The Impact of Medical Technology on Health Care Finance

| The Impact of Medical Technology on Health Care Finance| Patricia Brewer| | | | | Health care costs have been rising for several years. United States health care Expenditures surpassed $2. 3 trillion in 2008, more than three times the $714 billion spent in 1990, and over eight times the $253 billion spent in 1980 (Kimbuende, 2010). Slowing this growth has become a major policy priority, as the government, employers, and consumers increasingly struggle to keep up with health care costs.In 2008, U. S. health care spending was about $7,681 per resident and accounted for 16. 2% of the nation’s Gross Domestic Product. This is among the highest of all industrialized countries. Total health care expenditures grew at an annual rate of 4. 4 percent in 2008, a slower rate than recent years, yet still outpacing inflation and the growth in national income. There is a general agreement that health costs are likely to continue to rise in the near future.Many analysts have cited controllin g health care costs as a key for broader economic stability and growth, and President Obama has made cost control a focus of health reform efforts under way. By 2016, total health spending is projected to rise to $4. 2 trillion. Rising health care costs raise health insurance premiums, which are also growing at a much quicker pace than overall inflation or workers' earnings. Health spending has been rising two and a half percent a year, faster than the gross domestic product over the past four decades (Covington, 2008).Although Americans benefit from many of the investments in health care, the recent rapid cost growth, plus with an overall economic slowdown and rising federal deficit, is placing great strains on the systems used to finance health care, including private employer-sponsored health insurance coverage and public insurance programs such as Medicare and Medicaid. Since 1999, family premiums for employer-sponsored health coverage have increased by 131 percent, placing incr easing cost burdens on employers and workers.The average cost of a one-day stay in a hospital has now risen to over $500, the total cost of a coronary bypass operation and follow-up treatment has reached $37,300, and the average cost of delivering a baby now exceeds $2500. As costs have increased, fewer people have been able to afford the medical care they need. Over 37 million Americans, including over 12 million children, carry no health insurance at all and are unable to afford private health care, they must rely on a public health system that cannot deal with such a burden.With workers’ wages growing at a much slower pace than health care costs, many face difficulty in affording out-of-pocket spending. Government programs, such as Medicare and Medicaid, also account for a significant share of health care spending, but they have increased at a slower rate than other private insurance. Medicare per capita spending has grown at a slightly lower rate, on average, than private health insurance spending, at about 6. 8 vs. 7. 1% annually between 1998 and 2008.Medicaid expenditures, similarly, have grown at slower rate than private spending, though enrollment in the program has increased during the current economic recession, which may result in increased Medicaid spending figures in the near future (Kimbuende, 2010). A major cause of the rise in health care spending is due to advancements in medicine and technology. Both have improved and lengthened the lives of many Americans, but as most know they do not come without a cost. Newly rising procedures are often expensive to give and increase overall health care spending. According to theCongressional Budget Office, â€Å"the bulk of increases in health care spending could be attributed to the development and dissemination of new technologies and medical services. † Such advancements also lead to changes in practice, which together tend to increase spending. Consumer demand and increased utilization a dd to costs (â€Å"Changes in Medical Technology,† 2007). Ethics comes in at this point because medical technology is highly valued as a â€Å"beloved feature of American medicine. † Patients expect up to date procedures, doctors are primarily trained to use it, and the medical industries make billions of dollars selling it.The rising costs are seen as a major issue because many people in the United States aid from the new procedures and treatments produced each year. Medical technology refers to the procedures, equipment, and processes by which medical care is delivered (Barbash, 2008). Changes or advancements in technology would include new medical and surgical procedures, as well as new drugs and medical devices, such as scanners and defibrillators. Also the recent rise and interest in universalizing Electronic Medical Records and the use of preventive medicine has attributed to the growing costs.Technological innovation has given us vaccines, antibiotics, advanced heart disease care, splendid surgical advances, and fine cancer treatments (Barbash, 2008). Most health policy analysts agree that the long- term increase in health care spending is principally the result of the health care system’s incorporation of these new services in clinical practice. A robotic surgical device is an example of how technology advancement can increase health care costs. These high tech procedures of becoming extremely popular and seem to be the future of surgery.These robots allow surgeons to operate remote-controlled robotic arms, which may facilitate the performance of laparoscopic procedures. Laparoscopic surgery is associated with shorter hospital stays than open surgery, as well as with less postoperative pain and scarring, and lower risks of infection and need for blood transfusion. Robotic technology has been adopted rapidly over the past four years in both the United States and Europe. The number of robot-assisted procedures that are performed worl dwide have nearly tripled since 2007, from 80,000 to 205,000. Robotic technology affects expenditures by increasing the cost per procedure.Robotic surgical systems have high fixed costs, with prices ranging from $1 million to $2. 5 million for each unit. Surgeons must perform 150 to 250 procedures to become adept in their use (â€Å"Robotic Surgery Technology,† 2006). The systems also require costly maintenance and demand the use of additional consumables. The use of robotic systems may also require more operating time than alternatives. Robot- assisted procedures may contribute to shorter hospital stays, which will decrease costs, but at the same time require physicians to train on these instruments. Each instrument is a pricey expenditure for a hospital to pay for (Barbash, 2008).To maintain these instruments and keep them up to date will be an added cost as well. These instruments perform miracles and may seem like a wonderful addition to the surgical world, but are not ch eap. Advancements in scanner technology, such as CT’s, allows for greater visibility at a higher resolution than was possible before. Innovative scanners, advanced applications, and exciting breakthroughs in clinical procedures are driving an increased use of a CT as a primary diagnostic tool for procedures such as colonography, cancer detection and staging, lung analysis, cardiac studies and radiotherapy planning (â€Å"Diagnostic Imaging,† 2011).Hospitals and other health care facilities are pressured to purchase such equipment to keep up with the public demand for these high-specialized tests. With out such machines and technology the public will turn elsewhere to receive the care that they so desire and need, which will end in a loss of profit for such hospitals and other facilities. Another technological advancement that has a great impact on healthcare finance is the emergence of the Electronic Medical Record. Electronic Medical Records is a computerized medical record created in an organization that delivers care, such as a hospital or physician's office.Electronic medical records tend to be a part of a local stand-alone health information system that allows storage, retrieval and modification of records. The 2003 IOM Patient Safety Report describes an EMR as, â€Å"a longitudinal collection of electronic health information for and about persons, immediate electronic access to person- and population-level information by authorized users, and provision of knowledge and decision-support systems that enhance the quality, safety, and efficiency of patient care (â€Å"Electronic Medical Records,†2011). † The adoption of these records can be quite costly.The price of an EMR system can range from a thousand dollars to ten thousand dollars, and in some cases they can cost even more. EMR costs increase as the system becomes more feature-rich. Huge facilities can buy complete EMR systems that cost around plus forty thousand dollars. Tr aining and maintenance costs also have to be taken into account when purchasing EMR’s. All staff must be trained to operate the new machines, coming familiar with the new software and patient records. If you want to utilize the EMR product to its full potential, then you need hardware that perfectly complements the software.Purchasing computers and up to date software that will last for the long term is also an added cost. These systems also require maintenance to keep them working sufficiently. A facility may also need to hire a networking professional to monitor and maintain the network in their facilities. A networking expert will ensure that the workstations remain connected to each other and seamlessly exchange data (â€Å"Electronic Medical Records,† 2011). The installation and upkeep of EMR’s is not a cheap process. Many hospitals and private facilities are hesitant to make the improvement.The costly technology can improve the quality of care for patients by knowing ones medical history and prescription drugs they are on or allergic too. It can also decrease unnecessary testing in many cases. President Barack Obama, as part of the effort to revive the economy, has proposed a massive effort to modernize health care by making all health records standardized and electronic. His aim is to computerize all health records within five years. He believes the quality of health care for all Americans gets a big boost, and osts will decline. Independent studies from Harvard, RAND and the Commonwealth Fund have shown that such a plan could cost at least $75 billion to $100 billion over the ten years they think the hospitals would need to implement program. The healthcare initiative will be one of the priciest parts of the plan. Along with the high costs a major concern of the government is that lack of skilled workers to build and implement the necessary technology. The biggest cost will be paying and training the labor force needed to create th e network.The savings of such a plan could be substantial. The government estimates that a fully computerized health record system could save the industry $200 billion to $300 billion a year, and could ultimately slow the rapid rise of health care premiums, which have cut into Americans' pay checks. There are many advantages that the Electronic Medical Records pose for both patients and physicians. The EMR can reduce errors in medical records. Handwritten records are subject to lots of human errors due to misspelling, illegibility, and differing terminologies.On-screen or printed text is often far more legible than handwritten. This can help prevent patient’s receiving the wrong medication or procedures, saving doctors from medical malpractice suits (Molar, 2010). Clinical errors cause at least 44,000 deaths annually in the United States. These deaths largely result from process errors, or the failure to provide recommended treatments for patients with certain medical conditi ons. With direct medical costs estimated at $17 billion annually, these errors impose a substantial burden on both the health care system and society as a whole.The real time paperless record include reducing the need for costly reproductions of laboratory findings and diagnostic reports, which in many health care facilities are still typed, copied, and physically carried to a hospital floor, clinic office, or medical records room to be placed in the patient's chart (Hunt, 2009). Loss of reports, or delays, are common until this information reaches the chart and the providers. While wages are rising at a rate of around 3% a year, health care costs are growing at about three times that rate (Goldman, 2009).Prescription drugs also play a role in Health Care finance. Advances in pharmaceuticals have transformed health care over the last several decades. Today, many health problems are prevented, cured, or managed effectively for years through the use of prescription drugs. In some case s, the use of prescription medicines keeps people from needing other expensive health care such as being hospitalized or having surgery. In 2007, 90% of seniors and 58% of non-elderly adults rely on a prescription medicine on a regular basis (Kimbuende, 2010).Since the 1990s spending on prescription drugs has been a much more prominent component of growth in total spending. From 1995 to 2005, it grew by an average of about 10 percent per year and is still on the rise as the future of prescription drugs lies in the baby boomer generation (â€Å"Technological Change,† 2008). Increased Medical Technology has led to the use of defensive medicine by many health care physicians. Defensive Medicine refers to services that have little or no clinical value, but that physicians order or perform at least to avoid lawsuits (â€Å"Technological Change,†2008).With high malpractice premiums, more physicians everyday are turning to this type of practice. It is raising health care cost s by performing unnecessary tests and procedures on patients that may not need them. There is reason to believe that new technology can in fact reduce health care spending. Some vaccines may offer the potential for savings, and certain types of preventive medical care may help some patients avoid costly hospitalization for acute care. Future advances in molecular biology and genetics, may one day offer the possibility of savings if they make curative therapies available.Continued advances in understanding the genetic origins of disease offer the credible possibility that future providers will accurately predict the health risks faced by individual patients and design therapies tailored specifically to them (Convington, 2008). Overall, examples of new treatments for which long-term savings have been clearly demonstrated are few. Many medical advances to date have increased spending because they made treatments available for conditions that were previously impossible to treat or were not aggressively treated.Furthermore, improvements in medical care that decrease mortality by helping patients avoid or survive acute health problems paradoxically increase overall spending on health care because surviving patients live longer and therefore use health services for more years (â€Å"Technological Change,† 2008). With the baby boomers approaching retirement age and living past recent life expectancy age, health care costs are projected to rise even further. Technological advances and new medicines and prescription drugs are keeping people alive longer and putting a strain on our health care system.In coming decades, the share of the population that is covered by Medicare will expand rapidly as members of the baby- boom generation become eligible for the program, and the share that uses long-term care services financed by Medicaid will also probably increase. According to the American Hospital Association, â€Å"the first boomers will reach 65 in 2011 and 37 mi llion of them will be managing one chronic condition by 2030. † Also 14 million Boomers will be living with diabetes, that's one out of every four Boomers. Almost half of this generation will live with arthritis, and that number peaks to just over 26 million in 2020.More than one out of three Boomers, over 21 million, will be considered obese. As these patients live with multiple chronic diseases, demand for services will increase. The number of physician visits has been increasing for all adults, up 34 percent over the last decade, and this trend is expected to continue. By 2020, Boomers will account for four in 10 office visits to physicians and over the next 20 years, Boomers will make up a greater proportion of hospitalizations as they live longer but with multiple complex conditions.At the same time, the number of registered nurses, primary care and specialty physicians will not keep pace with demand. As the Boomer generation is more racially and ethnically diverse, there will also be a greater need for caregivers who reflect the diversity of and increase in this population (â€Å"How Boomers will change Health Care,†2007). With changing demands, expectations and new technology, care delivery will also change. Boomers have lived through an amazing array of medical advances, from polio vaccine to radical heart surgery, and that trend will continue over the next two decades.Medical Advancements are taking place every day and are given rise to growing health care costs. Rising health care expenditures lead to the question of whether we are getting value for the money we spend. Compared to other high-income countries, the U. S. spends more, but this spending is not reflected in greater health care resources, such as hospital beds, physicians, nurses, MRIs, and CT scanners per capita  or better measures of health. The United States needs to figure out a way to use these advancements to our benefit and reduce cost while maintaining good quality o f care to every patient.With the growing elderly population, medical technology is in high demand as many people over 65 are suffering with at least one chronic condition. The Untied States government and health care providers need to figure out a way to reduce the health care costs. The incorporation of preventive medicine and Electronic Medical Records can aid in cost reduction for the future. Unnecessary testing should be avoided to also help reduce costs. Hopefully, EMR’s can reduce the amount of tests being performed and duplicated.Policies focusing on new and expanding technologies may have success in reducing the rate of growing health care costs but can be difficult to implement. In the long run, bringing health spending growth closer to the rate of overall economic growth would require finding ways to slow the development and diffusion of new healthcare technologies and practices, as well as developing ways to weigh the costs and benefits of new technologies (â€Å" Technological change,† 2008). References Barbash, G. (2010). New Technology and Health Care Costs. New England Journal of Medicine.Retrieved from http://www. nejm. org/doi/full/10. 1056/NEJMp1006602 Convington, L. (2008). An Alliance for Health Reform. Retrieved From http://www. allhealth. org/publications/cost_of_health_care/health_care_costs_toolk Diagnostic Imaging. (2011). Hospital and Healthcare Management. Retrieved From http://www. asianhhm. com/medical_sciences/advances_CT_technology. htm Electronic Medical Records. (2011). Open Clinical. Retrieved From http://www. openclinical. org/emr. html Goldman, D. (2009). Obama’s big idea: Digital Health Records.New York Times. Retrieved December 2, 2011, from http://www. nytimes. com/subscriptions/Multiproduct/lp3004. html? campaignId=384LY How Boomers Will Change Health Care. (2007). American Hospital Association. Retrieved From http://aha. org How Changes in Medical Technology affect Health Care Costs. (2007). Retrieve d From http://www. kff. org/insurance/snapshot/chcm030807oth. cfm Johns Hopkins University (2006, November 28). Robotic Surgery Technology Gives Doctors ‘Sense Of Touch'. ScienceDaily. Retrieved December 6, 2011, from http://www. ciencedaily. com ­ /releases/2006/11/061128121916. htm Kimbuende, E. (2010). Health Care Costs. Kaiser Family Foundation. Retrieved From http://www. kaiseredu. org/Issue-Modules/Prescription-Drug-Costs/Background-Brief Technological change and the Growth of Health Care Spending. (2008). Congressional Budge Office Retrieved From http://www. cbo. gov/ftpdocs/89xx/doc8947/01-31-TechHealth. pdf The Long Term Outlook for Health Care Spending. (2007). Congressional Budget Office Retrieved From http://www. cbo. gov/ftpdocs/87xx/doc8758/11-13-LT-Health. pdf

Difference Between Atomic Weight and Atomic Mass

Difference Between Atomic Weight and Atomic Mass Atomic weight and atomic mass are two important concepts in chemistry and physics. Many people use the terms interchangeably, but they dont actually mean the same thing. Take a look at the difference between atomic weight and atomic mass and understand why most people are confused or dont care about the distinction. (If youre taking a chemistry class, it could show up on a test, so pay attention!) Atomic Mass Versus Atomic Weight Uranium has two primordial isotopes (uranium-238 and uranium-235). Uranium-238 has 92 protons plus 146 neutrons and uranium-235 92 protons and 143 neutrons. Â  Pallava Bagla/Getty Images Atomic mass (ma) is the mass of an atom. A single atom has a set number of protons and neutrons, so the mass is unequivocal (wont change) and is the sum of the number of protons and neutrons in the atom. Electrons contribute so little mass that they arent counted. Atomic weight is a weighted average of the mass of all the atoms of an element, based on the abundance of isotopes. The atomic weight can change because it depends on our understanding of how much of each isotope of an element exists. Both atomic mass and atomic weight rely on the atomic mass unit (amu), which is 1/12th the mass of an atom of carbon-12 in its ​ground state. Can Atomic Mass and Atomic Weight Ever Be the Same? If you find an element that exists as only one isotope, then the atomic mass and the atomic weight will be the same. Atomic mass and atomic weight may equal each other whenever you are working with a single isotope of an element, too. In this case, you use the atomic mass in calculations rather than the atomic weight of the element from the periodic table. Weight Versus Mass: Atoms and More Mass is a measure of the quantity of a substance, while weight is a measure of how a mass acts in a gravitational field. On Earth, where we are exposed to a fairly constant acceleration due to gravity, we dont pay much attention to the difference between the terms. After all, our definitions of mass were pretty much made with Earth gravity in mind, so if you say a weight has a mass of 1 kilogram and a 1 weight of 1 kilogram, youre right. Now, if you take that 1 kg mass to the Moon, its weight will be less. So, when the term atomic weight was coined back in 1808, isotopes were unknown and Earth gravity was the norm. The difference between atomic weight and atomic mass became known when F.W. Aston, the inventor of the mass spectrometer (1927) used his new device to study neon. At that time, the atomic weight of neon was believed to be 20.2 amu, yet Aston observed two peaks in the mass spectrum of neon, at relative masses 20.0 amu and 22.0 amu. Aston suggested there two actually two types of neon atoms in his sample: 90% of the atoms having a mass of 20 amu and 10% with a mass of 22 amu. This ratio gave a weighted average mass of 20.2 amu. He called the different forms of the neon atoms isotopes. Frederick Soddy had proposed the term isotopes in 1911 to describe atoms that occupy the same position in the periodic table, yet are different. Even though atomic weight is not a good description, the phrase has stuck around for historical reasons. The correct term today is relative atomic mass - the only weight part of the atomic weight is that it is based on a weighted average of isotope abundance.

In Search of Peace essays

In Search of Peace essays What the world needs today is a civilization based on love and compassion, and not on competition. A civilization that is not dying to be victorious, but which is keen to live with peace. Nowadays terrorism, war and human killing are in vogue. Powerful nations control the less powerful nations as their right. Humanity is suffering at the hands of brutal politicians. There is no peace in the world and within the self. Innocent children are asking their parents, teachers and friends what is going on around them. Everybody is in search of peace. Where is peace? The world religions long ago defined peace as individual responsibility for the wellbeing of others. Let us remind ourselves of that forgotten lesson and reflect on how everyone of us individually can contribute towards peace in the world? Let us briefly survey the concept of peace given by the world religions. Peace means freedom from war and unrest. In ancient Hebrew thought, peace was not only the absence of war, but also the wellbeing, if not prosperity, of people. A famous passage which appears twice in the Bible (Is: 2-4 Mi. 4: 1-3) describes "... all nations are going to Jerusalem to learn the divine law; beating their swords into plowshares and their spear into pruning hooks, abandoning their swords and learning war no more." The study of Israelite traditions shows that peace was a social concept. It was visible and produced harmonious relationship in the family, in local society and between nations. The salutation shalom expressed positive aim of encouraging friendship, cooperation and living together for mutual benefit. The New Testament defines peace as "an orderly obedience to the eternal laws of God", so peace in the God's city is the perfect union of hearts in the enjoyment of God (19:13). The salutation of peace frequently appears in the New Testament. In the Quran, the Arabic word Salam has been used for peace. It has been generally used as a greet...

3 Cases of Misuse of Dashes

3 Cases of Misuse of Dashes 3 Cases of Misuse of Dashes 3 Cases of Misuse of Dashes By Mark Nichol In each of the following sentences, dashes are erroneously employed, resulted in confused sentences. Discussion following each example explains the problem, and one or more revisions illustrate solutions. 1. When driving long distances- know that children get restless. A dash is not applicable when one clause naturally follows another. â€Å"Know that children get restless† does not abruptly break from the subordinate clause that precedes it, so a comma suffices here: â€Å"When driving long distances, know that children get restless.† 2. Few banks can afford their customer experiences to plateau for long before customers with ever-increasing expectations choose to do business with a competitor- or worse- with a disruptive market entrant. â€Å"Or worse† is treated here as a parenthetical phrase but is not intended as one. Because what follows the first dash signals a syntactical break, only that first dash is called for. In addition, because worse, on its own, is parenthetical to the phrase â€Å"or with a disruptive market tenant,† it should be bracketed by punctuation, but two mere commas suffice (and a pair of dashes would confuse in proximity to the preceding one): â€Å"Few banks can afford their customer experiences to plateau for long before customers with ever-increasing expectations choose to do business with a competitor- or, worse, with a disruptive market entrant.† 3. Some features predicted in this article- like seat belts- became ubiquitous, while others- like braking distance indicated on speedometers- never caught on. As mentioned in the discussion for the previous example, employing one or two dashes more than once in a given sentence can be confusing, as readers see several phrases separated by the dashes with no indication of syntactical hierarchy, so avoid doing so: â€Å"Some features predicted in this article, like seat belts, became ubiquitous, while others, like braking distance indicated on speedometers, never caught on.† If two complementary phrases, such as those specifying examples in the original sentence, are going to be used parenthetically, the pairs of punctuation marks must be identical to indicate their equivalence. However, in this case, because a comma already exists in the sentence, the sentence organization is still muddled (and the statement is crowded with commas), so it is more helpful to the reader to frame the two examples in parentheses: â€Å"Some features predicted in this article (like seat belts) became ubiquitous, while others (like braking distance indicated on speedometers) never caught on.† Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Punctuation category, check our popular posts, or choose a related post below:30 Religious Terms You Should KnowRunning Amok or Running Amuck?Shore It Up

Can freedom of speech guaranteed by 1st Amendment be lawfully and Essay

Can freedom of speech guaranteed by 1st Amendment be lawfully and soundly used to advocate abolishment of 1st Amendment - Essay Example Even advocating illegal acts is legal. Therefore, if we can use our freedom of speech to, for example, control someone with our lies, or to impose our personal convictions to others, there is no reason why we could not use that same freedom to advocate its own abolishment. Every single individual has the right to express their opinion. Although, sometimes not entirely. In some cases an individual may not be allowed to fully express his right of free speech because it may lead to criminal actions or have a bad effect on the society. This way of prevention is called censorship and it is a crucial symptom of collectivism. Furthermore, if everything gets under the control of the government (gets nationalized), it will mark the end of free speech. No matter how offensive its content is, freedom of speech is protected by the first Amendment and it is believed that academic freedom is a â€Å"bedrock of education in a free society†, furthermore, it cannot be denied, unless the speaker breaks the rules of the first Amendment that forbid the use of fighting words (which are not essential part of exposition of ideas and are likely to provoke a person to take revenge). Everyone has a right to express themselves freely, as long as they respect the few of restrictions of the first Amendment. Using that right, we can lawfully speak about almost anything. And, yes, we can use that right to speak against the first Amendment without doing anything that is illegal. But the fact that we have the legal right to speak against the first Amendment does not mean that anyone has to hear about it. â€Å"Free speech does not require anyone to listen.† But who would want to limit or completely abolish his rights? Theoretically, freedom of speech can be lawfully used to advocate abolishment of the first Amendment, but there are not many people who would agree that it would be a good thing to abolish it, and, without the support of the listeners, the one who advocates the

Elements of change and continuity in the history of London and its Essay

Elements of change and continuity in the history of London and its cinematic representation - Essay Example It was the Normans who introduced the feudal system to Britain (Norton, 1829). And even before and after that, London has been a town of merchandise mainly (Norton, 1829). It was a city of banks as well (Michie and Williamson, 2004, p.12). These two features of the city have remained till date. And from a very early period, the citizens of London had many privileges given to them by the respective rulers, which were not enjoyed by the rest of the Britain's inhabitants (Norton, 1829, p.50-75). Even in the present scenario, Londoners are more well-off that all other British people. And the position of London as one of the most important places of commerce in the world, though dimmed, has not been entirely lost. The history of merchandise has imparted this city a unique system of governance: Formerly every man in London followed a trade: he therefore belonged to a company. And as the commonality, all the men of London together assembled, i.e. all the members of all the companies, elected the Mayor, so to this day the electors of the Lord Mayor are the members of the companies† (Besant, 2010, p.209). Though many people have shifted from trade into other vocations, the power given to the members of the companies remain (Besant, 2010, p.209). Secondly, the presence of West Minster abbey in the heart of London city is yet another mark of constancy. Even after London adopted democracy, the vestiges of monarchy lingered and even in cinematic depictions of London, the monarch and the palace inevitably finds a place. (Alfie, 1966, Together, 1956, London, 1994). The twentieth century London evolved as a city completely controlled by the rule of law, in the aftermath of the World War 1 (Michie and Williamson, 2004, p.2). Throughout the twentieth and twenty first century, the city has shown great political stability. In the 1950s, city of London, as a business hub, was under a transformation from the dominance of British currency to the rule of US dollar (Schenk, 2004, p.326). The crisis imparted by this diminishing economic dominance has returned to this city now and again and cost it man y developmental pitfalls. And this is why the recent economic recession that affected the United States first had a severe impact on this city as well. 1950s was a decade of the opening up of the economy of the city to such foreign influences. The

Public finance Essay Example | Topics and Well Written Essays - 2000 words

Public finance - Essay Example This paper analyzes the possible impact of welfare reform over labor supply incentives. For so many years, the US has been involved in welfare reforms that any dating of the beginning of welfare reforms is irrational. In many ways, the welfare reforms in the past two decades have given rise to labor supply. The life of the people relying on welfare reforms has become more difficult due to the work requirements for welfare recipients, the decline in the real value of welfare benefits, and the sanctions for not complying with the requirements imposed by the state for welfare recipients, such like the work related participation activities held mandatory for the welfare recipients. Due to which, people would be encouraged to opt for being in or entering in to the labor force rather than leaving or applying for the social welfare programs. Such decisions or choices are based on the perceived toughness of the state’s welfare program and thereby, are influenced by the state’s rhetoric in relation to the welfare reform and not just enforced by the requirements of the law of the state. However, the sanctions imposed on the welfare recipients may simply compel them to seek work by throwing them off the welfare rolls. Also, the time limitations of the number of years for which a particular welfare recipient can benefit from the social welfare program may subsequently lift some welfare recipients off the welfare program. ... nalysis, which are: the precise evaluation of response elasticities, comprehensive specification of the distribution of income, as well as some perspective of the social welfare weights. The former two elements are positive and can be determined through thoughtful evidence based analysis. On the other hand, the last element mentioned above is normative and thus, something at which perspectives may differ. Now, we will discuss that how these elements will operate in the structure of earnings and taxation. In relation to labor supply responses, an important distinction lies between the intensive and extensive margins of labor supply. The studies on optimal taxation investigate the outcomes for tax design (Diamond 1980; Saez 2002; Laroque 2005). When the people are permitted to respond to the variations in the tax schedule by selecting to work or not, and how hard to work, then the schedule of optimal tax can vary to a great extent. Particularly, when this choice of employment becomes c omparatively more significant, then the rates of optimal marginal tax can reduce dramatically, even to a negative value, for the people with low earnings capacity. According to Brewer, Saez, and Shephard (2010), an impelling inference is that if the state government commends redistribution then the workers having low income should be given an earnings subsidy since the participation tax rate for low earnings would be negative. Therefore, the extensive model signifies that work contingent credits or earnings subsides, such like the working tax credit or the earned income tax credit, should be the constituent of an optimal tax system, which is in acute contrast to the intensive model. This is among the vital lessons from the new optimal tax design. Due to the large extensive elasticity, the