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Discuss the location selection criteria for distribution centers, warehouses, and manufacturing plants Answer

Discuss the location selection criteria for distribution centers, warehouses, and manufacturing plants. How might these factors be considered important when locating a manufacturing facility? How do they differ from the factors considered important when locating a distribution facility?

Ans:

Facility location refers to choosing the locations for distribution centers, warehouses, and production facilities to facilitate logistical effectiveness and efficiency. The major factors influencing location of the facility are markets and resource availability. Most of the facilities are located near one or the other. Labor and transport services are two other key factors in facility location. Labor is of special significance because it can be considered as both a market in the sense of demand for products and a resource in terms of human resources to staff a particular facility. The transportation system makes other resource factors mobile and allows a firm to combine factors of production that originate great distances apart. Changing trade patterns, spurred in part by multicountry trade alliances, also have a profound influence with respect to the location of distribution facilities.

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What are the four central issues driving current federal health policy? Which do you believe is more important? Answer

What are the four central issues driving current federal health policy? Which do you believe is more important?

The healthcare expenses continue to grow and adressing the growth is a a major burden for policy makers. The number of unemployed/uninsured makes it difficult for insurance companies to keep prices down because the bigger the pool the more the costs can be spread out. Currently employers have been shifting the costs to employees through higher premiums and health savings accounts. Medicare enrollees have increased with the rise in baby boomers applying for insurance. The recession has created a demand for medicaid and other social programs putting the states and federal government in further debt. Cost drivers are technology and prescription drugs, rise in chronic diseases, and admin costs. The government contains costs by putting more regulation on the healthcare providers and on insurance companies.

http://www.kaiseredu.org/issue-modules/us-health-care-costs/background-brief.aspx

Pharmacy costs have continued to increase due to greater drug use, higher drug prices, the launch of novel but expensive new drugs, and “trading” up from older generation drugs, possibly off patent, to newer, expensive brand drugs. Twenty years ago, pharmacy costs represented about 5% of total managed care health care costs, and today, that amount is closer to 20%. Certainly, we have significant new drugs for important medical conditions not previously available, and we all favor the increased appropriate use of cost-effective medications. Also, cost-effective drug use may offset or reduce the need for more expensive medical resource consumption. Regardless of the value, pharmacy program costs are increasing, and managed care responds by implementing various management strategies.

The four central issues driving current Federal health policy are as follows: 1) cost; 2) affordability; 3) accessability; and 4) quality of care. The federal government want to find more affordable health are so no one would be left out for health care. It is important to look for ways and means to lower the cost of health care. The recent transition of baby boomers coming to retirement has increased the Medicare and Medicaid expenses; therefore; affordability comes into focus. Also, if we lower the cost of health care might effect the quality of care if the government does not make sure the quality of care is included in the health care reform. I believe all of the above issues are important.

http://www.healthcare.gov/blog/2013/03/anniversary-looking-forward.html

Four of the central issues that have become the focus of federal health policy are: Medicare and Social Security funding, future federal health programs, increase in the number of choices for consumers, and managed care competition in Medicare. In my opinion, the funding of Medicare and Social Security are of biggest concern. This is due to the fact that both of these federal trusts are about to be maxed out with needing to support an aging population of Baby Boomers. The funds were meant to have the current workforce support those who are retired and we are entering into a time where the current workforce is smaller than those who need to be supported by it.

Cost is important, as it must be balanced against tax revenue that the government collects. Affordability and accessibility are intertwined – high premiums decrease access to health care for most people – if they can’t afford the insurance (or if the insurance doesn’t provide enough reasonable coverage), people are less likely to seek healthcare services before they become emergent. Quality of care is huge – none of the other factors matter if the outcomes of care aren’t reasonably positive and based on efficient and effective use of medical resources. Our medical resources are limited. Therefore, according to the most basic economic principle – the law of supply and demand, the scarcer a resource is, the higher the price paid for that resource. However it isn’t that simple in healthcare. There are many factors driving up the costs – the least of which is the demand for those services. Time and time again we’ve read that the majority of healthcare spending is on a small proportion of the population that suffers from multiple, complex and chronic diseases. Yet a significant amount of our resources are consumed by other factors. Think about it. We’ve read about the healthcare reform and its requirements. But do we fully understand the costs of meeting those requirements? How much will administrative costs increase if we have to add people to the administrative side just to keep up with the regulations? What about the cost of investing (and reinvesting) in technology to keep up? How often will we need to update our computer systems and software? What will it cost to do so? How will those costs escalate (thanks to inflation) over the years? And what about wasted time and resources when billing and coding errors are made? How many claims are denied or returned to the provider because they weren’t “clean?” How complicated the claims process has become! With no standardization of claims processes, it is difficult just to know what to include on a specific claim for a specific payer.

Cost, medicare and social security are the central issues driving health care policy.   The question is do we have enough tax dollars to cover everyone health care in the USA?   Does our tax dollars cover the healthcare of our grandparents and now parents? I believe we absolutely do, but how do we free up tax dollars locked up on Military Defense ? The issue i believe is how to convince congress to unleash other spending to cover universal health care.

The price of healthcare skyrocketing and government programs such as Medicare and Medicaid are going to be hard pressed to keep pace. Something that I find very interesting is that most Americans that have insurance only really pay for a small percentage of the total cost for visits to see providers and have procedures done. Greg Scandlen from the National Center for Policy Analysis reports that 85% of healthcare visits are paid for third-parties. His article says the 15% that is for the most is alternative medicine, dental work, cosmetic surgery, and vision and he believes these costs have not drastically risen because people are more conscious about the expenses that they have to pay for directly. This involves increasing the number of consumer choices and letting the consumer know more details of the health expenses so they can make more informed decisions. The article lists some great ideas to controlling costs.

http://www.ncpa.org/pub/ba398

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Discuss three (3) changes from the traditional or “old” paradigm of leadership to the new paradigm Answer

Discuss three (3) changes from the traditional or “old” paradigm of leadership to the new paradigm. For each change, explain one (1) factor in the current business climate that necessitates each change. Which change in your opinion has been most effective for today’s business environment? Why? (25 points) (A 1½-page response is required.)

 

Leadership in its old sense with authority, control and superiority has been a successful strategy until recently. Organizations have been built around this kind of leadership, where one person rises to the top and others follow. Charismatic leaders have led movements, and others have felt honored to be followers. But given the changes in our world, this type of one person leadership seems inappropriate. The problems that will face us over the next few decades demand a different approach to leadership. In our globalized world, we need as many people as possible to feel able to dream of positive change and to take responsibility for some of that change.

Among traditional leadership scholars, leadership is still centered on the concept of achieving group or organizational goals. Our current approach to leadership has created large bureaucracies incapable of operating efficiently or responding to the demands of customers. Research on leadership, organizational effectiveness, information processing, quantum mechanics and chaos provides a set of concepts which not only help to explain why many of today’s corporations are not doing well, but also how to make them better. The effectiveness of organizations is a function of the leader, resources, organizational structure and the followers.

To be effective, the leader must have adequate resources to accomplish the job, an appropriate organizational structure, a set of followers to perform the tasks and certain leadership skills and abilities. Leadership is a function of the leader’s motivation, skills, style and level of conceptual ability. High Performance Leadership is founded on matching the right leader to the appropriate organizational level. Motivational level is a function of the match between the organizational structure, the level of the organization at which the leader works and organizational climate. The structure must be such that the leader is able to operate within his/her time frame of discretion. The organizational level and climate must match the leader’s skill and conceptual level.

Burn introduced the notion of transformational leadership as one of two forms that leadership can take (the other being transactional), and he has become famous for initiating a movement to reconceptualize leadership as a transformational process—”when one or more persons engage with others in such a way that leaders and followers raise one another to higher levels of motivation and morality” (1978). Bass suggests that “a shift in paradigm is in order’. Bass seemed to equate leadership with a leader who gets “performance beyond expectations” out of his/her employees.

One result of this transformation in the concept of leadership has been the rethinking of leadership definitions. Rost’s definition says that leadership is an influence relationship among leaders and followers who intend real changes that reflect their mutual purposes. This contemporary definition is composed of four basic components, each of which is essential and must be present if a particular relationship is to be called leadership.

(1) The relationship is based on influence. This influence is multidirectional, meaning that influence can go any which way and the influence attempts must not be coercive. Therefore, the relationship is not based on authority, but rather persuasion.

(2) Leaders and followers are the people in this relationship. If leadership is defined as a relationship, then both leaders and followers are doing leadership. He does not say that all players in this relationship are equal, but does say all active players practice influence. Typically there is more than one follower and more than one leader in this arrangement.

(3) Leaders and followers intend real changes. Intend means that the leaders and followers promote and purposefully seek changes. Real means that the changes intended by the leaders and followers must be substantial. The changes the leaders and followers intend reflect their mutual purposes. The key is that the desired changes must not only reflect the wishes of the leader but also the desires of the followers (Rost, 1991).

Rost reminds us that leadership is not what leaders do. Rather, leadership is what leaders and followers do together for the collective good. In today’s society, leaders operate in a shared-powered environment with followers. Today we live in world where many people participate in leadership, some as leaders and others as followers. Only when we all work together can we bring about successful changes for our mutual purposes.

Slowly scholars and practitioners alike are giving up on the old ways of leadership, the industrial paradigm. This traditional approach to leadership is characterized by a top-down philosophy, where the leader is decisive, efficient, unemotional and in-control. The changes in the way we view leadership can also be found in other disciplines where descriptions of our world are objective, single, mechanical, hierarchical and controllable. The post-industrial leadership paradigm, on the other hand, is characterized by collaboration, power-sharing facilitation and empowerment. This new view of the world is more complex and diverse, mutually shaping and spontaneously changing (Rogers, 1992).

 

Bibliography:

Burns, J. M. (1978). Leadership. New York: Harper & Row.

Bass, B. M. (1985). Leadership and performance beyond expectations. New York: The Free Press.

Daft, R. L. (2002). The Leadership Experience, (2nd ed.). Mason, Ohio: Thomson South- Western. Chs. 1-3, pp. 1-112.

Rogers, J.L. (Summer, 1992). “Leadership Development for the 90’s: Incorporating Emergent Paradigm Perspectives.” NASPA Journal: 243-251.

Rost, J.C. (1991). Leadership in the 21st Century. New York: Praeger.

 

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Needham Pharmaceuticals has a profit margin of 3% and an equity multiplier of 2.0 Answer

Needham Pharmaceuticals has a profit margin of 3% and an equity multiplier of 2.0. Its sales are $100 million and it has total assets of $50 million. What is its ROE?

Ans:

ROE = Profit Margin * Total Assets Turnover * Equity Multiplier

ROE = (Net Income/Sales) * ( Sales/Total Assets) * ( Total Assets/Common Equity)

ROE = (3%) * (100/50) * 2 = 3% * 4 = 12%

 

(3-6) Du Pont Analysis

Donaldson & Son has an ROA of 10%, a 2% profit margin, and a return on equity equal to 15%. What is the company’s total assets turnover? What is the firm’s equity multiplier?

Ans:

Profit Margin = Net Income/Sales

ROA= Profit Margin * Total Assets Turnover

10 %    = 2 % * Total Assets Turnover

Company’s total assets turnover = 5

ROE = Profit Margin * Total Assets Turnover * Equity Multiplier

15% = 2% * 5 * firm’s equity multiplier

Firm’s equity multiplier = 15/10 = 1.5

(3-7) Current and Quick Ratios

Ace Industries has current assets equal to $3 million. The company’s current ratio is 1.5, and its quick ratio is 1.0. What is the firm’s level of current liabilities? What is the firm’s level of inventories?

Ans:

Company’s current ratio = Current Assets/ Current Liabilities = 3/Firm’s level of current liabilities

Firm’s level of current liabilities = 3/ 1.5 = $2 million

Quick Ratio = (Current assets – Inventories) / Current Liabilities

1 = (3 – Inventories)/2

Inventories = 3-2 = $1 million

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Analyze the income statement of Eastman Kodak include your analysis of indicators like earnings per share Answer

ACC230 / ACC 230 / CheckPoint: Analyzing an Income Statement
CheckPoint: Analyzing an Income Statement
Resource: Ch. 3 of Understanding Financial Statements • Complete Problem 3.16b on p. 111 (Ch. 3).
Analyze the income statement of Eastman Kodak located at http://wps.prenhall.com/bp_fraser_financial_8 (Select Chapter 1 from the top menu, then Internet Links in the left-hand menu to access the income statement.)
Write a 200- to 300-word response to the problem. In addition, include your analysis of indicators like earnings per share, operating income, and comprehensive income.

Eastman Kodak Company – I have looked at the differences between the operating income, total liabilities, and the total shareholder’s equity.
As we look at the company’s assets we can see that there were substantial changes that occurred from 2003 to 2004. In 2004 there was a $5000 increase in cash and equivalents. There was an increase of $217 million in the net receivables for 2004. In the net inventories for 2004 the company saw an increase of $80 million. In comparison from 2003 to 2004 the company’s deferred taxes had decreased $40 million. In 2004 the other current assets were $24 million less than in 2003. In the discontinued operations the company saw a decrease of $42 million. In 2004 the company saw a decrease of $539,000 in property, plant, and equipment net. In 2004 the company had increased their goodwill assets to $97,000 and had raised their long term assets to $202,000.The company did not claim any discontinued operations in 2004 for the company’s long term assets. In the end this left the company with a total decrease of $109,000 in total assets for 2003 to 2004.
The company’s liabilities and stockholder’s equity it was shown there were many changes that occurred during 2004. In 2004 there was a decrease in long term debt and the net of current portion was $450,000. In 2004 the company also saw a deduction of $36,000 in pension and postretirement liabilities and an increase of $84,000 in other long term liabilities. In combination the liabilities were $675,000. There was an increase of $407,000 in retained earnings in 2004 while common stocks and additional paid in capital remained the same. There was an increase of $148,000 in the accumulated other comprehensive loss and an increase of 3,000 unearned restricted stocks. There was also a decrease of 8,000 in treasury stocks at cost. In total there was an increase of $566,000 in the shareholder’s equity and a decrease of $109,000. In return this is the balance for the total assets and liabilities for the company. In my opinion, there is some concern here for the stockholders, because of the decrease of the net income from 2003 to 2004.
Eastman Kodak appears to be profitable even though their net income has decreased. They show an increase in sales since from 2002 to 2004, but their operating costs also increased by 15.3 % from 2002 to 2003. The increase in sales was primarily through acquisitions and the impact of foreign exchange rates on their holdings. Kodak’s largest holding, Digital and Film Imaging Systems, experienced a 1% decrease during this period. In a comparative analysis of the years 2003 and 2004, Kodak increased their current assets and decreased total assets. This reflects the disposal of assets such as equipment, plant and property, and complete discontinuance of certain operations. This decrease in total assets can be seen as a prudent move in their restructuring process. They also decreased their number of employees in 2004 and cut back on their advertising expense.
Kodak has decreased total liabilities by 4%. This is the result of decreases in short term and long term borrowings. By paying off debt, the company is improving its overall financial position. Kodak also sows a positive net profit margin even though they show a loss in 2004. Kodak’s other income in 2004 resulted from settlements in favor of Kodak which will not recur in future periods. There is a drop in total shareholder’s equity, but they have shown an increase in the equity percentage held by the company. This seems to be the result of $104k more shares in 2004 than in 2003, since the total number of shares outstanding remained constant in 2003 and 2004. Retained earnings on stock increased in 2004. The company seems to be in good standing from a profitability viewpoint. If they continue with the changes to the company’s structure, they should be able to stay in a profitable income margin.

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compare and contrast the reigns of Theodosius and Justinian Answer

In an essay (800 words), compare and contrast the reigns of Theodosius and Justinian. 1. Explain the significance of the Nika riots. 2. Discuss the continuation of the Eastern Roman Empire and the importance of its geographic location. 3. Explain the influences the Eastern Empire had on the Near East politically and religiously. 4. Describe how the Eastern Roman Empire became the Byzantine Empire? Prepare this assignment according to the APA guidelines

Theodosius, Justinian and the Byzantium Empire

Theodosius was the last emperor to rule a united Roman empire. Under his reign, Christianity was established as the state religion. He protected the religion from the threats of paganism and Arianism. Theodosius became the emperor of Rome in AD 379. After spending a few years of military campaign against the Goths, he reached to a settlement with them on 382. During his reign, the Goths were allowed to live in Thrace under their own ruler. Theodosius was baptized in 380 following a severe illness. The Arian bishop was replaced by an orthodox Catholic bishop on 380. During the early period of his rule, he had a moderate attitude towards paganism but later made all temples and churches under the authority of Nicene Catholics. During his reign, Theodosius won two civil wars which he fought against the usurpers Maximus and Eugenius. He also won wars against pagan forces. Under his rule, he brought peace to the Eastern Empire with his diplomatic involvements and also used his rebuilt military to defend it. He modified Constantinople beautifully and won the admiration of his people for that. After his death, the prevalence of Nicene Christianity was continued and it lasted all through the middle ages. (Hobart, R, 2000).

Justinian ruled the Roman Empire during the period of AD 527-565. His period is significant in roman history as it marked the end of the Roman Empire. The new Byzantium Empire was established during this period. The spread of Islam and the rise of Franks are two important aspects during his reign. (Nelson, L.H., n.d). He was the first powerful ruler of the Byzantine Empire. Under his reign, the Byzantine Empire included most of the land surrounding the Mediterranean Sea. His armies captured some parts of the former Western Roman Empire comprising North Africa. The architectural tradition of the ancient Rome and Greek empires was continued under his rule. The domed Church of Holy Wisdom or Hagia Sophia was one among the monuments that was built during his period. Another important element of his period was that he reformed and codified the Roman law. This modified legal code established the famous Byzantine legal code which continued for centuries and even helped in framing the modern concept of state. (Byzantine Empire, 2013).

The Nika riot was one of the most fatal riots in history that happened during the time of Justinian. In the riot, almost half of the city of Constantinople was burned and thousands of people were killed. Ancient romans had a practice of enjoying sporting events taking sides based on different factions. Some of the murderers from the Blues and Greens escaped from prison before hanging them to death. As part of a chariot race announced on 10 January 532, a riot broke out and the mob demanded the escaped murderess be pardoned. On that day, the people were not grouped as Blues or Greens, instead they had a unified slogan ‘Nika’ which meant “Win!” or “Conquer!”. Some of the senators of Justinian worked as conspirators behind the spreading of the riot. They also wanted to coronate Hypatius. The riot was however controlled by working out a plan to separate the two groups. Nearly thirty thousand rioters were killed in the riot. The significance of the Nika riot was that Justinian could eliminate his enemies and could pursue his vision for a united Roman Empire. He rebuilt Constantinople and the Hagia Sophia after the riot. (Nika riots)

During the course of time, the united Roman Empire was declining and rulers felt that it would be better to divide the empire into two for effective governance. The East –West split of the empire happened in the time period of AD 379 to 395. Though Emperor Theodosius unified the Empire, the unity couldn’t last long after his reign. His two sons Arcadius and Honorius again divided the empire and became the rulers in the East and West respectively. Over the years, civil wars broke out in the Western Empire while the Eastern Empire was stable. In AD 330, Emperor Constantine had inaugurated a new city at Byzantium, a former Greek city. It was named as Constantinople and was declared as the new capital of the empire. In AD 476, the western half of the Roman Empire collapsed while the Eastern half continued and flourished. The Eastern half of the Roman Empire was later known as the Byzantine Empire. The geographic location of Byzantine Empire and its capital of Constantinople were tactically significant for the empire. Constantinople was positioned between the Black Sea and the entry to the Mediterranean Sea. It means that most of the trade relations between North Africa, Asia and Europe had to pass through the Byzantine Empire. Thus the geographic location helped the empire to develop as a wealthy empire for a long period. (Global History II Regents Review).

After the decline and collapse of the Western Roman Empire, the eastern half of the Roman Empire continued the tradition of the Roman Empire.  The eastern empire continued to preserve the plentiful advancements of the Greek and Romans for Western Europe. For example, they preserved the Roman legal code for centuries. They preserved and protected the Roman and Greek culture and Christianity and also tried to spread the ideas into other parts of the world. The Byzantium Empire, during its height influenced the Near East both religiously and politically. Most parts of the ancient Near East followed the Orthodox Christianity of the Byzantium Empire. The governance and tax systems were also influenced by the practices of the Byzantium Empire. However this influence lasted only until the rise of Islamic civilization in the Middle East. (Global History II Regents Review)

 

 

 

References

Byzantine Empire (2013). In History.com. Retrieved on June 29, 2013 from

http://www.history.com/topics/byzantine-empire

Global History II Regents Review. Byzantine Empire. Retrieved on June 29, 2013 from http://www.icsd.k12.ny.us/legacy/highschool/socstud/global2_review/index.htm

Hobart, R (2000). Theodosius the Great. Retrieved on June 29, 2013 from

http://www.thenagain.info/webchron/mediterranean/Theodosius.html

Nelson, L.H. (n.d). Lectures for a Medieval Survey. Retrieved on June 29, 2013 from

http://www.the-orb.net/textbooks/nelson/justinian.html

Nika riots. In Wikipedia. Retrieved on June 29, 2013 from

http://en.wikipedia.org/wiki/Nika_riots

 

 

 

 

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Discuss the interrelationships between healthcare costs, quality, and access from the Roemer model of health services systems Answer

Discuss the interrelationships between healthcare costs, quality, and access from the Roemer model of health services systems. Make suggestions on how one would maximize access and quality while keeping costs low. Now, analyze why these suggestions have not been put into place.

In order to maximize access and quality while keeping costs low, One would have to make sure everyone one has healthcare insurance, which will allow more access to healthcare upon creating more options for disabled to get to their healthcare appts. Quality would be monitoring chronic diseases and managing them so there is less hospital stays and keeping cost low would be making sure all patients keep up on preventative visits in order to keep people healthy and safe. In order to maximize access and still provide good quality services the health care system need to be designed which will allow everyone in the United States to have health coverage. In reality, this would be impossible. The reason why I say this because health service is a business which is system designed to bring in revenue for treating the sick. All employees that work in the United States pays a certain percentage toward their health care. In other words, there is a certain percentage of their income taken out from health care. People who are unemployed cannot afford to purchase health insurance every month. For example, I was laid for 2 years and 4 months, I found it very difficult to pay for health coverage. The cheapest was $330 per month. My unemployment check was $330. I did not have any money left over to buy food or pay a bill. Eventually, my unemployment ran out and I was forced to get public assistance. So, therefore, I could no longer pay for health coverage so I had to sign up for Medicaid. I had to wait two month to get medical coverage. I am a diabetic so I could not get the supplies for two months. The money I received from Pubic Assistant was just $80 a month plus food stamps for $199. I was able to buy food and pay one bill but I had to medical coverage due to the waiting period.

In this post you mention that you would lower the monthly premiums so that they would be more affordable.   What strategies would you use to accomplish this?   Who would pay for the reduction in premiums that would be experienced by Americans?

Typically, healthcare organizations, physicians/clinicians, and insurance payers charge a high dollar amount for exams and procedures due to non-payment from self pay patients, inaccurate demographic information, high cost to collect amounts and lack of reimbursement volumes. Of course there are many other factors involved, but these are a few big reasons that healthcare organizations will speak to. The access to quality health care is limited by types of insurance coverage, geographic location, and physicians themselves, as some of them only take certain payer types from primary care or specialist visits. For exams or procedures, the patients’ insurance or lack of coverage plays a critical role as terms of payment or reimbursement from the payers is not guaranteed or extremely limited due to increasing cost monitoring. Hospitals and physician clinics are strongly discouraged to schedule elective procedures that put that organization at risk for non-payment from payers. For self pay patients, strong scripting from registration or financial assistance staff is provided to try and collect payments up front with heavy discounting in order to collect as much as possible. Emergent care situations call for stabilization and patient care based on a clinicians medical judgement, but all other services are debatable between the patient and the healthcare organization.

In order to reduce the cost to accomplish Lorraine’s idea, the payers and clinicians would have to lower their costs so that the patient is paying for the majority of the cost. The last time I checked the overwhelming number of physicians and payers are not hurting for profits, so analyzing their true costs and profit margins would be a good start, lowering the payers requirements for payment would provide higher revenue flow for the hospitals and in turn lower the costs for the patients.

If we consider the fact that specific populations have different characteristics and demographics which impact healthcare delivery.   These characteristics can be such things as income, race, age, location, etc.   How do the characteristics of a specific population impact the healthcare services they demand and the services these receive?

The population that comes to my mind right away is our Spanish speaking population. In reality it is any population with English as their second language. I pointed out the Spanish speaking population my organization utilizes our Language Services department primarily for Spanish interpreters. The barrier between languages can pose significant communication issues.

Without an interpreter, physicians and medical personnel are unable to obtain an accurate past medical history, current chief complaint, signs & symptoms, allergies, current medications, etc. Also, it’s difficult to explain the plan of care to a patient and their family members if their is a language barrier. It can be difficult to convey the small things to a patient or family member; it could be something as simple as explaining where the family lounge is located in order to grab a refreshment or use the free washer and dryer that is provided to them.

I think in general, a language barrier effects the care that a patient receives. It’s truly unfortunate, but it’s definitely a reality. I am definitely a people person and I love talking to my patients, unfortunately I am not bilingual and therefor cannot carry on a conversation with someone who only speaks Spanish or any other language for that matter. I still provide the same task-oriented care to those patients (hourly checks, medication administration, vitals, etc), however the overall experience they receive is not the same.

We have several Spanish interpreters employed through our organization. Typically, we have one staffed in the ER 24 hour per day, one that is utilized for clinic appointments and the other is utilized for inpatient consults. The Spanish interpreters are amazing and they help close the gap in communication. Sometimes it can take a great deal of coordination ensuring the doctors, nurses, patients, family members and other medical personnel are all available at the same time for daily rounds or important updates, but it’s definitely beneficial. We also have interpreter phones that we use in order to get results immediately and to find an interpreter for a not as common language.

Lowering monthly premiums is a great idea and of course the problem would be the implementation of this idea. A possible suggestion that is being utilized now in certain hospitals is a tier payment system. Employees that make the min to 30,000 pay a certain amount, then 31,000 to 50,000, and so on. There is a program at my hospital that covers your deductible expenses as well as your out of pocket expenses if you only make a certain amount of money and have a certain family size. For example, if you only make 30,000 a year and have a family size of 4, and are single, you would qualify for this benefit.

Another idea, is a form of socialized healthcare that the current administration is striving to change. We already pay a certain amount into Medicare and for programs such as Medicaid, so instead of the pot of taxes going towards these two separate groups, how about having a large pot that it goes into.

The way this would work:

  1. Cut Medicaid programs altogether – they are being taken advantage of severely and instead of a person trying to get a job with benefits, they work to stay on the program.
  2. Give every single American basic healthcare. You must be an American citizen (with a valid social security number!!!).
  3. All preventative care would be covered 100%. (All well child checks, vaccinations, and yearly adult physicals as well as all dental preventative cleanings and a yearly eye exam).
  4. You would get 3 sick doctor’s visits a year. These include all general illnesses such as the flu, colds, ear infections, generalized pain, headaches, etc.
  5. You get 2 specialized visits a year. These include: ENT, Ortho, Neuro, Psych (mental health), Rheumatologist, etc.
  6. All emergency care visits that deal with lacerations, asthma attacks, chest pain, shortness of breath, MVAs, limb loss, severe headache, severe loss of blood, etc. would be covered 100%. This includes hospital stays for recovery and necessary lifesaving surgical procedures. If you try to come into the ER and only have the flu or a cold, you will be charged. This will hopefully get people to think twice before they use the ER as a doctor’s office.
  7. All pregnancies and the birth itself is covered 100% until the second child. The well visits, medications, ultrasounds, testing, hospital stay, etc. Baby is covered as well. After the birth of your second child, you will be expected to pay 50% of the cost. After the birth of your fourth child, you will be expected to pay 100% of the cost.
  8. You get 2 minor procedures and 1 major procedure (unless it resulted from an emergency accident) covered 100%. Minor procedures: vasectomy, Lasik, dental surgery, gall bladder removal, hernias, etc. Major LAVH, tumor removal, exploratory lap, etc.
  9. If you wish to purchase more coverage, then you will have those options and we can use the capitalist system that we all love.

Of course, this is just an idea and it is not perfect. It will require a board at multiple levels – kind of like a judicial board (Supreme Court of Indiana and then the Supreme Court of USA).

The reason that hospitals have to charge so much for items when consumed outside of the hospital by first generation customers is two-fold;

1) Hospitals have to have individual per-patients packaging which is very expensive. This single-use packaging is very expensive but extremely necessary to avoid cross-contamination and for use in isolation rooms.

2) Price per units are an average of the cost of the item as it is consumed in the hospital. This means that the average includes what the item cost after the best insurance reimbursement to the direct payment and indigent patients. Is many seem like a lot of money but it is the average cost per unit.

Ok I lied there is a third. The cost of the manpower for receiving, stocking, direct care personal, sanitation, etc. also adds to the cost. The product touches many hands before it is in your nurses hand ready for use.

When people think of the segment of the United States population most dependent on the health care safety net, they may first imagine the urban poor in crowded emergency rooms at urban public hospitals. Although this group no doubt has serious health care problems, residents of rural areas may, in fact, have greater health care needs and face access barriers that are no less substantial. Rural populations are generally older, poorer, and have lower levels of education than their urban counterparts. There are far fewer hospitals and physicians in rural communities; the time it takes to travel to health care providers is often greater and public transportation less available. These problems may be magnified in rural areas far distant from any urban center. As the federal government gives states greater responsibility for designing health policies, the fundamental differences between rural and urban areas as well as among different types of rural areas will need to be recognized. Although state policymakers need to understand the differences that exist between rural and urban areas within their borders in order to design effective policies, most national data sets containing the relevant heath care information (e.g., the National Health Interview Survey [NHIS] and the Medical Expenditure Panel Survey [MEPS]) do not allow for this type of substate geographic analysis.

 

This information gap can be filled in part by the National Survey of America’s Families (NSAF), a survey of children and adults under the age of 65 in over 44,000 households that is being conducted as part of the Urban Institute’s Assessing the New Federalism (ANF) study.1 The NSAF provides representative information on the nonelderly population for 13 ANF focal states and for the nation as a whole.2 Among a broad range of demographic and economic data, the NSAF contains information on insurance coverage, health status, access to care, and use of health services. Of the ANF states, only eight have substantial rural populations; this brief presents state-level data for these states – Alabama, Colorado, Michigan, Minnesota, Mississippi, Texas, Washington, and Wisconsin.3

 

http://www.urban.org/publications/309533.html

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ACC 400 Accounting for Decision Making week 5 Case 13-4 and Case 13-5 Lease Classifications Answer

Case 13-4 Application of SFAC Number 13

A -The Theoretical Basis for the Accounting Standard that requires certain long-term leases to be capitalized by the lessee. Certain condition for specific long-term leases that is the theoretical basis for accounting standards. The condition that must be met for capital leases are as follows.

 

  1. The contract for the lease has to be put in possession of the lessee at the end of the lease time frame if not before.
  2. The lease contract includes an option to buy the assets at a lower price.
  3. The time frame of the lease contract has to be at least 75% if not more of the predicted period of the asset.
  4. When the lease contract begins, the current amount of installments should be around 90% of the fair amount of the asset being leased.

B –How should Lani account for this lease at its inception and a determination made of the amount recorded?

Lanie should be able to see the documented fair or current value of the upcoming installments as debit to fixed assets and also the capital lease as credit to obligation.

C – Expenses related to this lease Lani incurs during the first year of the lease, and how will they be determined?

The expenditure related to the lease Lani will incur should be in the form of a prepared amortization table with the principal amounts and interest clearly separated for each of the installments. The interest should be documented as an expense just as depreciation will be documented as an expense on the assets leased.

D – How should Lani report the lease transaction on its December 31, 2006, balance sheet?

The leased item on the December 31, 2006 balance sheet would be documented as fixed assets as follows.

 |Fixed Assets           |Long-Term Liability                      |Current Liability                     |

|                                     |                                     |The current part of the               |

|                                     |Responsibilities or accountability   |responsibilities or accountability is |

|Lease Assets Depreciated at Cost Less|are answerable to capital lease,     |answerable to finance lease, which     |

|                                     |meaning the installments have to be   |mean the installments have to be paid |

|                                     |paid after the first year             |in the year following the first year. |

Case 13-5

Lease Classifications

 

A – What criteria must be met by the lease in order that Doherty Company classify it as a capital lease?

The Doherty company has to meet certain criteria in the lease for the lease to be classified as a capital lease. The first criteria is that the leased asset has to be able to be transferred to the lessee by the end of the leasing period stated in the lease. A buy out alternative has to be included in the lease with a substantially discounted cost as opposed to the market value to the lessee on the date asset can be purchased. The lease time frame has to be a minimum of 75% of the leased assets business related life. The current value of the payments leased have to be the same or more than 90% of the fair amount and the rate of interest to decrease the payments of the lease is less than the lessee’s accumulative borrowing rate.

B – What criteria must be met by the lease meet in order that Lambert Company classify it as a sales-type or direct financing lease?

The criteria that has to be met for the Lambert company to categorize the lease as sales-type lease would be for Lambert to be an equipment dealer. The lease would be a direct financing lease if Lambert was not an equipment dealer.

C – Contrast a sales-type lease with a direct financing lease

A capital lease would apply when the person leasing would be a dealer or a company that sells leased equipment. “A capital lease is an example of accrual accounting’s inclusion of economic events” (Investopedia, pg. 1, 2010). If the dealer or owner of the company do not lease the assets, the lease would be referred to as a direct financing lease. With a sale type lease, the complete rate of interest would be the current amount of the least payments is sellers rate of the asset leased. From the time the lease began, the lessor realizes a gross profit that would be the same as the current amount of the least of the leased payments minus the cost associated with the asset leased. The interest income would be the same as compared to the complete interest rate multiplied by the net lease retrieved at the beginning of the time frame in the lease. A capital lease would apply when the leaser doe not deal in the assets being leased, in which the lease would be considered a direct financing lease. A gross income would

not be realized when the lease starts, so all the profit incoming would interest. The total rate would be the current value of the least amount of leased payments would be the same as the leased assets expenditures. The income from the interest would also be the same as the complete interest rate multiplied by the net lease coming in at the start of the lease time frame.

References

 

Investopedia, 2010, Capital Lease, Retrieved June 20, 2010, http://www.investopedia.com/terms/c/capitallease.asp