Water Desalination using Vacuum Membrane Distillation Essay

Water Desalination using Vacuum Membrane Distillation - Essay Example Of course, it can also be used for water desalination [5]. Vapor migrates from the membrane surface to the permeate side. How this process occurs varies with the different configurations, depending on the feed solution which is treated [3, 11, 16]. All the configurations have advantages and disadvantages, depending on their applications. In Direct Contact Membrane Distillation, for instance, the membrane is in direct contact with the water only during liquid phases. According to classical heat transfer theory, a thermal boundary is formed when liquid is in direct contact with a solid surface when their temperatures differ. This thermal boundary stays next to the solid surface, where the liquid exhibits its temperature fluctuations. The process of heat and mass transfer illustrates the membrane distillation process, wherein a microporous membrane separates two fluids of differing temperatures (membrane thickness of). The feed temperature decreases from at its bulk to at the membrane’s surface. Accordingly, the permeate temperature increases from at its bulk to at the membrane’s surface. Two thermal boundary layers appear at the feed side (with the thickness of) and the permeate side (with the thickness of) of the membrane respectively, as shown in Fig. 3. where is the mass transfer flux through the membrane and is the latent heat of the volatile component. Here, is only a small part of the energy transferred through the membrane in the form of latent heat. The temperature difference between the two sides of the membrane also conducts heat through the membrane and the gas that fills the pores with flux, written as The equation illustrates the temperature difference between the two sides of the hydrophobic membrane. Accounting for the vapor pressure difference is illustrated by, which is the driving force for mass transfer through the membrane. Three mechanisms regulate the mass transfer through the membrane: The mass transfer mechanism

Manipulation Case Study Essay Example for Free

Manipulation Case Study Essay Who has manipulated my mind in relation to reality? I believe that society has manipulated my mind in relation to reality in some way because I think that reality is just a state of mind. The physical aspect of the things I can see, touch, taste, etc. make me believe that everything I encounter is factual. Also society says to believe only what you believe to be real and don’t believe in fantasy because you have no physical connections to imagination. How can I break free from the bonds of those who seek to manipulate me? I can break free the bonds of those who seek to manipulate me by choosing what to believe and to have an open mind when using critical thinking. I can use my logic when it relate how I receive information by make choose whether to let negative energy in my life affect me or choose to overcome it decide how I’m going to reaction to the situation. I believe that sometimes if people actually took the time think about things before they reacted on pure emotion then they can see that taking a few seconds think any negativity in their life they choose how they should react. An example when I’m driving and somebody cuts me off naturally I’m upset and wondering why this person would do something like. In some cases I want to speed next to the person in engage in an offensive gesture or go on verbal rant at that person but I usually take a second to think about it and realize maybe this person is in hurry or not pay attention while driving. By me choosing to restrain from getting in a road rage battle with that driver chose to the better person because at the end of the day we both are just trying to get to or destination. What preconceptions do I have in my life that might distort my vision of reality? The preconceptions that I have in my life that distorted my vision of reality is that all people are decent and kind. As a kid growing up I believe that all people were decent and kind because society was more civilized and simple. Now that I’m a adult I know that is not true at all because of how society is nowadays with in rapid increase in crimes such as murders, kidnappings, child molestations, etc. People have ability to be decent and kind but some choose to evil and cruel. Every person has the potential to be criminal because in today’s society have become desensitized.

Environment issues and energy saving methods

Environment issues and energy saving methods Environment issues and energy saving methods Hotels and resorts use intense amounts of natural resources (e.g., water, electricity) in providing luxurious accommodations for guests. These practices pose risks to the natural environment, on which the tourism industry relies. Energy management has been an important part in the environmental protection and welfare of human being. Due to the unprecedented rise in prices of some sources of energy use and their non-renewable characteristic (UK uses 95% of the energy source come from non renewable energy), therefore there is a need to preserve, reduce and to find alternative source of energy (Energy Efficient Office, 1994; Chan Lam, 2002; CHOSE, 2001; Verlag, 2003; Verginis Wood, 2001). There are many factors such as size, occupancy, age of facility and geographical location; can contribute to the energy consumption of a hotel and thus with a proper energy management can help to reduce the cost and magnitude of savings. For a hotelier to successfully develop an environmental friendly hotel, he first need to create an environmental policy-is an agreed documented statement of a companys stance towards the environment in which it operates (www.environmentalpolicy.org.com) which include its intent to reduce waste, encourage recycling and carbon footprint and uses of natural resources on a daily basis and this will in turn be passed onto the staff. The company can then use this environmental policy to apply for ISO 14001, -is a guide to environmental management principles, systems and supporting techniques. ISO 14001 is the internationally recognised specification for an environmental system within the organisation. This gives a company the accreditation that it is in accordance with the legislation and is environment friendly (www.environmentalpolicy.org.com) How the accommodation manager at operational level can reduce energy consumption? There are mainly four areas of a hotel that the accommodation manager can save energy namely: Lighting Heating, ventilation and air conditioning ) Laundry and kitchen General operations (such as, pumps, steam boilers swimming pools Lights -represent approximately 15-20% of hotel electricity consumption Halogen lights sources generally last 2-3 times longer than incandescent lights and are 10-50% more efficient. Long product life reduces the amount of solid waste generated and maintenance costs associated with changing bulbs. Periodic cleaning may be necessary to keep them of peak rated efficiency(my ton.1996.greening your property). Lights can be switched off in areas not in use and if occupancy is low, the some floors can be closed to access and do not need lighting or few and heating. Other ways to save on electricity could also be to install switches, timers, dimmers and motion detector. By regularly cleaning light fixtures, replacing light shades with translucent types and using brighter colours on walls will also improve efficiency of lighting. Bedroom the most important part of a hotel Natural carpeting can be use instead of those made from wool, sisal or coir, which uses lots of energy for its manufacturing and also uses non-renewable products as raw material. Instead of changing bed linen daily, it can be kept for a longer period of time unless objected by the guest and thus the hotel will save on water and might as well wash linen at a temperature of 40Â °C instead of 60Â °C resulting in a third less energy being used.) The heating ventilation and air conditioning system uses between 25-40% of total energy of a hotel. A proper energy management will involve regular maintenance, sensors and other smart controllers, load reduction measure and fan motor and chillers replacement or upgrades or better indoor air quality (my ton.1996.greening your property). Kitchen and laundry Hotel laundry and kitchens can consume lots of energy and water as well as detergents and other chemicals. By maintaining the equipment as well as their proper use, energy can be save and also improve their efficiency for example keeping the oven away from the refrigerator. General operations During periods of low occupancy, group guests in relation to mechanical and electrical system this will result in energy savings in unused areas (my ton.1996.greening your property) Laundry can be done at night times when the energy rates are at lower prices examples British gas rates are cheaper after 9am (off-peak). Equipment that are energy efficient can be brought for examples those who have the sleep feature when not in use Bathroom Using towels for more than one day, vanity packs that contain shower case, cotton wool and sewing kits can be given only on request of the guest wastage, shower gels might as well be given in refillable dispensers instead of small pack thus preventing and saving natural resources. Product use in cleaning contain toxic chemicals instead hotel can use those that are non bio-degradable and are dispensed in sprays instead of aerosol cans thus contributing to the environmental protection and safety of staff Examples of hotel in UK 1)The Wyndham worldwide brand for example, Travelodge in the UK, work globally and locally with environmental best practise and product along with the help of employees and abide to the legislation, they focus on Educating and influence all internal and external stakeholders Reducing energy consumption and track performance Reduce water usage and recycle Improve air quality Minimise waste and reusing material Implement sustainable procurement practises Some action they undertaking to educate the customer are To encourage them in giving some advice on how to save energy To encourage them to use the same sheet and thus save energy and water usage Turn off lights, air conditioner or heater and turn off water when brushing teeth and have quick shower Bring own toiletries (Source from uk green hotels, eco-friendly. www.wyndham.com) 2) Number 43 a small boutique hotel in UK intends to save energy by these following procedures: Replacement of light bulbs with energy saving ones Encourage staff and guests to switch off unwanted appliances or equipment Make sure that staff are aware and the importance to turn radiator down/off thermostat when room are unoccupied Closing curtains where appropriate Make sure staff are aware not to overfill kettle Heaters or air conditioners are off on floors are not in use Installation of double glazing where possible Ensuring all new appliances are energy efficient Using Dryer Balls in laundry operation (Saves 25% on running time) Check the levels of thermal insulation on all cooking appliances to avoid unnecessary heat loss. Avoid opening oven doors by using the viewing windows to inspect food. (Source from environmental policy of number 43 boutique hotel www.no43.org.uk) Details of how the structure and design can help with environmental issues? Hotels consume more energy (Â £/m2) than industrial buildings, naturally ventilated officers and secondary schools, according to the Energy Efficiency Office). Structure of an eco friendly hotel.. The structure of a hotel can be altered in such a way so that energy can be save and thus reducing the cost. As mentioned before practises such as changing bulbs to compact fluorescent bulbs, or sensitive motion lights, key cards that monitor the switching of electrical appliances and so on, a hotel can do a lot more about its structure, for example Use of furniture made up from recycle product for e.g. in bedroom, bathroom and all around the hotels Use of low emission paint for interior decoration and artist paintwork so that it ensure low carbon emission, does not contain solvent or release harmful gases or compound that can cause environmental effect. Carpets mattress can be made from natural fibre such as horsehair, flooring if of carpet can be use with new technology that is under floor heating and act as an insulator, green carpets can be made from recycle product as well.(www.greenfloors.co.uk) The Pavafloor Thermal System is a thermal insulation system for solid floors where a solid wood or dry fix tile system is specified. Wood fibre boards have particularly good health and environmental benefits, helping to control internal moisture levels, being entirely non toxic, and also locking up carbon in their use.(www.greensteps.co.uk) The wall- different product can be use for insulation for inside and outside of a hotel, it can be made of wood fibre and be placed on masonry wall to cover and protect it.(www.greensteps.co.uk) The key card system that can activate room services such as lights, TV and other electrical equipment can reduce the CO2 emission. By using a programmable thermostat, hotels can save a lot on energy for heating and air conditioning since they can preset the temperature as per the time of day or season and temperature of the day. Setting a thermostat two degrees cooler in winter and 2 degree warmer in summer saves 2,000 lbs (909kg) of CO2 a year. (www.IHG.co.uk) A displacement air conditioning system uses less energy than a window unit one and also makes less noise. Other practises such as using recycle product such as furniture help to save energy and resources. (www.IHG.co.uk) Water efficient showerhead contains vacuum flow valves which pumps air into water stream, it is as refreshing and powerful as normal ones except that it uses less water thus less energy, this can also be done to the tap used in bathroom as well High efficiency toilet uses up to 6 litres and new one with dual flush uses as little as 3 litres. The Interflush enables the WC, which would usually release the entire contents of the cistern when flushed, is converted to one, which only releases water whilst the flush handle is depressed. Therefore, only the exact amount of water required to flush the pan is released. Once the pan is clear, simply release the handle to stop the flow of water. (www.greensteps.co.uk) Roofs planted with low-maintenance plants such as sedums improve the thermal performance of buildings, helping to keep them cool in warm weather and insulating them in winter.-The plants and the thin layer of soil also work like a sound barrier, especially when its wet, thus helping to reduce noise pollution. Other environmental benefits include improvements to air quality, biodiversity and storm water runoff.(www.ihg.co.uk) Recovery of exhaust heat from air conditioner or heater can be used to warm or cool adjacent rooms by using a method that do not mix the incoming and outgoing of air and transferring and thus save energy(www.uswitch.co.uk) Natural lava stone signage at the entrance and on the lawns replaces traditional plastic and metal signs use in gardens and pools can use water that move in cycle and there is no wastage,encouraging plant growth and green vegetation may help in soil erosion and noise pollution and save as well on The design of a building Climate-responsive design is based on the way a building form and structure moderates the climate for human good and well-being(www.facilitiesmanagement/greenbuilding) Construction The building as a core The roof can be made up of different kind of material that can help to insulate, look trendy, waterproof and is also resistant and lasting, such an example will be the pavaproof pitched roof system for flat or any other type of roof. Pavaroof system uses rigid, waterproof and breathable insulation boards. The boards are tongue and grooved on all edges, allowing for rapid and simple installation.( http://www.natural-building.co.uk/pavatex_roof_systems.htm) The wall can be made up of wallpaper that is eco friendly, made from recycle materials or low emission paint examples of these paints will be oikos or NBT paint and finishes. NBT systems naturally regulate moisture to protect the building fabric while offering excellent levels of thermal and acoustic performance( http://www.natural-building.co.uk/ecopaint.html) Windows and doors- the use of double glazing and triple glazing are the most common ones use for good insulation, triple glazed gives extra thermal and acoustic performance and need not be more expensive than the double glazing one. . (www.greensteps.co.uk) The doors can be made of material such as timber withy all joints sealed and prevent heat loss; manufacturer that provides a rot and fungal decay warranty can be use. Energy efficient lift can help to save energy particularly in big hotels Volume shape and layout of the building envelope Smaller volumes give better energy economy. Smaller surface areas reduce heat loss . Open planned buildings require additional heating, orientation of windows affect solar gain (accommodation management- Christine Jones- Val Paul new edition 1996) Sitting of a building Exposed sites with high wingspreads gives reduced U values and increased ventilation rates. Elevated sites are cooler, polluted sites, e.g. noises or air, will require ventilation (accommodation management- Christine Jones- Val Paul new edition 1996). However temperature cannot be control by natural ventilation and wind effect, thus other factors such as the opening size of windows, when to open it, location, size, and indoor temperature need to be taken into consideration. Therefore cooling/heating systems need to be in place. It is important to carefully select the type of heating system use, if it is an HVAC system (a computerised control system for climate control in building) being use, care should be taken so as the appropriate temperature is being use and thus save energy, that is a set temperature and set points, Limitation of the thermal output and ventilation rates. Use of timers, motion sensitive and thermostat can be an advantage New innovative heating system such as the Underfloor heating system seems to be a good investment, it uses a ground source heat pump to supply hot water and heating, enhancing the buildings energy efficiency and reducing its impact on the environment.(www.uswitch.co.uk) Solar system can be use to generate the energy required for a hotel and this source of energy is readily available and renewable. It can be install on roof of building where there will be a big areas for the panels. . Water plant can be installed in a garden underneath and it help to collect rain water, this can be use for irrigation, toilets and other purposes thus saving energy. Other example can be the use of biogas, geo-thermal , bio-mass boiler and insulation and wind power but all these will depend on the location of the building and the capital available to invest in these and might be use for future source of energy The legislation Eco design for energy-using products regulation 2007 SI 2037- sets out requirements for energy-using product manufacturers to reduce the negative environmental impacts of their products, and to ensure free trade of these products throughout the EU.( www.netregs.co.uk) It came in force in august 2007 and implement that an authorised person need to inspect that the product being bought and carry out test and ensure it is in comformity with the product requirement that is being eco friendly. Buildings Regulations 2000, SI 2531-Introduces requirements for builders to calculate and display energy ratings on new or altered buildings (www.netregs.co.uk) It implement that the building for example a hotel need to be of the specific height, floor area and so on, be in accordance to the UK law Energy information (household air conditioners)(no2)regulations 2005 SI 1726-Requires household air conditioner suppliers to provide labels showing energy consumption, and dealers to display this information to potential buyers (www.netregs.co.uk) Energy information (lamps) regulations 1999 SI 1517-Requires regulated lamp supplier to include a label showing the energy efficient, luminous flux, wattage and average rated life on the lamp or its packaging. Dealers must ensure lamps are labeled with this information (www.netregs.co.uk) Energy performance of buildings (certificates and inspection) (England and wales) regulations 2007 SI 991- Expands energy efficiency ratings for certain appliances and requires household refrigerator and freezer suppliers to provide energy consumption information to potential buyers. (www.netregs.co.uk) EU regulation on a revised community eco-label award scheme 1980/2000-Expands energy efficiency ratings for certain appliances and requires household refrigerator and freezer suppliers to provide energy consumption information to potential buyers (www.netregs.co.uk) Environmental Permitting (England and Wales) Regulations 2007 SI 3538-Introduces a new system for environmental permits for industrial activities and waste operations in England and Wales, including landfill and waste incineration, and sets out the powers, functions and duties of the regulator. (www.netregs.co.uk) Clean Neighborhoods and Environment Act 2005- Introduces additional noise, litter and waste controls including site waste management plans, and classifies artificial lighting and insects as statutory nuisances. (www.netregs.co.uk) Control of Pollution (Amendment) Act 1989 c.14- Requires carriers of controlled waste to register with the Environment Agency or SEPA and outlines the penalties (including seizure and disposal) for vehicles shown to have been used for illegal waste disposal.( www.netregs.co.uk) Controlled Waste Regulations 1992 SI 588- Defines household, industrial and commercial waste for waste management licensing purposes (www.netregs.co.uk) Environmental Protection (Duty of Care) Regulations 1991 SI 2839- Imposes a duty of care on any person who imports, produces, carries, keeps, treats or disposes of controlled waste to ensure there is no unauthorised or harmful depositing, treatment or disposal of the waste. (www.netregs.co.uk) Conclusion: The importance for saving energy cannot be stretched enough, by saving energy we ensure a better future for the forthcoming generation as well as the current one in terms of our environment we living in. This report have given a general idea how energy is being saved and can also be saved in future but it also point out how difficult it can be if planning for a long term plan to save energy, to switch to renewable energy, we need to invest in solar, wind turbines and so other alternative sources, but this require investment, expertise and it also depend on the location and generating power. For short term plan, we can see that hotel are successful in adopting the new ways since it is cost effective for them and switching price is not that high and by working closely with the staff and guest of a hotels, it is easily achievable. Many hotels and customer are being environment conscious and it have become important to show their concern and also participate in the protection, thus we can see nowadays that hotel are now after the designation of being called green and that will contribute to enhance their marketing strategy and gives them an advantage to competitors as well as promote a good image of the hotel.

Impact of the Media on Society :: Television Media TV Essays

Impact of the Media on Society   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Media technologies are becoming an important aspect of today’s society. Each and every day, people interact with media of many different forms. Media is commonly defined as being a channel of communication. Radio, newspapers, and television are all examples of media. It is impossible to assume that media is made up of completely unbiased information and that the media companies do not impose their own control upon the information being supplied to media users. Since many people use media very frequently, it is obvious to assume that it has affects on people. According to the text book Media Now, "media effects are changes in knowledge, attitude, or behavior that result from exposure to the mass media," (386). This leaves us with many unanswered questions about media and its influences. This paper will look at how the effects of media are determined and explore the main affects on today’s society - violence, prejudice, and sexual b ehavior.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  In order to understand how media can affect society or individuals, it is first necessary to look at different approaches that can be taken to analyze the media. According to the book Media Now, there are two main approaches that are used: the deductive approach and the inductive approach. The deductive approach is when a social scientist first comes up with theories or predictions through systematic observations of the media, and then uses the results of their research to support the theory or prove it false. An inductive approach is slightly opposite because this method looks first at peoples interactions with media and with each other, and then creates theories from the real-life situational research. The inductive approach tends to be used more frequently because its theories are based off real instances. Another difference in the ways to approach researching the effects of media is how some social scientists are interested in quantitative information while others are more interested in qualitative information. Quantitative information is when the desired results are as many as possible, while qualitative information is when the desired results are made up of the best, most useful information. All of these approaches and methods of research influence how social scientists determine the ways that media effects society and individuals. The kinds of studies done by these social scientists create detailed profiles of media and its content, and identify trends overtime. For example, one study found that exposure to alcohol advertising and television programming has been shown to be associated with positive beliefs about drinking and alcohol consumption (Austin 2).

Health Care Delivery Systems Essay

Bursting the Health Care Bubble A source states that, the 30 million uninsured Americans have forced the United States to put part of the responsibility of health care into the government’s hands (Terry 116). By 2014, the changes in the health care system will be life changing for some, while others will have little to no effect by the reform. A surgery specialist from New York states that, â€Å"†¦46 million people in America lack access to health care and†¦ has been based on a person’s ability to pay† (Goldberg 6). Since 2010, the Health Care Reform Act already started making changes in our economy and will continue to do so until for many years, or the election of a new President. These changes will allow each person to have little to no excuse on why they are not taking responsibility of their health. As I sat patiently in the waiting room for my doctor who was twenty minutes late, I sat and watched the clock every few minutes until a nurse came to greet me. I couldn’t help but look around at the other patients next to me thinking†¦Ã¢â‚¬Å"right, privilege, or responsibility?† Was it my right to be here, my privilege, or my responsibility? Going through the scenarios in my head, I could think of examples that could fall under each. A small child ran about the waiting room while her mom sat in her chair reading â€Å"Country Living†, an elderly couple sat holding hands to my left, also waiting patiently for someone to greet them. I could hear the medical assistants at the front desk gossiping and discussing insurance matters. I couldn’t help but feel sorry for them after learning what pain insurance companies could be. Originally, while sitting there unwearyingly for the doctor and watching the people around me, I thought it was a privilege to get to be one of the lucky ones that had insurance, which better allowed me to take care and responsibility of my own health. This then lead me to my next thought, the reason that I am here right now is because I am the one taking responsibility for my own health (†¦and maybe the help of my parents until I am 26†¦ hopefully). As the nurse called me back, I had finally come to a  conclusion. Health care in the United States is a responsibility, not a right and no longer a privilege. The responsibility of healthcare if shifting everywhere, whether it be changing into the hands of patients, medical personnel, or the government. According to www.dictionary.com, being responsible is being accountable. I feel that many American’s in the United States have trouble being accountable for their own actions, and like to put the blame on someone or something other than themselves. â€Å"Americans do not blame themselves for their health care problems†¦instead attributing the rising health care costs to the profits made by drug and insurance companies† (Blendon 636). Even from the standpoint of our country as a whole, many would like to believe that we don’t make mistakes and that we are better than the rest. Even on Google, there are many websites containing all the reasons that American’s think they are superior to other countries†¦ and sadly, there is a long list. Reality has to hit at some point, and someday I hope many of us can recognize that we aren’t perfect, and that in fact we do make mistakes, mistakes that can hold even the lives and the decisions of others. Thinking I am being proactive and taking responsibility for my own health, I finally get to see the doctor after not only a thirty minute wait in the lobby, but a two to three week wait just to see my family physician. Marshall Kapp, the director of Florida State University’s Center for Innovative Collaboration in Medicine & Law, states that â€Å"†¦practicing physicians in the United States are already extremely busy† he goes on to say that adding new patients to practices will only result in either more hours to the day or a longer wait to get into your doctor, depending on the physician because of the reform (418). Marshall Kapp fears that â€Å"†¦affordable health insurance†¦ may still fail at actually providing medical care† (416). Because each physician will have more patients, will each patient be receiving the right quality of care? Or even the right medical care at all because of the long wait? In the same article he goes on saying,  "According to an official of the American College of Physicians, ‘newly insured patients can anticipate difficulties gaining access to primary care, particularly in undeserved communities’† (416). More patients will then  cause a shortage of physicians in the United States. Another source goes on to say that â€Å"Americans’ are far less satisfied with the availability†¦of health care in their country than Canada and the British are with theirs†¦ Nearly three-fourths of Americans in 2003 expressed dissatisfaction with the availability of health care in their country† (Blendon 629). Although Americans no longer have an excuse on why they aren’t taking responsibility, will the number of patients decrease the quality of care or the access to a physician? The Health Care Reform Act is predicted to reduce health care costs, which will then lead people to receive preventative care and will also allow Medicare patients to receive a physical with â€Å"no direct costs or low costs to patients† (Terry 116). Terry begins to then say that â€Å"preventative medicine and chronic illnesses-for instance, diabetic patients- are going to have incentives and better coverage (116). Edward J. Dougherty, Senior Vice President of B&D C onsulting in Washington D.C.†¦ says, ‘There is a greater focus on preventative care, on wellness, on patient education, and intervention before an acute event or episode occurs. That provides opportunities for anyone†¦Ã¢â‚¬  (Terry 116). The wise words of Dr. Baker that will haunt my brain forever went a little something like this, â€Å"As I was shaving this morning, I looked in the mirror and saw the person who was responsible for high health care costs.† Every time I look in the mirror, I am now disturbed by these same words, as I’m sure many of my other class mates are as well. Dr. Davis Goldberg goes on to tell a story of Joe Skin, â€Å"Joe Skin died of metastatic malignant melanoma because he could not afford the $100 it would have to cost him to see a local dermatologist two years earlier, when he only had melanoma in situ. Unable to afford the original fee, he left his pigmented lesion untreated, until a seizure from metastatic disease ended with him having multiple surgeries at a cost of $350,000 to tax payers† (Goldberg 6). I wonder if Mr. Skin looked in the mirror while he was shaving that morning to realize that he would be one of the reasons for high health care costs in America. Unfortunately, because Joe Skin didn’t have health insurance he decided to not take responsibility for his health, which then resulted in more problems than before and even resulted in death. This seems to be a  popular trend in the uninsured Goldberg states, â€Å"The uninsured also tend to wait longer and get sicker before seeing a doctor† (6), he then states that a popular trend among the uninsured is that they are â€Å"†¦less likely to receive recommended preventative and primary care services, face significant barriers to care and ultimately face worse health outcomes† (6). The overall attitude toward health care changes dramatically when you bring those who are uninsured into the health care industry. â€Å"Americans’ attitudes toward the health care system are related to difference between those with secure and comprehensive coverage, and those without it† (Blendon 628). A source states that, one of the purposes of the Healthcare Reform act is to better allow each person to take responsibility into their own hands, as well as â€Å"†¦lower health costs† (Terry 116). The responsibility and the cost of health care have been taken out of the physicians and the medical staff’s hands, and into those of the governments. Nathan Kaufman, Managing Director of Kaufman Strategic Advisors states, â€Å"It is a brutal fact that hospitals can no longer afford to delegate the responsibility and accountability of cost and quality of care to an independent medical staff of physicians practicing†¦Ã¢â‚¬  (167). Like we have discussed earlier, the reform is supposed to help lower the costs, but Kaufman believes that â€Å"health care costs will contribute to the destabilization of the economy† (164). He then proceeds with Richard Foster, the chief actuary for Centers of Medicare & Medicaid Services, who also states that â€Å"†¦the new law will increase the nation’s overall spending on healthcare by $289 billion through 2019† (Kaufman 164). This budget will then cut the spending in other important areas, which will then raise our taxes once again to pay back the borrowed money (Kaufman 164). Dr. Baicker also states that â€Å"†¦ there is much less to fund public schools, roads, and other necessary public services† (Goldberg 6). Although the Healthcare Reform or PPACA seems to be a good idea in many ways, this is where it all seems to be a little bit fishy, and when life seems to be all great and dandy with the reform, we will eventually be hit with the reality of the damage that our government and what our decisions have caused us. Dr. Katherine Baiker also questions the concept of the PPACA stating, â€Å"Yet the question remains: What will work? What is the most effective way to ration  health care?’ (Godberg 6). There are consequences to most every situation, and I do not know if physicians or patients are prepared for the consequences that the PPACA will bring us. The question is not if there are consequences, but when will we be affected by them? According to â€Å"Americans’ Health Care Views of Care, Access, and Quality† states that American’s have little to no faith in their government and were ready for some sort of reform (624). With the Healthcare Reform Act already facing high disputes and the non-support from many health care providers and some politicians, and because we spend so much time building the reform up, our nation is not aware of what is about to hit. At some point, Americans are going to be forced with higher taxes, and I fear health care providers who are also not prepared for the consequences will be faced with, and will not get the benefits of the reform to its fullest. Dr. Blendon says that, â€Å"†¦ when issues like health care rationing, increased taxes, and longer waiting times are raised, public alternatives fall sharply† (641). Later in the article, he also begins to say that †Å"less than half† of the people agreed to pay higher taxes to achieve the goal of a â€Å"universal health plan† (Blendon 642). Kaufman states, â€Å"Those who recognize the existence of a bubble and prepare for its brutal realities can benefit when the bubble bursts† (167). He also begins to say that, health care providers who do plan for the bubble bursting, â€Å"†¦will be able to treat higher volumes of patients at lower predictable costs per episode, demonstrating measurable high quality and providing an exceptional patient experience† (167-168). For those who do not prepare themselves for the â€Å"bubble burst† who will be responsible? Everyone involved in the health care system will be responsible for some of the â€Å"lack of thought† that has gone into this health care reform. One of the man purposes of the reform is to also help the quality of care, which is one of the many responsibilities that physicians face in the health care industry. Although doctors have many patients, if a patient is taking the responsibility of taking care of their own health, then it is th e responsibility of the physician to provide the best quality of care. A source states, â€Å"Health reform policies currently envisioned to improve care and lower costs may have small effects on high-cost patients who consume most resources. Instead, developing interventions tailored to improve care and lowering costs for specified types of complex and costly patients may hold greater potential for â€Å"bending the cost curve† (Kaufman 166). Changing the quality of care isn’t done at no cost, but a source states that â€Å"†¦health care organizations must contribute on some level to promoting the highest quality of care, the greatest safety of the patient, and the best patient experience† (Liang 1426). Coming from personal experience, if a patient is satisfied with their visit(s) and receives the best quality of care and experience possible, the likelihood of them returning is much greater. In the article â€Å"Quality and Safety in Medical Care: What Does the Future Hold?†, brought up some interesting points about physician to patient relationships during their medical stay or the decisions made about their health. Doing so will make the patient more understanding and responsible for their own health. It is important for the physician and the patient to make decisions together and understand the benefits, consequences, and the outcome of each procedure. A source states that â€Å"†¦less t han one-half of hospitalized patients stated they were always involved in the decisions about their treatment, and almost one-third of the patients indicated they did not know who handled their care in the hospital† (Liang 1426). Allowing a patient to take more responsibility for their health is a lot harder when they have no idea what is going on. The quality of patient care affects the quality of a patient’s life. Dr. Blendon says, â€Å"†¦most Americans are satisfied with the quality of medical care they and their families receive, and they do not see the issue as a top problem† (648). A source states that â€Å"†¦ the Institute of Medicine has defined quality as ‘the degree to which health services for individuals and population increase the likelihood of desired health outcomes and are consistent with current professional knowledge† (Schuster 3). When dealing with health care I believe that it is always the patients responsibility, but if the physician giving incentive to the patient stay proactive and understand what is going on, than how can the patient be responsible? The thoughts on health care are constantly changing, whether its people’s right to be provided with health care, whether it’s a privilege to be able to receive health care, or whether it’s the respo nsibility of those apart of the health industry and the patients to receive the right kind of health care. A source states that, â€Å"Finding ways of doing more with less will continue to be hospitals’ biggest challenge†Ã‚  (Hospitals are expected to do more with less 4). The health care reform will be in full force before we all know it. As a citizen and patient, I know that it is my personal responsibility to keep proactive on my health, help make decisions for my fellow American’s to make the best health system possible. So every morning, when I stare into the mirror, I know that the reason the health care industry is the way it is, was because I made it that way. Health care is a responsibility, not a right and no longer a privilege.

Comparison of Healthcare Policies between France and the US The WritePass Journal

Comparison of Healthcare Policies between France and the US Introduction Comparison of Healthcare Policies between France and the US ) Health Statistics in 2013 reveals that life expectancy in France is high at 82.2 and is currently ranked third amongst OECD countries. In contrast, life expectancy in the US is amongst the lowest at 78.7 (OECD, 2013). The difference in life expectancy in both countries is a cause of concern since the US has one of the most expensive healthcare systems in the OECD and yet fares worse in health outcomes, including life expectancy(Baldock, 2011). The OECD (2013) notes that compared to France and other large OECD countries, the US spends twice as much per individual on healthcare. Interestingly, public health expenditure for health is highest in the US compared to all OECD countries. However, it does not practice universal healthcare coverage with the public supporting only 32% of the total healthcare cost (OECD, 2011). Individuals eligible for Medicaid include the elderly, families with small children and those with disabilities (Rosenbaum, 2011). Approximately 53% of the US population is covered through the Patient Protection and Affordable Act or Obamacare (Rosenbaum, 2011). Under this Act, employers are required to purchase health insurances for their employees. Only a small portion of businesses pays for full coverage with majority requiring their employees to share in the cost of their health insurances (Rosenbaum, 2011). The OECD (2009a) states that 46 million people in the US are left without public or private health insurance. This could place a significant burden to the US healthcare system that is struggling in providing equitable access to healthcare services in the country. The World Health Organization (2014) explains that equitable access is achieved when individuals, regardless of their socioeconomic status, enjoy the same type and quality of healthcare. This is not achieved in the US where statistics (OECD, 2009a) continues to show that high-income groups enjoy better health and appropriately covered by healthcare insurances while those in the lower socioeconomic status continue to have poorer health status. This disparity in health status and healthcare insurance coverage continues to be a challenge in the US. Public spending per capita in the US continues to be the highest in the OECD countries even with the increased participation of the private sector in financing healthcare in the country (OECD, 2013). In recent years, the OECD (2013) observes that public spending across OECD countries continue to decline. On average, healthcare spending of these countries only grew by 0.2% in the last 4 years. While there is a variation on the decrease of public spending, the major reason for the slowdown is due to drastic cuts in health expenditures. In France, the Statutory Health Insurance (SHI) currently covers almost all residents. Until 2000, SHI covered 100% of all residents (Franc and Polton, 2006). Today, almost all of the residents are still covered under SHI. However, a few have purchased private health insurances to complement SHI. Public spending for healthcare is 77.9% while France spends 11.9% of its GDP in healthcare (OECD, 2011). This is in contrast with the US where public spending for healthcare accounts to only 47.7% but spends 17.9% of its GDP on healthcare (OECD, 2011). Interestingly, SHI covers both legal and illegal residents in France. This is opposite in the US where illegal residents are not covered by publicly funded healthcare insurance. There are approximately 21 million immigrants in the US with most having an illegal resident status (Moody, 2011). Health coverage remains to be a concern for this group since they work on jobs that pay very low wages and with no healthcare coverage. Hence, this group is three times more likely to have no healthcare coverage (Stanton, 2006). Currently, this group comprises 20% of the total uninsured population in the US (Moo dy, 2011). The lack of universal coverage in the US suggests that healthcare policies in the US may not be inclusive as opposed to France where almost all residents have private or public health insurance coverage. Rosenbaum (2011) explains that the Patient Protection and Affordable Act or Obamacare is expected to boost healthcare coverage for legal immigrants who are in low paying jobs. However, only legal immigrants who have been in the US for at least five years could qualify for Medicaid or purchase state-based health insurances. Currently, all states in the US have expanded Medicaid coverage to low-income groups. Specifically, a family of four with a combined annual income of $33,000.00 and an individual with $15,800.00 yearly income are now eligible for Medicaid. This legislation provides health coverage to approximately 57% of the uninsured population in the US (CDC, 2011). For legal immigrants who have not reached five years of stay in the US or are earning more than the Medicaid limit are allowed federal subsidy when purchasing state-based health insurances (CDC, 2011). As opposed to France where illegal immigrants enjoy the same healthcare coverage as legal immigrants and citizens, those in the US on illegal status remain uninsured and could not purchase state-based health insurances (CDC, 2011). Healthcare access for this group is limited to community health centres across the country. It is noteworthy that only 8,500 community health centres are in existence today and yet they cater to at least 22 million people each year (CDC, 2011). Almost half of those who access primary health centres are the uninsured. While hospitals are required by law to provide emergency care for all individuals regardless of their resident status, those who are uninsured do not have health coverage to sustain their long-term healthcare needs (Rosenbaum, 2011). Current healthcare policies in the US might actually promote health inequality since it only provides primary basic healthcare services (CDC, 2011) to the marginalised group, which may include low-income and ethni c groups. In France, The Bismarckian approach to healthcare has been used for several decades but in recent years, there is now an adoption of the Beveridge approach (Chevreul et al., 2010). In the former, health coverage tends to be uniform and concentrated while in the latter, the single public payer model is promoted. In the Bismarckian approach, everyone should be given the same access to healthcare services while the Beveridge model allows for stronger state intervention (Chevreul et al., 2010). This also suggests that tax-based revenues are used to finance healthcare. The mix of both models is necessary to respond to the increasing demands for healthcare in the country and to regulate the increasing cost of healthcare. Chevreul et al. (2010) emphasise that the SHI is now experiencing deficit due to increasing rise of healthcare expenditure in the country. The French parliament, through the Ministry of Health regulates expenditure by enacting laws and regulations. Importantly, France regulates prices of specific medical procedures and drugs (Chevreul and Durand-Zaleski, 2009). This development is crucial since failure to regulate prices could further drive up healthcare costs. However, regulation of prices of medical devices remains to be poor. In a survey (OECD, 2009b), expenditures for medical devices is high and amounts to â‚ ¬19 billion annually. Although it comprises 55% of the pharmaceutical market, increased demand for medical devices have also increased SHI expenditures on these devices (Cases and Le Fur, 2008). It should be noted that only 60% of the medical devices are covered by SHI (Cases and Le Fur, 2008). Regulation of the prices of these medical devices is not as strong as the market for drugs and other major medical equipment. This implies that increasing healthcare costs of medical devices could have an impact on pu blic health spending policies in France. Healthcare Issues and Challenges One of the major issues in both countries is the rising healthcare expenditure. As noted by the OECD (2013), there is a disparity between healthcare expenditure and rising healthcare costs in OECD countries. The average increase in healthcare expenditure only amounts to 0.2% and yet healthcare cost continues to rise. In France, this disparity has promoted the Ministry of Health to increase private insurance of its members to help cover healthcare services not normally covered by the SHI. In the US, the debate on Obamacare and the reluctance of the government to cover illegal residents continue to be a challenge in providing equitable healthcare Meanwhile, high costs of medicines could have an impact on healthcare, especially amongst those who are covered by Medicaid and those who could barely afford state-subsidised healthcare insurances (Moody, 2011). This is in contrast to France where cost containment is in place for medicines. To illustrate the lack of healthcare costs regulations, the US spends more on developing medical technologies, which only benefits a few of the patients. The country is also burdened with high administration and pharmaceutical costs. Doctors in the country are also amongst the highest paid in the OECD countries (Greve, 2013). Moody (2011) argues that cost containment remains to be a problem since lowering down prices of medicines or healthcare costs for beneficiaries of Medicaid would lead to doctors’ reluctance to treat Medicaid patients. The lack of priorities in healthcare spending in the US has resulted in higher spending on certain areas and low spending on others. However, this does not translate to better health outcomes for the whole population. Elderly care is one area where there is high spending but the amount of spending does not necessarily translate to better health outcomes. As noted by Haplin et al. (2010), the elderly are more vulnerable to chronic healthcare conditions, such as dementia, cardiovascular diseases, type 2 diabetes. Hence, healthcare costs for this group are relatively higher compared to other members in a community. In a report published by Stanton (2006), approximately 40% of US healthcare expenditure is devoted to elderly care, but this group only comprises 13% of country’s population. It is projected that in the succeeding years, healthcare cost for this group will continue to rise with the ageing of the US population (Stanton, 2006). The same issue is also seen in France, where increasing healthcare cost for the elderly is also expected in the succeeding years (Franc and Polton, 2006). Both countries also lack coordination of care and gatekeeping for the elderly. Although there is an emphasis on elderly care in both countries, lack of continuity of care often leads to poor quality care, duplication of healthcare, waste and over-prescription (Franc and Polton, 2006; Evans and Docteur and Oxley, 2003; Stoddard, 2003). In France, this issue was first addressed through the creation of provider networks and increasing the gate-keeping roles of the general practitioners (GPs). However, the latter was largely unsuccessfully and finally abolished with the introduction of the 2004 Health Insurance Act (Franc and Polton, 2006). In this new legislation, patients have the freedom to choose their own healthcare providers or primary point of contact. Most of the primary points of contact are GPs. This scheme is successful in F rance due to incentives offered to the patients and GPs. This scheme has been suggested to improve the quality of care received by the patients since there is more coordination of care between GPs and specialists (Naiditch and Dourgnon, 2009). This scheme also drives up the cost of visits to specialists and could have influence healthcare financing policies (De Looper and La Fortune, 2009; Naiditch and Dourgnon, 2009). Another issue common to both countries is the competition between hospitals for patients who can afford private healthcare. Consumer demands for healthcare in the US have increased. Hospitals respond by increasing their services to separate them from their competitors (Moody, 2011). For instance, by-products of this competition results to increasing the size of the patient rooms and providing in-house services such as full kitchens, family lounges and business service. All these have not been related to improved health outcomes of the patients. In France, the differences in healthcare costs between publicly funded hospitals and private for-profit hospitals spark a debate on whether common tariffs are the solution to cost containment (Chevreul et al., 2010). Despite the implementation of common tariffs, there is still a growing difference on the healthcare costs between the private and public sectors. Currently, the reform plan Hospital 2007 (Chevreul et al., 2010) states that the obj ective of introducing a common tariff for public and private hospitals has been withheld until 2018. This shows that healthcare policies respond to current trends in health provision in France. ‘Convergence’ and ‘Path Dependence’ Starke et al. (2008) explain that history and institutional context all play a role in influencing healthcare policies in a welfare state. Healthcare policies that tend to be resistant to change illustrate institutionalist or ‘path dependence.’In the event where changes are needed, those that follow ‘path dependence’ change their policies but do so within the boundaries set in the original healthcare policies. On the other hand, healthcare policies that follow the ‘convergence’ pathway or functionalist perspective tend to integrate best practices and are more responsive to social, political and economic changes. Healthcare policies in France and the US tend to follow the ‘convergence’ pathway. The historical context of France reveals that a unitary presidential democracy was established in 1958 (Cases, 2006). In this system, the central government retains sovereignty and policies implemented in local or regional levels are approved by the central government. Despite the practice of central dirigisme, many regions in France have practiced coordination and decenstralisation. Political parties elected to the French government all have a common goal in financing the healthcare system in France. It practices cost-containment by regulating healthcare costs, reducing healthcare demands and restricting healthcare coverage (Chevreul and Durand-Zaleski, 2009). All these cost-containment policies have generally been met with public discontent. In recent years, the introduction of Supplementary Health Insurance enabled the French government to still deliver quality care at reasonable cost. Further, the introduction of direct payment, although reimbursable, also discourages wasteful consumption of healthcare (Chevreul and Durand-Zaleski, 2009). Although changes in healthcare policies tend to be restrictive more than three decades ago, France is now taking the ‘convergence’ pathway in its healthcare system. This suggests that healthcare policies are more responsive to social and economic changes. France also regards its people as equal but retain their freedom to choose a healthcare provider and hospital. The manner of healthcare financing in France allows service users to choose from competing healthcare professionals. Service users could also access specialists due to little gatekeeping in the country (Naiditch and Dourgnon, 2009). All these changes in the France’s healthcare system reflect ‘convergence’ rather than ‘path dependence’. Convergence in healthcare is also shown in both countries through its policies on increasing personal contributions of service users for healthcare (Mossialos and Thomson, 2004). There is also an increasing reliance on private health insurers to bridge the gap in public healthcare delivery. The increasing public-private mix exemplifies convergence. There is also a trend towards community healthcare and decentralisation of healthcare (Baldock, 2011; Chevreul et al., 2010; Blank and Burau, 2007). This trend relies on community healthcare practitioners to provide care in home or community settings. This has been practiced in other developed countries where patients with chronic conditions receive care in their own homes (Chevreau et al., 2010). This approach is also applied when caring for the elderly. Similar to other Welfare states, the US and France are experiencing population ageing. The proportion of the elderly in both countries is expected to rise in the succeeding years (Chevrea u et al., 2010). As mentioned earlier, this translates to increases in health expenditures and cost for this group. Marked increases in health expenditures for this group would mean further reduction on public spending or cost containment. All these could have an impact on public spending in the future and might increase insurance premiums of individuals. There is also the possibility of raising SHI contributions in France or reducing healthcare coverage of Medicaid in the US. Both strategies could fuel public discontent, increase the gap between the rich and the poor and promote health inequalities (OECD, 2008; Starke et al., 2008; Stanton, 2006). Since the main aim of the policies in both countries is to achieve optimal health for all, the realisation of this aim might be compromised with an ageing society. It is also noteworthy that since public funds are bankrolled by taxes, increasing number of elderly could mean reduction in number of employees who are economically productive. This could also lead to lower tax collections and decreased public funding for healthcare. As shown in both countries, healthcare policies are becoming more responsive to the social and economic changes. This does not only suggest a direction towards ‘convergence’ but suggests that this pathway could be the norm for many OECD countries. Conclusion Healthcare policies in the US and France have been influenced by social and economic changes in recent years. Although both aim to achieve universal coverage, it is only France that has achieved this with almost 100% of its citizens covered with healthcare insurance. The US is struggling to meet the healthcare needs of its citizens with almost 46 million still uninsured. Its Obamacare is still met with criticism for its failure to provide public healthcare coverage for most of its citizens. Only the poor and those unable to afford basic healthcare services are covered under Medicaid. In Obamacare, those with marginal incomes could purchase federal-subsidised healthcare insurances. Both countries are also faced with the challenge of an ageing society. The inequitable allocation of healthcare services to this group also promotes social discontent. Almost half of public expenditure is channeled to the elderly, which only comprises 13% of the whole population. 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