Hospital Organization

Hospitals continue to be the largest segment of the health care industry, measured by economic volume and delivery of a wide range of professional services. HEALTH CARE SERVICES The different segments of the health care delivery system provide various combinations of services. The specific combination offered depends on a variety factors that prevail in a location, including state and local licensing laws, reimbursement structures, availability of medical personnel and facilities, and the demographic details (such as age and industrial distribution) of the potential patient population.The unique aspect of the health care industry from an audit perspective is the health care delivery system – the revenue cycle. The other cycles are essentially similar to those in manufacturing or selling enterprises. Services are generally described by a six-level classification. Those levels indicate, but do not strictly define, the type of organization, the level of medical treatment involved , or the severity of, or prognosis for, the medical situation. The levels are: †¢Preventive – Health education and prevention programs provided by business and other organizations, such as schools and family planning clinics. Primary – Early detection and routine treatment of health problems, such as are often provided by physicians’ offices, industrial and school health units, and hospital outpatient and emergency departments.†¢Secondary – Acute care services, typically provided by medical personnel, through hospitals, using elaborate diagnostic and treatment procedures. †¢Tertiary – Highly technical services, such as for psychiatric and chronic diseases, provided through specialty facilities and teaching hospitals. †¢Restorative – Rehabilitative and follow-up acre, typically provided by home health agencies, nursing homes, and halfway houses. Continuing – Long-term, chronic care, typically provided by geriatric d ay care centers and nursing homes. The growing economic magnitude of the health care system has led to increased regulatory activities focusing on health care. This increase in regulation interacts with a growing demand for more health care and for increasingly technical and complex methods of providing it. The largest and most evident regulatory activity involves reimbursement by state governments. Other regulatory activities are concerned in varying degrees with the availability and quality of health care.There are continued initiatives by state government to link such regulations to reimbursement in order to enforce compliance. The presence of multiple regulatory systems influences the demand for and the nature of professional accounting services required by health care institutions. Those systems often emphasize reporting requirements, and health care institutions tend to view compliance reporting as a major use of accounting data. Auditing services in particular are affected be cause the regulatory agencies rely heavily on the attest activities of the health care institution’s independent accountant.STRUCTURE AND ORGANIZATION Patient care is the essential function of a hospital. Other vital roles include medical education and research. Recently, many larger general hospitals have become total community health centers, providing a wide range of outpatient services in addition to traditional impatient care. One characteristic of the growth of the health center concept is the emergence of such diverse related organizations as real estate holding companies and medical management companies.These organizations are a response to changes in the reimbursement, regulatory, tax and financial environment facing hospital management. Such nontraditional organizational structures and patterns of activity are needed to provide adequate financial resources to support the delivery of health care by hospitals. Some observers see these changes as leading to major multi hospital systems, so that in the future a few major health entities may control the majority of the hospital beds in the country. Hospitals may be classified by type of ownership and mode of operation, as follows: Government – Hospitals operated by governmental agencies and providing specialized services to specific groups and their dependents, such as the military, veterans, government employees, the indigent and the mentally ill. †¢Investor-owned (proprietary) – Hospitals owned by individual proprietors or groups of proprietors or by the public through stock ownership. The objective of such hospitals is to operate for profit. †¢Voluntary nonprofit – Hospitals operated under the sponsorship of a community, religious denomination, or other nonprofit entity.This is the largest category (in number of hospitals), comprising two major types: teaching hospitals and community hospitals. a. Teaching hospitals – Generally university-related hospitals, t heir health care service activities combine education, research and a broad range of sophisticated patient services. Large community hospitals affiliated with medical schools and offering intern and resident programs are also considered teaching hospitals. b. Community hospitals – Hospitals that traditionally are established to serve a specific area, such as a city, town, or county, and usually offer more limited services than teaching hospitals do.Hospitals may also be categorized by the type of care provided, as short-term (acute), general, long-term general, psychiatric, and other special care. The mode of a hospital’s operation and type of care occur in various combinations, such as government psychiatric or short-term pediatric. THIRD-PARTY REIMBURSEMENT OR PAYMENT A major difference between health care entities and commercial enterprises is that the recipient of health care services – the patient – in most cases does not pay directly for the service s. Instead, payment is made by some other organization.The payment is often referred to as a â€Å"third party†. Typically, a hospital’s most significant patient revenue sources are its reimbursement contracts with third parties. In each case, there is an identifiable group of patients whose health care services are paid for, in whole or in part, by the third party. The amount of the reimbursement, as well as the eligible class of patients and other administrative matters, is covered by regulations or contracts. The major third parties are governmental agencies. Of these, the state government is the largest.Medicard is state-administered third-party reimbursement program designed to underwrite hospital costs of the medically indigent and those eligible for certain types of public welfare. Medicare is a third-party reimbursement program administered by the Health Care Financing Administration of the Department of Health and Human Services. State governments have long be en involved in reimbursement for health care services, and their involvement has increased through participation in the Medicard Program. Recently, the continued growth of third-party expenditures for reimbursement has fostered a number of state-based cost control programs.Of increasing importance are a wide variety of controls at the state level, usually referred to by terms such as state rate control. The state government has been quite active in encouraging or supporting such programs. The impact of governmental and commercial third parties on hospital is affected by when the reimbursement or payment is determined and the basis of the reimbursement or payment. Third-party reimbursement systems are either retrospective or prospective. Retrospective refers to third-party reimbursement systems that determine the amount to be paid after the services have been performed.In prospective payment systems, the amount is determined before the services have been performed. Reimbursements or payments are usually based on either the costs (to the hospital) of services performed for eligible patients or the amounts charged by the hospital for such services. The regulations or contracts of the third party contain specific provisions designed to ensure that only certain costs or charges enter into the determination of the reimbursement or payment. There are also provisions to ensure that reimbursement or payment is made only for services to eligible patients.Third-party payers can be expected to continue to refine their approach as the volume of payments increases. The difference between the hospitals established rates for services rendered and the amounts received or receivable from third-party payers known as a contractual allowance and is shown as a deduction from gross patient revenues on the statement of revenues and expenses. PAYMENTS AND SETTLEMENTS Under many retrospective reimbursement and prospective payment contracts, the hospital is paid throughout the year on a n interim basis.The payment is based on estimates of costs expected to be incurred during the year in serving patients. At the end of the fiscal year, a reimbursement report is filed with each third party, and any difference between the final cost settlements, by providing an independent basis for third-party reliance on the hospital’s accounting records. Reimbursement reports typically include cost-finding calculations that segregate direct costs by cost centers and allocate overhead costs from indirect or nonrevenue-producing centers to revenue-producing centers, using one of several allocation methods.Departments that provide direct patient services such as nursing, laboratory, and radiology are examples of revenue-producing centers, while support or overhead units such as laundry, dietary, and administrative services are typical nonrevenue-producing cost centers. This allocation produces an operating cost for each revenue-producing center, consisting of its direct costs p lus its share of indirect costs. After all costs have been assigned to revenue-producing centers, they are apportioned to the various third-party payers. STATISTICSDepartmental activity or usage statistics are employed in most cost-finding methods used to allocate overhead costs to revenue-producing centers. Some statistics, such as square feet of space, may remain unchanged from prior years. The auditor should, however, inquire whether changes have occurred. Simple observation is helpful; a new wing, department, or floor plan means that statistics must be updated. Certain statistical information is generated by the various transaction cycles. Examples of statistics that are generated in the buying cycle are: Payroll pesos – Used to allocate employee benefits, health and welfare costs, and other compensation costs. †¢Hours worked – Used to allocate nursing administration costs and sometimes employee cafeteria costs. †¢Full-time equivalent employees (FTE) â₠¬â€œ Sometimes used to allocate employee cafeteria costs. Other statistics utilized in cost-finding and third-party reimbursement are generated by departmental activity studies and surveys. Examples of such statistics are pounds of laundry, housekeeping hours of service, social service hours, and cost of drugs and medical and surgical supplies issued to nursing stations.Medicare regulations require a study of at least four 2-week periods annually. FUND ACCOUNTING The audit guide prescribes the use of fund accounting for the external financial statements of nongovernment, not-for-profit hospitals. Fund accounting entails the maintenance of separate or group accounts for hospital resources according to the spending objectives set by donors, other outside sources, or the board of trustees. (Investor-owned hospitals are regarded as business enterprises and report as such. ) Two broad classes of funds are used: †¢Unrestricted funds, which encompass assets other than those that are r estricted, as defined below.Many authorities believe that this class of funds should be referred to as general and that the term unrestricted is misleading, since restrictions other than those imposed by donors or grantors may be placed on assets of these funds. A reserve account maintained under a bond indenture provision is an example of an asset that is included in unrestricted funds but is restricted as to use. †¢Restricted funds, which encompass assets that are subject to restrictions imposed by specified external parties, that is, donors or grantors. Examples are plant replacement and endowment funds. AUDIT STRATEGY AND RISK ASSESSMENTIn many ways, the accounting systems and controls that operate in health care institutions are the same as those in any other industry. Because of regulation by governmental agencies and consumer group pressures, however audit concerns for hospital client is expanded considerably. Those concerns, fee pressures because of the nonprofit nature of many institutions, and competition among firms all create a need for this audit analysis to streamline audit procedures and improve audit efficiency as much as possible. In developing an audit strategy for a hospital engagement, the auditor had a thorough understanding of the patient mix.The geographic location of the hospital, the range of service it provides, and state regulations influence the age, financial status, and insurance coverage of the patient population. In particular, the audit strategy will vary depending on whether the services are rendered on a charge-paying or cost-reimbursement basis. If most of the hospital’s services will be paid on a cost-reimbursement basis; the propriety of costs incurred is a primary concern of the auditor. The accuracy of departmental revenue classification is also important in the cost apportionment process.The payment is made either directly by the patient or by third parties based on actual charges billed; auditing statistica l data and departmental cost classification is deemphasized since those data do not affect revenue. In planning hospital audit, it is important to have an understanding of the hospital’s current financial position and financial trends. Analyzing financial ratios may lead to a fuller understanding of the hospital’s operations and problems than could be obtained from reviewing raw data. It is also helpful to compare the hospital’s operations and financial position with those of the other institutions.Inherent risk in considerations in the health care industry revolves around the third-party reimbursement structure. A key concern is billing procedures, which are complicated by the very significant involvement of third parties. TYPICAL TRANSACTIONS, INTERNAL CONTROLS, AND AUDIT TESTS PATIENT REVENUE CYCLE The major source of revenues in a hospital is services provided to patients. Revenue was recorded, at hospital’s established rate, on the accrual basis at t he time services are performed. Patient service revenues are recorded separately by source (laboratory revenues) and by patient type (inpatient or outpatient).Additionally, the source of payment of each patient is essential information that was captured by the accounting system. Hospitals generally billed inpatients after completion of a patient’s stay in the hospital. The actual amount received by the hospital may vary depending on contractual arrangements between the hospital and the patient or a third-party payer. Services rendered to private-paying patients are billed at the established rates, except that courtesy allowances may be granted to doctors, employees, or members of religious orders and charity allowances may be granted as determined by patient needs and hospital policy.To understand the hospital’s patient revenue cycle, the auditor should become familiar with the various functions and departments that may serve patients and should also understand how tho se functions and departments relate to accounting for patient revenue. SUBSTANTIVE TESTS OF ACCOUNTS RECEIVABLE Hospital receivables have several characteristics not normally found in receivables of commercial organizations. First, full-rate charges to patients for services received may be settled for an amount less than the full rate because of contractual arrangements with third-party payers courtesy, charity, or other policy discounts.In addition, large amounts of receivables are paid by third-parties, and payment may be made by a single payer or combination of payers (e. g. , commercial insurance, Medicare, Medicard, workers’ compensation and the patient. ) Since a patient may have more than one insurer, it is possible for duplicate payments to be made on the patient’s account. This results in credit balances in accounts receivable, which are characteristic of hospitals with aggressive billing procedures.The auditor should review the components of these credit bala nces, and if they are significant, consider reclassifying them. Since the hospital must refund duplicate payments, the auditor should review controls over issuance and use of refund checks to determine that they are for valid credit balances and that they are payable to the proper payee. In most hospitals, accounts receivable are classified according to the patient’s billing status, generally using the following categories: †¢Inpatient:Admitted but not discharged (commonly referred to as â€Å"in-house patients†) Discharged but not billed (accounts awaiting final or â€Å"late† charges, or unbilled as a result of a backlog in billing procedures – which might indicate a control weakness) Discharged and billed †¢Outpatient: Unbilled Billed These categories of inpatients and outpatients may be expanded further to indicate private-paying status or third-party responsibility for payment. The existence and accuracy of accounts receivable are normally tested by reviewing subsequent cash receipts.The validity of admitted-but-not discharged patient receivables can be tested by comparing accounts with the daily census report or by relying on compliance tests of admitting function. Confirming balances with patients may be difficult, and the auditor should consider confirming other items, such as number of days spent in the hospital, types of insurance coverage, or, at least, the policy number and insurance company. This information confirms that the patient was in the hospital. Negative confirmations generally produce adequate results for the â€Å"self-pay† or patient portion of the bill.Typical responses for the third-party portion state that the patient believes the bill will be paid by the insurance company or that the patient is unable to confirm because of insufficient information. NONPATIENT REVENUES Revenues from sources other than patient charges consist of interest on invested funds, unrestricted gifts and grants, tr ansfers from restricted funds, and expenditures of restricted fund assets for the benefit of unrestricted (general) funds. Audit steps for material nonpatient revenues should include, but not limited to: †¢Confirming investment activity with banks or an external trustee. Reviewing date and documents underlying gifts, grants, and bequests, such as board minutes, correspondence, and acknowledgement receipts. †¢Reviewing research or grant documentation. †¢Confirming pledges (or otherwise obtaining satisfaction as to their existence) and evaluating their collectability. BUYING CYCLE Payroll. Hospital employees may be classified as professional and nonprofessional. Examples of professional staff are registered nurses and licensed vocational nurses. Nonprofessional employees include orderlies, housekeeping and maintenance personnel, and kitchen staff.Control over both professional and nonprofessional time is critical since salary costs constitute a significant portion of ho spital costs. Generally, the same payroll audit procedures used in other organizations of comparable size also apply to hospitals. Compliance testing of total payroll costs should include tests of controls over classification of costs by department, which is important for purposes of reimbursement and also for cost reporting. Misclassification of a reimbursable cost to a no reimbursable cost center could result in failure to receive reimbursement for that cost.The auditor typically reviews the appropriateness of the account distribution and traces amounts to the payroll register or distribution summaries. Those registers or summaries are tested for mathematical accuracy and then agreed to the appropriate general ledger accounts. Other Expenses. Hospital expenses are typically classified by departmental function (such as nursing services and laboratory services). Proper classification of costs by department is important for financial statement purposes as well as cost reporting and r eimbursement.The auditor should test the propriety of the general ledger account distribution by reference to purchasing documentation. Fixed Assets. Controls over the acquisition of property, plant, and equipment by a hospital should be the same for a commercial enterprise. Some hospital departments own and use expensive, highly specialized equipment, such as nuclear magnetic resonance devices. Department heads should, of course, but that involved in capital budgeting and purchasing decisions, but that involvement should not extend to overriding controls that have been instituted for purchases generally.

Discussion questions Essay

Do you think Kappmeyer should sign the proposal, and why? What pushed USS to stay with conventional technology? My recommendation based on analysis of the case and understanding the basic nature of disruptive technologies, and their impact on the general industry is that Kappmeyer should not sign the proposal. The main reason for that is USS is tying itself to an existing, but dying business model and technology. While this plan may make sense in the short-term, it does not have long-term sustainability. The market has already indicated that it is changing, adapting to minimills, and this trend would likely continue. As minimill technology becomes more sophisticated, their quality and other disadvantages would reduce and they would start competing with integrated manufacturing even in the high-end markets. Unfortunately for USS, there is no silver bullet. Since USS is already invested in the market, they will have to go through a difficult, and expensive, change, or they will end up perishing as the industry changes around them. USS current decided to stay with conventional continuous casting technology simply because they were looking at the shorter-term future, and was not willing to take the financial hit and risk associated with a new disruptive technology. Additionally, they were tying themselves to the requirements of the current customers, and ignoring potentially new users for the future. Did USS team get the right answer to the wrong question? What if, rather than whether USS should install CSP in Mon Valley, Kappmeyer has asked whether USS should invest in or participate in this technology? Would you have answered that question differently than you did when the problem was framed as Mon Valley issue? †¢ What should USS’s next technological move be? Should USS take another â€Å"long shot† to leapfrog ahead of Nucor? Or should it â€Å"get on the ground† neck-to-neck with Nucor, employing a viable commercial technology as soon as possible incrementally improving CSP? Readings †¢ Christensen (1995). Disruptive technologies: Catching the wave, HBR

Change the Culture of an Organisation Essay Example for Free

Change the Culture of an Organisation Essay The culture of an organization can be defined by the ‘way they do things’, this means the way they make decisions, operate and how they choose and achieve their objectives. As culture is a set of values and practices, changing it may be difficult and a long process, especially if the change is organized by a new chief executive. Changing the culture of an organization may not be easy especially if the new chief executive does not fully understand the previous culture and therefore does not embrace it in the change. This lack of knowledge may result in an inappropriate culture being chosen that could limit the company’s performance as productivity reduces. An example of a badly imposed culture can been seen with the Chrysler and Damier-Benz merge in 1998. Damier-Benz imposed their traditional and structured German culture on the free-spirited American car company Chrysler. The extremely different cultures created tension that later affected their efficiency as decision-making took longer and the workforce were not happy. The inappropriate culture resulted in a loss of $1.5 billon by 2006. In 2011, the new chief executive of Tesco, Phillip Clarke, also made a cultural change which proved unsuccessful. He proposed a strategy to change Tesco’s brand image to be known for â€Å"highly valued brands† as opposed to their cheaper â€Å"Value† products. The decrease in popular promotion deals such as vouchers and meal deals reduced their sales revenue and share value which fell by 15% by the end of 2011. This suggests that Clarke failed to identify Tesco’s main source of competitively. Therefore, both examples show that cultural changes may be difficult as the new chief executives lack knowledge and experience in the company. Culture change also takes a long time, especially as traditions and values are set. A prime example of this is with Sony. Sony is a Japan-based company who prides themselves in adopting a traditional Japanese business culture. Examples of their culture can be seen with their clear line of authority and their strong belief in respect. However, Sony’s reducing performance and the fast changing world alarmed the new chief executive, Howard Stringer, to change the culture to one that embraces change. Although proposals to change the culture were made in 2007, Sony’s culture has still not fully transformed which is reflected in their still low competitively. Therefore, it may still take some time for Sony to fully embrace an innovative culture as their Japanese culture has largely influenced the organization. It also took a long time for Marks & Spencer to introduce higher levels of technology, such as a stock control system, as they are said to have a ‘backward culture’. This is because they don’t embrace change and are led by system and procedures. These examples provide evidence that change in a business’s culture may not be done quickly as the organization is accustomed to the previous culture. However, changing a company’s culture can be easy if the new chief executive conducts the change in an appropriate manner. As culture change will have a direct impact on stakeholders, it is important for the new chief executive to inform all stakeholders of the changes and to also encourage feedback. The loss of the innovative leader of Apple, Steve Jobbs created much anxiety about the new CEO Tim Cook. Stakeholders feared Cook would change the company and reject all Jobbs practices especially as the two leaders have different personalities. The media worsened the situation with continuous negative press coverage which resulted in a decrease in consumer confidence as well as Apple’s share price. Although Jobbs had planned to make some strategic changes to the company’s practices, he reassured stakeholders by stating that â€Å"Apple will not change†. He also identified these new strategies and their benefits in a press release which justified his decisions and satisfied stakeholders. The newfound trust of stakeholders will enable Apple’s cultural change to be easier and happen more quickly. In view of the above, I believe that it is not easy to change the culture of a business, as the current practices are custom to the organization; this also suggests that the change will be quite a process and therefore won’t be done quickly. This situation is worsened as the chief executive is new and won’t have the necessary knowledge and understanding of the business to enable a smooth and quick transition. However, the ability for the new chief executive to change the business’s culture quickly and easily is highly dependant upon the reaction of the stakeholders. For example, BP’s customers may react positively as the new culture will increase the company’s responsiveness to customers. Shareholders may also react positively as the increase of innovation should increase BP’s competitive advantage which could increase the company’s value and share price. However, the increase in innovation may pose a threat the employees as management will expect higher quality and the need for more qualified personnel may be necessary. Therefore, support from stakeholders will encourage an easier and quickly transformation whereas negativity will not. The skills of the workforce is also important as if they are innovative the cultural change will happen faster. However, Sony is in a creative industry and their strategy to increase innovation still took a long time. This suggests that attitudes and beliefs of the workforce are also important. An easy change is also depend upon the new executives approach, is it forceful or flexible? Damier-Benz’s forceful approach result in a large amount of tension that slowed the change and resulted in a financial loss. Change the Culture of an Organisation. (2017, Feb 04).

School Administrator Public Relations - Comparative Critique of 10 Essay

School Administrator Public Relations - Comparative Critique of 10 Articles - Essay Example s are being voted down, teachers are striking, graduates are suing schools because they cannot read, parents demanding revised curricula, students and teachers being attacked in the classroom. The growth in news coverage of education reflects in part the public’s increased awareness of schools and their impact on society (Wilder, 2000). With the rapid evolution of protests in the streets, the discovery of the poor, the rise in industrial technology, and swiftly changing patterns, the social urgency of education has been firmly established in the public mind. The list of problems in our school can go on. Most large school districts now realize that part of their responsibility as social institutions is to keep the public informed about their operations. There are three basic groups of school leaders/administrators which the 10 articles have in common. First, the teachers, this includes primary and secondary and college/university professors. The next group, which we will refer to, in this article as the principal will include school principals, superintendents and university and college presidents, the last group, consist of the members of the school board. Wilder (2000) also mentioned that, if a school leader says that he does not care about what the public says about his school, that teacher, administrator or member of the board is a liability to all the schools. He explained that no school, public schools to be exact, has any moral right to allow itself to be unexplained, misunderstood or publicly distrusted for by its unpopularity it poisons the pond in which we all fish. Before going into details about the specific roles of the different groups, let us first take a closer look on accountability. This concept is one of the similar functions of the three groups and therefore needs special attention. The performance and costs of schools has generated increasing dissatisfaction which in turn lead to a greater demand for accountability and transparency on the

Just in Time (JIT) today Essay Example | Topics and Well Written Essays - 2500 words

Just in Time (JIT) today - Essay Example Two companies, one automobile and one glass manufacturer who have adopted JIT & TOC technologies were analyzed. As the automobile company is in the niche market, JIT it very much the answer to its specific needs. In case of the manufacturer its manual operations went in favour of the TOC. It is an established fact that the Just-in-Time (JIT) based System is the answer to manufacturing assembly operations. JIT has lead to the development of what is known as Lean Manufacturing. It offers scope for reducing inventories and introducing ways and means to improve productivity by planning optimal use of resources. By elimination of all activities that do not add value and/or are safety nets, maximum use of scarce resources like capacity, manpower and capital becomes achievable. It also results in value addition for the customer, improved bottom line and enhanced productivity of employees. This is the ultimate objective of Lean Design While there are a variety of softwares available, the most suitable are those that have been adopted and perfected by the larger Automobile companies like Toyota Corporation. They are the pioneers of the Just-in-Time concept and have perfected it to an extent that has made them world class competitors to larger companies in the world. In contrast, other methods try to automate current business process and while implementing, there is a risk of simply automating the waste. With them quality is an issue that is left for other standards like ISO etc. For these reasons, Just in Time is now a widely adopted philosophy for focusing on customer value adding activities through eliminating wastes and striving towards continuous improvement. Lean Designs are based on JIT methods and are most popular today. An ARC Groups’ strategy report authored by Simon Bragg (2004) suggests that today 36% of US manufacturers and 70% UK manufacturers â€Å"are today using Lean as

Account for changes, ststus and expectations of working class women in Essay

Account for changes, ststus and expectations of working class women in victorian period (england only) - Essay Example Women were beginning to question their allotted place in society as more and more opportunities opened for them in the urban centers of the country, providing them with a means of supporting themselves and freeing themselves from the yoke of male domination. However, at the same time, these positions were not the equal rights positions of modern times, so it was often difficult to determine whether one wanted to sacrifice freedom for comfort or comfort for freedom. Rarely was it possible to attain both and often it was found, too late, that it was possible to attain neither. The Victorian period’s characterization as a time of change is appropriate, particularly when taken in context with the changes occurring in the lives of women. Thanks to advances in technology and a general shift toward the cities, women’s spheres were fundamentally shifted in the home, in society and in work and they became more and more recognized as a force to contend with in the nation’s legislative process. The difficulties faced by women can be traced somewhat through literature, such as George Eliot’s Daniel Deronda (1876). A little knowledge about the author is itself an education in the struggle of women to accomplish their goals. Although the book is published under a male name as the only means by which it could possibly gain the attention of a publisher, the author was actually female, a woman named Mary Ann Evans. This begins to illustrate the inability of women to control their own careers or destinies as well as their struggles to break these bounds. In the Victorian era, the barriers of the class system rigidly defined the role of a woman. At the time women belonged to four distinct classes: nobility and gentry, middle-class, upper working-class, and lower working-class (Levine-Clark, 1991). These women each had their own specific standards and roles within society.

United State foreign policy towards Middle East Essay

United State foreign policy towards Middle East - Essay Example US has been accused of having inconsistent and incoherent foreign policy towards Middle East. The relation of United States government and the Middle East can be dated to a thousand years and since this period it has used various foreign policies in this region. Oren admits that the America’s failure to be clear and honest about its own motives, as much as its serial failure to interpret the Middle East as often befuddled relations with the region (Oren,pp.341). This paper explores the reasons for United States inconsistent foreign policy towards Middle East with a close reference to the text book power, faith, and fantasy: America in the Middle East 1776 to present. Combating Threat from Middle East and Adjacent Regions. The threat posed by Saddam Hussein in Iraq was fantastical and not real until the American forces hit the ground there. United states through its foreign policy seek to protect itself from Middle East threats while at the same time helping to safeguard the li ves of native people in the region. For example United States government has adopted different foreign policies in Iran and Iraq and also in Israel and Palestine. The United States foreign policy that is pegged on the pillars of deterrence, containment and preemptive strikes on terrorism and alleged terrorism attacks has been inconsistent and incoherent in Middle East.It has stressed force and sanctions and absence of nuclear weapons in Iraq and Iran while at the same employing diplomacy in Israel and Palestine and this has created a rather disparity and inconsistency in the foreign policy. (Parmar,pp.204). Pursuit of National Interest United States foreign policy is usually based on the national interest but in the Middle East, the pursuit encompasses overlapping, conflicting and inconsistent economic, political and strategic interest. Domestic influences usually determine the United States foreign policy and it is balanced by the interest of America and the greater good of mankind . Different political regimes in the United States also have their foreign policy blue prints and this has seriously led to the inconsistency of these policies towards Middle East. For example Democrats and Republicans have had different foreign policies towards Middle East once they are in power. There is usually more debate within the administration of United States government and the national security on foreign policy and it normally leads to contradictory, incoherent and inconsistent policy towards Middle East. Supply of Oil United States has depended on foreign crude oil for a long time and these imports are majorly from Middle East countries. Because of the massive petroleum reserves in the Middle East United States government has developed policies that are seen to be inconsistent and incoherent about the region. In view of this and the challenge posed by hostile domestic population, United States government has adopted an increasingly inconsistent policy in regard to the Mi ddle East region. The foreign policies are formulated in a careful strategy so as to wield acceptance from the Middle East masses and in the long run receive constant supply of crude oil. The need for secure flow of Middle Eastern oil into the United States economy has led to special relationship. The Middle Eastern countries especially Saudi Arabia has the largest deposit of oil reserves in the world but at the same time they are marred by instability. This instability is mainly caused by political regimes which are authoritarian. United States government through its foreign policy is supporting these political regimes in the Middle East in order to secure constant flow of oil (Rosati and Scott,pp.35). As a result, the United States government has preserved the status quo politics in the Middle East particularly in Saudi Arabia and the Persian Gulf sheikdoms. One of the major reasons for the inconsistent foreign policy in the Middle Eas

Economics of Business Strategy Case Study Example | Topics and Well Written Essays - 2500 words

Economics of Business Strategy - Case Study Example The managerial practices of the company are more products oriented so as to facilitate the customers, and provide them with different opportunities for making most out of their purchasing power. The company has also restricted itself from applying such policies where chances of bankruptcy are dominant, and have shifted towards consumer service. The management in particular operational management related to the decision making is widely practiced and encouraged by the company, the employees at the mediocre level, are involved with decision making, however such employees work within certain monetary limit. All this has made the company achieve laurels, 'We continued to strike what we believe is an appropriate balance between achieving our net income growth targets and investing in our future. In 2004, we delivered record earnings while increasing spending on marketing, promotion, rewards and card member services by 30 percent from a year ago. This increase came on top of a stepped-up l evel of investment spending in 2003' (Audit Repot 2004). American Express has incorporated different management strategies for optimization of their performance, and economic gain. The bank has implemented several different policies that minimized and reduced the indirect cost (goods and services other than raw materials, or "direct" expenses). The company's adopted policy has been to reduced and control expenses, such as office supplies, computer equipment, express delivery, and telecommunications. 'Our new survey and drafted policies shows that we as banking giant see the light at the end of the tunnel for an economic turnaround' (Anr Williams, senior vice president and general manager, U.S. Middle Market, American Express Corporate Services). The general manager further added that, 'At the same time, financial executives say that bank is challenged by rising expenses, and they're searching for new ways to control them - regardless of the economic climate'. The bank is involved in Expenses Management, and focused mainly upon corporate c ost-saving strategies. The company believed that cutting indirect costs and generating new revenue sources were equally important strategies in improving the financial health of their organization. The bank has encouraged and motivated their employees to participate enthusiastically towards compliance to those policies, the employees are urged to submit timely expense reports, desired employee adherence. 'Over the past several years, the institution have made strides in taking control of spending for travel, office supplies, computer equipment and other indirect expenses', (Anr Williams). 'But the push for profitability in these tough economic times has prodded the institution to expand their cost-control expertise and implement more effective solutions - such as new technology and innovative payment systems'. The web technology has emerged as an effective solution to cater for the surging expenses, the technology provided improved control and greater efficiency, and is being adopted by all the departments of the institution. The institution has adopted following practices for improving expenses management, and variety of strategies have been implied for streamlining the processes. The effective strategies are

Construction Contract Law Case Study Example | Topics and Well Written Essays - 3000 words

Construction Contract Law - Case Study Example These set of laws preside over the operation of government and safeguards the rights of individuals. As such, it is the very system of a well organised society. This essay will examine the importance of Alternative Dispute Resolution in resolving and expediting cases between and among the parties. In order to shed light to this, the case of Burchell v. Mr. and Mrs. Bullard will be used along with relevant provisions of the Housing Grants, Construction and Regeneration Act of 1996, The Woolf Report, Pre-Action Protocol for the Construction and Engineering Disputes and other current and relevant materials to Alternative Dispute Resolution and Construction Contract Law. Among the difficulties encountered in forming this paper was that due to the relatively new case of Burchell, materials used for this paper are limited to current case laws and articles which relates to the case. In the instant case, Mr Burchell, the claimant, had agreed to build two large extensions to the home of Mr and Mrs Bullard, the defendants, for which he was to be paid in four stages, as stated in their agreement. The Spouses Bullard refused to make the third stage payment, amounting to 13,540.99 and find fault about the work that had been done. The claimant's solicitors initially wrote to the defendants suggesting that the matter be referred for an Alternative Dispute Resolution through "a qualified construction mediator". Subsequently, this approach was discarded by the defendant's surveyor on the grounds that the matters complained of are technically complex, and as such mediation is inappropriate to settle the issue in the case. The claimant claimed 18,318.45. The defendants responded by counterclaiming 100,815.34 and further damages which were then not fully particularised. The claimant then brought a Part 20 claim against a sub-contractor in relation to the roofing works. There were no payments into Court and no Part 36 Offers made. At first instance the Court rendered judgment in favour of the claimant on his claim and awarded him 18,327.04 but likewise gave judgment in favour of the defendants on the counterclaim in the amount of 14,373.15. The result was that the defendants had to pay the claimant the difference, which with interest and VAT came to only 5,025.63. The claimant was awarded 79.50 on his counterclaim against the sub-contractor. The defendants were ordered to pay the claimant's costs of the claim and in turn, the claimant was ordered to pay the defendant's costs of the counterclaim. The claimant was also ordered to pay the Part 20 defendant's costs on the basis that the Part 20 defendant had only had 79.50 awarded against him and had made offers to settle from the beginning. The claimant appealed the costs award and made a further proposal for mediation, requesting the defendants to submit to the Court of Appeal scheme. The defendants, thereafter responded in the negative stating that they did not consider that this would be either "necessary or appropriate". In determining whether the circumstances of the case justified a departure from the general