000.00 is the principal.

 

You should never pay cash for a car. Instead of using your savings for the purchase of a car this will decrease your assets and increase your liabilities, wait until your assets generate monthly cash-flow and then purchase a car. That way the cash-flow from your assets will finance your liabilities. Also, your payment remains fixed and you will be paying with deflated dollars over time, assuming you stretch it out. This is why businesses never pay cash for anything, because they understand the economics.

 

Week Five – Principles of Finance

 

  1. What is the difference between stocks and bonds? Which represents more risk to the company? Why?

Stocks are EQUITY. They represent shares of ownership in a Corporation. A Stockholder is actually one of many owners of a Publicly Owned Corporation. If a Corporation dissolves for any reason owners of Common Stock (the main type of stock issued) receive the value of the sold assets of the Corporation AFTER everyone else is paid, including the IRS, Employees, Bonds, Accounts Payable, etc.

Bonds are DEBT. They are sold by

 

the Corporation in order to raise money for various purposes for use by the company. Bonds offer an interest rate to the Bondholder for the period of time that the Bondholder owns the bonds.

Since bonds do not represent ownership, the bondholder could lose their investment if the Corporation dissolves, but are paid BEFORE owners of stock. Bonds are not risky as they have a set payment schedule so there are no surprises. There is no such guarantee with stocks.

  1. Does a company receive money when its stock is traded in the secondary market? How does the company affect the price of its stock? Why is a company concerned about its stock price in the secondary market?

 

No, a company does not receive money when its stock is traded in the market. The company only receives funds in the initial public offering. The company affects the price of its stock by its financial management and performance (increasing revenues, net income, issuing dividends, making strategic investments, reducing debt, etc.), and by keeping the market informed about its accomplishments. The company is concerned about its stock price in the secondary market because it affects the company’s ability to issue more stock in the future (if needed to grow), the company’s ability to borrow in the future, the net worth of shareholders, the value of stock options (if provided as compensation to key employees), and the company’s ability to make acquisitions of other companie

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What can we do as managers to encourage ethical behavior and to raise ethical standards in our organizations Answer

What can we do as managers to encourage ethical behavior and to raise ethical standards in our organizations?    

What we can do as managers to encourage ethical behavior is that we should try to practice by example the ethical means that the company believes in. By being an example means not to strictly follow them literally and punish those who does not follow. Rather, we should give them a thorough lesson on why and how the organization is doing this ethical belief. I strongly believe that verbal communication is the best way to organize a team or department and not simply emailing them and scolding them without any initial approach. I believe as managers we need to be more involved not just with executives, but also employees who work under us. We need to make sure that people are being held accountable for their actions. Company policies should be reviewed more than just once a year for compliance standards. Ethical behavior can be encouraged through pro-active measures such as addressing ethical issues early before things escalate.

 

We should do the following as managers to encourage ethical behavior and to raise ethical standards in our organizations:

1) CanGo should come out with the code of ethics for the employees and managers to follow. The code of ethics should be available to all employees either on the company’s website or on the company’s intranet.

2) Business ethics training should be provided to all employees to make them aware of all the points and aspects of code of ethics.

3) Ethics training should be substantiated with proper case study and real life examples so that it is easier for all the employees to relate those situations to their working environment.

4) It should be mandatory for everyone in the organization to undergo this ethics training and also to have proper assessment done on Business ethics.

5) There should be Top management focus on the Business ethics so that all employees in the company understand the essence and business significance of Business Ethics.

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Explain why transport rates typically vary by 1) the weight of the shipment; 2) the distance a shipment is transported Answer

Explain why transport rates typically vary by 1) the weight of the shipment; 2) the distance a shipment is transported; and 3) the value of the transport service. Provide an example of how these variables affect a shipping rate.

 

Transportation rate depends on various factors such as product characteristics, weight of the products, distance and value of the transport service e.g. whether it is by air, land or water. There are different kinds of products e.g. chemicals, petroleum products and machine parts that need to be transported and rates would vary for all of them according to their makeup. A product weighing 200 pounds may cost $100.00 per hundredweight, while 1000 pounds of this product going to the same destination may only cost $50 per hundredweight. Higher dense products would be charged lesser compared to low dense products because the amount of space required for the same weight would be much larger in the case of lower dense product as compared to high dense product. But this method of calculating transportation rate based on the product characteristics, weight, and distance could become very complex as there could be ‘n’ nos. of combinations and this could be very tricky to calculate and keep track of so many transportation rates. So, a simpler method of rate determination needed for the transport community. This was accomplished through the class rate system, which simplified each of the three primary rate factors—product, weight, and distance. One widely used system for simplifying the number of products is the National Motor Freight Classification (NMFC), which has 18 separate ratings, or classes, from 500 to 354; the higher the rating, the greater the relative charge for transporting the commodity.

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When Vanna White sued samsung for appropriation and under the Lanham Act, she won her case under California Answer

When Vanna White sued samsung for appropriation and under the Lanham Act, she won her case under California common law right of publicity claim and under the Lanham Act. List the eight sleekcraft factors that are required to prove a Lanham Act complaint.

 

The Lanham Act of 1946 is a federal law passed to afford businesses protection of their trademarks. This law is really a protection of a company’s goodwill. A trade mark becomes associated with that company and is used as a means of identifying that company’s goods or services. The Sleekcraft factors that are required to prove a Lanham Act compliant

(1) strength of the mark;

(2) proximity of the goods;

(3) similarity of the marks;

(4) evidence of actual confusion;

(5) marketing channels used;

(6) type of goods and the degree of care likely to be exercised by the purchaser;

(7) defendant’s intent in selecting the mark; and

(8) likelihood of expansion of the product lines.

 

(Found in Vanna White/Samsung case in lecture and taken from AMF, Inc. v. Sleekcraft Boats, 599 F.2d 341, 348–9 (9th Cir. 1979).

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What does the uniform commercial code (UCC) state regarding price and warranty Answer

What does the uniform commercial code (UCC) state regarding price and warranty? What if a price is not specified in an agreement? What if a price is specified in an agreement? Does the UCC modify the price? What about a warranty? What rights does the buyer have for a guarantee under the UCC? What protection is granted to the seller? (Points : 20)

Uniform commercial code (UCC) states that the parties can conclude a contract for sale even though the price is not settled. In such a case the price is a reasonable price at the time for delivery if

– Nothing is said as to price

– The price is left to be agreed by the parties and they fail to agree

– The price is to be fixed in terms of some agreed market or other standard as set or recorded by a third person or agency and it is not so set or recorded.

When a price left to be fixed otherwise than by agreement of the parties fails to be fixed through fault of one party, the other may at his or her option treat the contract as canceled or himself or herself fix a reason able price.

Where, however, the parties intend not to be bound unless the price be fixed or agreed and it is not fixed or agreed, there is no contract. In such a case, the buyer must return any goods already received or if unable so to do must pay their reasonable value at the time of delivery and the seller must return any portion of the price paid on account.

Express warranties by the seller are created as follows:

(a) Any affirmation of fact or promise made by the seller to the buyer which relates to the goods and becomes part of the basis of the bar gain creates an express warranty that the goods shall conform to the affirmation or promise.

(b) Any description of the goods which is made part of the basis of the bargain creates an express warranty that the goods shall conform to the description.

(c) Any sample or model which is made part of the basis of the bargain creates an express warranty that the whole of the goods shall con form to the sample or model.

Implied Warranty is implied in a contract for their sale if the seller is a merchant with respect to goods of that kind. Under this section the serving for value of food or drink to be consumed either on the prem ises or elsewhere is a sale.

However, if the buyer before entering into the contract has examined the goods or the sample or model as fully as he desired or has refused to examine the goods, there is no implied warranty with regard to defects which an examination ought in the circumstances to have revealed to him; and an implied warranty can also be excluded or modified by course of dealing or course of performance or usage of trade.

References: Garrett, G.A. (2010). World Class Contracting. 5th Edition. CCH Incorporated. pp 407-409

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HSM 542 Rationing Healthcare: America’s Best Bet Answer

HSM 542 Rationing Healthcare: America’s Best Bet
Abstract
Rationing Healthcare: America’s Best Bet
Introduction.
Within the last decade private insurance premiums have doubled, rising four times faster than wages. Insolvency of the current government assisted healthcare programs, Medicare and Medicaid, are on track to occur within the next eight years (Singer, 2009, para. 3). Facts such as these lead most experts and scholars such as Peter Singer, bioethics professor at Princeton University, to believe rationing of healthcare is not only necessary but highly desired for all stakeholders involved. The fact of the matter is that healthcare is a scarce resource, and like all scarce resources, it requires close management and rationing to ensure its best use.
At present, healthcare in a sense, is rationed through price. In the realm of public opinion however, rationing healthcare is often times connected to the highly politicized word, ‘socialism’ and is highly undesired. In its truest form however, rationing simply put, is a way of distributing limited resources to garner the best overall “bang for the buck.” In healthcare, rationing is a manner of which providing the best quality of care to the largest number of patients. Investopedia defines rationing as:
The artificial restriction of raw materials, goods or services. Rationing commonly occurs when governments fear a shortage and want to make sure people have access to necessities, such as after a natural disaster or during a war. Governments can also impose rationing in the face of failed policies such as central planning, or may be forced to use rationing as a result of shortages (“Definition of ’Rationing’,” 2013, p. 1). This paper’s purpose is to examine the rationale behind the rationing of healthcare. It will examine the affect it has on healthcare delivery, impact on healthcare providers and consumers, possible solutions, and the role healthcare administrators/managers play in the process. The paper will reference institutions such as the National Institute for Health and Clinical Excellence (NICE) and other national healthcare systems like Great Britain, Australia, and Canada. In addition, a definition of quality-adjusted life-year will be presented and debated as a possible option to ration care fair and proportionately.
Affect Rationing Has on Healthcare Delivery.
Challenger’s arguement. Sally C. Pipes, Chief Executive officer of Pacific Research Institute and adversary to the rationing of healthcare, wrote an article titled “Obama Will Ration Your Healthcare.” Within the article, many subjects are discussed, including the National Institute for Health and Clinical Excellence (NICE), a rationing system that controls government costs. It is Pipes’ belief that rationing healthcare will result in the elderly population being discriminated against due to cost benefit analysis. Her article goes on further to state, “the process of determining which drugs and which treatments would be approved for use would be quickly politicized” (Pipes, 2008, para. 9). There is strong argument that rationing healthcare would ultimately fail in the hands of public opinion. To make this point, Pipes references lessons learned in managed care during the 1990’s. The goal of cost containment was successful however rejected by US citizens resulting in Congress passing a patient’s Bill of Rights (Pipes, 2008, para. 8).
Other advocates against healthcare rationing state similar responses to Sally Pipes. Claire Andre and Manuel Velasquez, members of the Markkula Center for Applied Ethics, go as far as quoting Euripedes, 500 B.C.:
I hate the men who would prolong their lives by foods and drinks and charms of magic art perverting nature’s course to keep off death. They ought, when they no longer serve the land to quit this life, and clear the way for youth.
It is their firm belief that through rationing, healthcare would result in the elderly and disabled populations being limited in their care because of a measure called a quality-adjusted life-year (QALY). QALY is a unit designed to enable a comparison of the benefits achieved by different forms of health care (Singer, 2009, para. 22). Andre and Velasquez state the morals of such rationing would be unjust and take away constitutional rights to receive equal care.
Proponent’s arguement. Many proponents for rationing healthcare resources feel it is only a matter of time before it becomes necessary. Healthcare analysts and providers predict a health care crisis because of:
* Costs of Healthcare
* Increased number of uninsured individuals
* Unknown status of current healthcare system
Factors that are affecting these conclusions consist of:
* Expenses are rising faster than the cost of living.
* Medicare and Medicaid spending (which comprises 26 percent of the federal budget) is expanding faster than the economic growth rate
* Individuals and their families continue to pay a significant amount out of pocket (Ukleja Center for Ethical Leadership, 2012, Slide 3)
While these factors are compelling, the numbers representing US spending costs ultimately lend credence to the argument for healthcare rationing.
In June of 2011, the National Coalition on Health Care reported healthcare spending reached 18.2% of US Gross Domestic Product (GDP), up by 5.1% from the prior year (The National Coalition on Health Care, 2011, p. 1). With a continued climb in spending, insolvency of the current healthcare system could occur as early as eight years. President Obama has plainly stated “that America’s health care system is broken” (Singer, 2009, para. 5). Proponents for the rationing of healthcare are in agreement with the President and see little to no alternative.
While some feel rationing is the way to avoid bankrupting the healthcare system others believe the wrong form of rationing is already occurring in the form of ability to pay. Examples of such rationing comes in the form of pharmaceutical deductibles for life saving medication. If the individual is unable to afford the medication they go without. Professionals like Simon Rottenberg, Professor of Economics at the University of Massachusetts, and David J. Theroux, President and Chief Executive Officer of The Independent Institute and Publisher of The Independent Review, warn against this form of rationing and instead, believe it should be based on a measurement of life quality. They state:
There is a strong emotional attraction for price controls as a way for the government to “do something.” However, well-intentioned motives are not enough—the results also count and whether the consequences from government action are beneficial to the public, especially the disadvantaged, or not (Rottenberg & Theroux, 1994, p. 1).
Examples of where well-intentioned government motives failed in their attempts to ration health care based on price can be found in Germany and Japan. Due to the belt tightening based price rationing both countries experienced shortages of medications, reduced funding for research, and black market criminal activity, along with dissatisfied patients (Rottenberg & Theroux, 1994, p. 2).
Although there is a valid argument for rationed care, determination of what factor should be used to determine who gets what care is still up for debate. Under the solutions category of this paper quality-adjusted life-year (QALY) will be further defined and labeled as the best way to ration care. A method for calculating QALY will be explained and its validity defended.

Current Impact on Healthcare Consumers and Institutions.
Health care organizations around the world all rely on some form of rationing of care due to limited resources. Ultimately rationing limits access to healthcare. In the case of the United States, this is done through health coverage both government and private. Creating a universal coverage system will require a rationing system that is both ethical and cost effective. Its impacts can only be examined in theory based on review and comparing of the US to that of other countries’ such as Canada and Great Britain.
Review of healthcare rationing in the United States. When comparing the United States’ current healthcare coverage system to those of other countries, the country does not measure up. Under the current system, health care costs in the US result in absorption of approximately one in six dollars of national spending (Singer, 2009). A poor economy along with increased healthcare costs have reduced the number of those with healthcare coverage. In 2012 the estimates indicate approximately 44.6% of US citizens have health care coverage, a decline of 1.2% from the prior year (Young, 2013). At present, the US spends 1.5 times more than other countries around the world (Kane, 2012, para. 8) with 90% percent of Americans who believe the US healthcare system needs fundamental changes or a complete overhaul (Center for American Progress, 2007, p. 3).
Great Britain. In Britain, all citizens have healthcare coverage, a sharp contrast to the United States. 76% of citizens in Great Britain approve of the current system (Singer, 2009) and 9.6% of GDP is spent on their healthcare needs (Kane, 2012, table 2). The country uses the National Institute for Health and Clinical Excellence (NICE) as a resource for determining the rationing of health care services. NICE is an independent organization that provides national guidance and standards on the promotion of good health and the prevention and treatment of ill health (NHS Choices, 2011, para. 3). The organization focuses on:
* Public health
* Health technologies
* Clinical practice
* Quality standards
* Quality and outcomes framework
Canada.
Possible Solution.
QALY is an opportunity as a measurement for a unbiased approach to organizing healthcare under an umbrella of unified understanding. As a proponent to rationing of healthcare, QALY offers an approach that focuses on the best quality of life compared to that of life extensions. For example, an individual who is 3o years of age has a life expectancy of 70 years compared to that of someone who is 85 years of age who has exceeded their life expectancy. It is cost beneficial to provide life -saving medicine to the individual who is at 30 opposed to the one who are 85 because there is a greater bang for the buck. In essence QALY is a measurement that can help determine the best way to use resources and allocate funds toward the best overall outcome. Unfortunately this decision can result in death for those of less dire circumstances or for those that are less likely to result in successful outcomes. Until American citizens decide on the emphasis of cost vs. life the matter will remain unresolved. Until then, healthcare remains in a grey area where they attempt to balance the value of life with the costs that are associate with maintaining life.

References
Andre, C., & Velasquez, M. (2010). Aged-Based Health Care Rationing. Retrieved from http://www.scu.edu/ethics/publications/iie/v3n3/age.html
Center for American Progress. (2007). Health Care by the Numbers: Ensure Affordable Coverage for All. Retrieved from http://www.americanprogress.org/issues/healthcare/news/2007/05/03/2962/health-care-by-the-numbers/
Definition of ’Rationing’. (2013). Retrieved from http://www.investopedia.com/terms/r/rationing.asp#axzz2Lp5M2H7u
Kane, J. (2012). Health Costs: How the U.S. Compares With Other Countries. Retrieved from http://www.pbs.org/newshour/rundown/2012/10/health-costs-how-the-us-compares-with-other-countries.html
NHS Choices. (2011). Health watchdogs and authorities . Retrieved from http://www.nhs.uk/NHSEngland/thenhs/healthregulators/Pages/nice.aspx
Pipes, S. C. (2008). Obama Will Ration Your Health Care. Retrieved from http://online.wsj.com/article/SB123060332638041525.html
Rottenberg, S., & Theroux, D. J. (1994). Rationing Health Care: Price Controls Are Hazardous to Our Health . Retrieved from http://www.independent.org/publications/article.asp?id=1201
Singer, P. (2009). Why We Must Ration Health Care. Retrieved from http://www.nytimes.com/2009/07/19/magazine/19healthcare-t.html?pagewanted=all&_r=0
The National Coalition on Health Care. (2011). Health Care Spending as Percentage of GDP Reaches All-Time High. Retrieved from http://nchc.org/node/1171
Ukleja Center for Ethical Leadership. (2012). Rationing Health Care. Retrieved from www.csulb.edu/colleges/cba/ucel/modules/documents/rationing-health
Young, J. (2013). Number of Uninsured in U.S. Rises as Workers Lose Jobs and Health Insurance. Retrieved from http://www.huffingtonpost.com/2012/02/14/number-of-uninsured-in-us_n_1276189.html

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In supplier partnerships, state the key characteristic of the products or services of business organizations forming strategic partnerships, and explain why Answer

Ans: The key characteristic of the products or services of business organizations forming strategic partnerships can be grouped into six main categories: cost, quality, cycle time, service,

Cost:

Price

  • Logistics costs (Transportation, Inventory, Administration, Customs, Risk and

damage, Handling and Packaging)

  • Operating costs
  • After sales service costs

 Quality performance (e.g., ISO 9000 accreditation)

  • Marketability
  • Durability
  • Ergonomic qualities
  • Flexibility of operation
  • Simplicity of operation
  • Reliability

cycle time

Speed to market

  • Delivery lead time
  • Development Speed
  • On time delivery
  • Fill rate

 Service

  • Ability to modify product
  • Supply variety
  • Technical support
  • After sales services (e.g., Warranties and Claims policies)
  • Flexibility (Payment, Freight, Price reduction, Order frequency & amount)

• Delivery frequency

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What are some of the major provisions, principles, and changes in regards to funding mechanisms for universal service Answer

What are some of the major provisions, principles, and changes in regards to funding mechanisms for universal service under the 1996 Act?

 

The Act of 96 changed the Universal Service from Vail, which started as a way to get all of the telephones to talk with each other – by getting rid of the competing, non interconnected telephone networks. To what we  have today in Section 254, which are the guidelines that govern Universal Service. It is no longer limited to  affordable telephone service to all Americans – passed 1934; but it has been broadly defined as a evolving  level of telecommunication services that should reflect the advances in telecommunications and information services. So they have to periodically reevaluate  because of the advances in telecommunication and information services. The concept today is better today because of the ability to reevaluate because of the rapid changes.

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VoIP has been the subject of several FCC NPRMs (Notice of Proposed Rule Making). What is VoIP Answer

VoIP has been the subject of several FCC NPRMs (Notice of Proposed Rule Making). What is VoIP and why does it present a regulatory challenge?

VoIP, Voice over Internet Protocol, allows callers to make phone calls over the internet. It is the ability to carry phone calls over an IP data network. It allows you to make voice calls using broadband internet connection instead of a regular phone line. The present regulatory challenge comes from the fact that this technology was not addressed in the Telecommunications Act of 1996. The internet is considered an “enhance service” , (which according to FCC is  any service offered over common carrier with exception to DSL, Cable and powerlines – they are considered  information services) therefore it is not regulated. Telephone companies are regulated and are required to pay the Universal Service Fund (USF) and the challenge now becomes should they be charged the USF because of the phone calls.

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Criticism has been leveled at the curative rather than health promotion/disease prevention focus of the U.S. healthcare system Answer

Criticism has been leveled at the curative rather than health promotion/disease prevention focus of the U.S. healthcare system. Should the focus change? Why or why not? Do you see evidence of a shift occurring? If so, what do you think is contributing to that change?

The focus is changing through changes in the Medicare benefits, curative was the primary focus of healthcare and now it is preventative. It should be prevention because it saves millions of dollars in healthcare benefits to prevent instead of cure. Our government is getting smarter by covering more prevention services than waiting for someone to get sick before we care for them. However, we are not there yet but moving into that direction. The wellness approach is a great way to encourage and prevent illness. Changing your lifestyle to a more healthy way of life a little at a time helps a lot. It is all about prevention instead of curative because curative costs and prevention saves healthcare dollars.

The preventive approach is being utilized at the Queens Long Island Medical Group (QLIMG) at all the various locations listed below. The healthcare professionals do their very best to direct their patients in the right path to go to prevent further serious illnesses.

Astoria Medical Office

31-75 23rd Street

Astoria, NY 11106

(718) 956-2200

Babylon Medical Office

300 Bayshore Rd.

North Babylon, NY 11703

(631) 586-2700

It makes sense to move to a preventive style, it saves money and saves lives. My employer is currently moving in that direction and it’s saving me money ever month for both me and my wife, by simply not smoking and getting a check up once per year. Americans need to be educated on better health.

In general, I believe health care organizations are putting more emphasis on preventive medicine. In a different thread, I’ve discussed my organization verifies that all patients admitted to the hospital and those who come in for clinic visits are immunized. If they are not up to date on immunizations, we ensure that before they leave they receive their vaccines unless parents oppose to vaccinating their children. We also spend a great deal of time teaching our patients and their families about their disease process and what their plan of care entails in order to avoid future hospitalizations (asthma teaching, diabetes management, etc). I wonder if there is a difference in the payer ratio between preventive medicine and curative medicine. I thought I heard that Medicaid pays more for preventive medicine. Also, just today, I received a letter from my primary physician’s office stating that it’s been a year since they’ve seen me and I should schedule an appointment for a routine check-up. I’m one of those people that usually sees their physician only when something is wrong. It could be partly due to having a high deductible plan and I don’t want to pay for it and it could be due to the fact that nurses usually don’t make the best patients. Either way, I think individuals (including myself) need to prioritize and realize the importance of preventive medicine. My friend was diagnosed with breast cancer at the age of 26; the lump was found on her yearly physical by her primary care physician. She told me that she usually goes in for a yearly physical because it’s one of the few visits that is 100% covered by her insurance.

As an educator, I am a firm believer of preventive medicine. I get to promote that in my Nutrition classes with actual evidence that many of our public health issues can be addressed before they reach critical levels. For example, back in 2010, we spent $147 billion on patient care that could have been prevented because it was all related to obesity. Conditions like heart disease, diabetes, circulatory problems, kidney disorders and many others are the end results of a consumer based culture that promotes harmful habits such as eating fast foods, drinking beer and convenience I like to call a drive through mentality. Why is it that our politicians are still fighting over who is going to pay for patients treatments instead of focusing how to prevent disease in a first place? It is simple. There is no money in prevention like there is for treatment.

What are the cultural factors which impact the way in which we approach our healthcare system?     Why do we not focus on prevention more on our system?

If we would focus more on Prevention it could eliminate a lot of surgeries and major illness. this that is possibly could lower some medical cost. I think most people do not focus on prevention because they wait until something goes wrong to get help. Many people can not afford healthcare insurance. So, they are faced with putting food on the table or going for an annual exam. Of course putting food on the table is a more important priority. I believe that in many instances individuals have indicators that alert them that something is not right with their bodies. It’s not until they can’t function or is forced to seek medical attention before they will go to the doctor. My mother is one of these individuals. She just will not go to the doctors. I try to encourage her to go but she just won’t do it.

How does the media impact our attitude toward prevention and wellness both in a positive way and a negative way?

Positively I think the media put the concern in our minds by making us aware of different illnesses. Recently I saw a commercial were a variety of people were laughing at one moment then crying seconds later. I initially thought this a comical commercial, but at the end of the commercial this condition was given a medical name. The commercial caught my attention because it was different, but it actually ended up being very informational. On a negative note things in the media may make individuals worry more. They may decide not to seek medical assistance out of fear of the unknown, or vice versa where they may go to the doctors unnecessarily for everything.

The media has positive affect when it properly educates and creates a sense of urgency for change. I think unfortunately that “fads” are created and the longevity for change fall to the wayside. The media focuses on diets and the new supplement of the month and Dr. OZ and misses that fact that our children are going to have a shorter sicker life than we are. We need to properly educate America and then maybe provide an insurance incentive for those who don’t drink or smoke and those who eat right and exercise regularly. We are less of a burden on the system and we should pay less because we cost less. I want to say that just because you have a reoccurring illness or a mental health diagnosis I don’t think you should have to go broke paying but paying a little more over a long period of time is better than not having insurance at all. We need big changes in attitudes and lifestyles in America and I can’t wait to

Medication commercial should be outlawed like cigarettes or booze; oh that right we have allowed those back in the media mostly due to ridiculously large donations by the company who produce them. Anyways, drug companies develop a new drug and they want to get it into the market as fast as possible so they advertise. These advertisement create a buzz about the product, they consumer then asks their doctor about it, the doctor prescribes it. Right? Well, almost. The manufacturer develops a drug and a representative goes to the doctors most likely to prescribe they offer presents, samples and cash bonuses and leave the product in the doctors’ office. What do you think a doctor is going to prescribe mediation in generic form or the new shiny box in the closet that makes him a little more money or a trip? Sometimes the pharmaceutical companies offer large gifts to the doctors and their staff so that they will advertise and advocate their medications. I have a friend that works for a pain management company and she has yet to pay for her own lunch, and she has been there over a year. There are some many pharmaceutical representatives in and out of their office offering them a variety of gifts just so the doctors will prescribe their meds.

According to our text book, “Individual factors include inherited (i.e., genetic) characteristics and individual behaviors that reflect a person’s beliefs, attitudes, and values. Another individual factor, health literacy, has only recently begun to be examined. Some databases (see the statistical section on the World Health Organization’s website) note that the United States has a 100 percent literacy rate, which is seriously overstated. A person’s ability to read and understand prescription dosages and times and conditions of usage will affect the outcome of treatment. A language barrier may affect a person’s ability to comprehend the proposed treatment plan.”

http://devry.vitalsource.com/#/books/978-1-56793-374-1/content/element/2010?locs[]=11-7&q=factors

What are the cultural factors which impact the way in which we approach our healthcare system?

 

Cultures plays a major role when it comes to healthcare. By health professionals understanding their patients cultures will makes them better understand them. Doctors should take some time to find out their religion, diet, communication/interaction. For example, Muslims fast during certain times of the year. If a Muslim is a diabetic then the doctor would have to explain that it is best not to fast in order to avoid hypogloycemia. Another example, would be Muslims are not comfortable with shaking hands with the opposite sex.

Why do we not focus on prevention more on our system?

I believe that we do not focus on prevention in our healthcare system, because it takes a lot of time. Most people do not worry about going to their annual check-up because they are not sick, they keep postponing it and it is the same with the regularly scheduled preventative exams such as mammograms and colonoscopies. People have to take time out of their busy scheduled to tend to their own maintenance. We as American workers focus too much on others and not ourselves.   If nothing is wrong, it is hard to spend the extra time and money to go to a checkup where they tell you everything is fine. The co-pays are too high and our employers are not very understanding when it comes to yearly physicals and other preventative procedures. The doctor’s offices and procedure places of business are just as bad. They do not offer appointments that would work around the regular Monday through Friday 8 – 5 pm schedule that most Americans work with. Perhaps if we were given a couple of days a year that was paid by our employers to get this all done, then maybe we would have better preventative care. You would have to show proof that you went to the doctor or had your procedure, which isn’t hard to do and then when submitted to work, you get paid. The government could offer some type of incentatives to those employers that have 90% or above compliance with preventative healthcare measures. Another idea would be a scheduled by the employer appointment for preventative care. They would schedule it, pay you for the day, and of course give you the day of, so that you would be able to get your preventative care done. Some companies already have a form of this where they receive a company physical. When I first was hired at St Vincent, I received a physical that was scheduled by them, but I have not gotten another from them. If they did this every year or every 2 years, this would be a great start towards preventative care compliance.

Many families are lacking the knowledge of proper nutrition, many doctors as well. The drive thru is killing us, a family can be feed from the dollar menu, this is a cheaper option for some people. Yes it should change because the greatest advances in America’s health have come from preventive and public health measures, and based on the history and evidence of disease prevention the opportunity remains vast for further gains through disease prevention and health promotion. Promotion/disease prevention also promotes a since of shared responsibility for the health of our nation and its communities and it gets all involved in the processes as well.

 

Human behavior plays a central role in the maintenance of health, and the prevention of disease. With an eye to lowering the substantial morbidity and mortality associated with health-related behavior, health professionals have turned to models of behavior change to guide the development of strategies that foster self-protective action, reduce behaviors that increase health risk, and facilitate effective adaptation to and coping with illness. Several decades of concerted effort to promote health and decrease risk through individual behavior change have produced successes, failures, and lessons learned.

Human behavior plays a central role in the maintenance of health and the prevention of disease. Growing evidence suggests that effective programs to change individual health behavior require a multifaceted approach to helping people adopt, change, and maintain behavior. For example, strategies for establishing healthy eating habits in children and adolescents might be quite ineffective for changing maladaptive eating behaviors—that is, when they are used to substitute one pattern for another—in the same population (e.g., Jeffery et al., 2000). Similarly, maintaining a particular behavior over time might require different strategies than will establishing that behavior in the first place (e.g., Ockene et al., 2000). Models of behavior change have been developed to guide strategies to promote healthy behaviors and facilitate effective adaptation to and coping with illness.

http://www.ncbi.nlm.nih.gov/books/NBK43749/

One of the strategies that is being used by employers and health insurance companies is to provide incentives to individuals to engage in healthy behaviors.   Do you support this approach?

Yes, I definitely support these incentives provided as employees who have desk jobs, do not get much exercise in general. Healthy behaviors such as getting up and taking a break every 2 hours, taking a walk, ensuring proper usage of back support and ergonomics for typing would decrease carpel tunnel syndromes, back pains and other injuries which would benefit the company by not paying for work compensation. Also having a gym in the company would be a great benefit for the employees as well.

Is there some financial incentives that we can provide to employees that may be effective?

Some companies have offered annual raises, or even an annual bonus to the best performers of healthy behavior. These kinds of financial incentives do usually make employees think about the change in a whole new light. All the guidelines of the healthy behavior program should be given to everyone that is willing to participate. Make sure that these and other incentive’s are monitored closely so the employee does not feel slighted by a missed bonus or raise.

My company currently offers wellness bonuses. These bonuses are our unused sick time. At the end of the fiscal year we can either cash them out for the bonus, or bank them for later use. Wellness programs can also penalize employees for not participating or having an categorized unhealthy life style. The link below is to an article that describes how large companies’ like Wal-Mart and Pepsi, charge there employees higher premiums for not participating in the wellness program. The gave of an example of a smoker vs non-smoker. The smoker paid $2000 more in premiums than the non-smoker. The article discussed how this practice and penalties will increase with the Affordable Care Act.

http://www.huffingtonpost.com/2013/02/22/health-insurance-should-employee-lifestyles-determine-cost_n_2741589.html

“As Company Wellness Programs Grow, Effectiveness of Finical Incentives Debated”

 

 

What do you think of the types of employer programs that are idenfied in this post? Do you think they are effective? Should employees be required to participate?   What are the benefits?

I think its good but maybe the cost could be reduced. Its good because the purpose of the program is to increase health prevention and health awareness. The Health Reform Act wants more health prevention to make people aware of their health choices and empowers them to become healthier by implementing programs to address’s questions that could prevent illnesses as well as injuries thus reducing the cost of health care.

Health promotion, also known as primordial prevention aims to help people increase control over and improve their health. Although it may have an effect on specific diseases, it has a more general aim: to enhance health in order to develop the person’s resistance to the adverse influences of physical and social environments. Illness prevention involves actions to eliminate or minimize conditions known to cause or contribute to different diseases.

 

http://www.sagepub.com/upm-data/44223_

http://phprimer.afmc.ca/Part3-PracticeImprovingHealth/Chapter8IllnessPreventionAndHealthPromotion/Healthpromotion

Curative Approach is used by treating the illness (cure), where preventative approach is used to prevent the illness such as a healthy lifestyle change or going for medical tests that your healthcare suggest or require a head of time. With that said, in my household we are take a preventative approach we all take vitamins and try to eat healthy on a daily basis, in which this helps with the costs of doctor visits during the year. I have noticed that my children have a healthy check up visit, which requires me to take them once a year for a physical or their routine shots. It has worked for my family. I would like to think that the curative approach will more doctor visits, more money spent, and less of me going to work. This wouldn’t make me a happy camper by using this type of cuarative approach.