The argument behind this is that if ones parents

Alcohol is a drink that is consumed orally and has an intoxicating effect. A drug when it is defined using medical terms is any substance that when consumed affects body functions whether positively or negatively. The argument is that medically prescribed drugs can help one recover from a certain illness but when drugs are taken for fun can lead to addiction and other bad side effects.As per the above given definition, alcohol qualifies to be a drug and thus should be controlled like other drugs. The essence of this paper is to support the argument that alcohol is a dangerous drug and thus should be controlled.Alcohol is one of the most abused drug with the most affected being the youths. No one wants to become an alcoholic victim but one accidentally finds himself in it. It is hard to determine when one would become its victim or not as there are many underlying factors that act as catalyst. One person may consume it for a short time and become addicted while another might take alon g time before becoming one.There are two theories that are advanced by psychologists and sociologists and thus each of them takes the respective perspective. According to psychologists there are some genetic predispositions that determine if one will become an addict or not.The argument behind this is that if ones parents were addicts then the chances of one becoming like them are higher. The other theory advanced by the later is that there are some social factors that may cause one to become addicted these are factors like environmental factors such as cultural exposures and other social practices.Any drug that can lead to addiction like alcohol is dangerous and thus should be controlled. Apart from this, it has a wide range of health effects for example it interferes with normal brain functioning something that causes psychiatric disorders such as depressive disorder, panic disorder and anxiety disorder. Unlike other dugs like cocaine and heroine where withdrawal can only be fatal if one has other health complications, alcohol withdrawal can be fatal.The reason behind this is that when alcohol is taken it stimulates the GABA receptors something that causes anxiety and when it is consumed in large amount and consistently, it desensitizes and reduces these receptors thereby causing the body to be entirely dependent on it such that when it is abruptly stopped, it leads to the breakdown of the central nervous system.The victim immediately registers some life threatening seizures or convulsions, hallucinations and in extreme cases it results to heart failure (Cohen, Sidney. 1983).Socially it has led many to lose their prestigious jobs as when people become addicted they are forced to consume it even when they are supposed to be busy at work and in sober mind. This economically affects the productivity of companies as drunken people cannot be expected to be productive. If anything they make them incur loses as they put off the very customers they are expected to s erve. For this reason, alcohol is an obstacle to development and should thus be banned completely (Cohen, Sidney. 1983).Studies show that alcohol car related car accidents are the main cause of death of the youth between 15 and 24. It also increases suicide, homicide and drowning cases as in most cases victims who commit suicide are drunkards or those who are drowned are its victims.Alcohol also interferes with ones thought system and for this reason; most drunkards do no reason appropriately. Alcoholism leads to reduced judgment and that is why victims can cross a busy road without checking whether the road is safe or not and one end up being hit. Most car accidents are drivers who are under the influence of drugs. Like it is mentioned above, alcohol clouds ones judgment such that it is hard to think straight.When one is drunk he/she loses control over everything such that one is aware that something is happening but cannot take the appropriate measure and that is how accidents res ult. â€Å"Alcohol, even at low doses, significantly impairs the judgment and coordination required to drive a car safely.† (Partnership for a Drug Free America).According to a survey that was done by the Davis Law Group in 2007, about 12, 998 died in car accidents where drivers were under the influence of alcohol. If these cases are to be reduced, then the government must wake up and adopt a zero tolerance strategy to alcoholism (Davis Law Group. 2007).

I Want to Be a Nurse Essay

Writing assessment Empire college offers a unique learning environment for the busy learner who may be juggling a number of roles, spouse, parent, manager, entrepreneur, volunteer, caregiver, and more. We offer a flexible learning environment, with individually designed degree programs, and opportunities to study online,face to face, or a combination of the two. In a type essay of no fewer than 300 words, please describe: 1. Your reason for applying to Empire State College. 2. Your personal and professional goals, and what topics or areas you hope to study 3. Your strengths and experiences (educational, employment, community and personal background) that will make you a successful student in our learning environment. MY LIFE STORY Life is a long journey to seek happiness and great joy! Sometimes we can successfully overcome some kind of hardships in life and sometimes we are still struggling and suffering but don’t ever be despondent. No matter how hard it is, as long as you stay persistent and self determined you will overcome those obstacles. There were so many stages on my risky challenge journey to find a happy life! To know who you are you must know where you began. My life starts in a small village in Viet Nam. Despite growing up with a privilege life full of food on the table, a warm bed to sleep in, plenty of toys†¦It is human nature to want what I don’t have-nurturing parents. My parents worked very hard to provide a better life that they never had. I and three of my brothers were grown up with unhappy childhood. We never had time to play with friends, go to the park or even get any gift on our birthday †¦.All of us had to work after school to help my parents earn more money for food and others basic shelters. When I was in the middle school I had to do all of the housework and trading in the market for foods. I believed that is why I am so independent on my life. MY name is â€Å"My† which is often misspelled and misunderstanding. But it carried a full meaning to my parents. First it means beautiful. Second it links to a country â€Å"United State of American†. When I was a kid my parents usually tell me about how wonderful American are which in . Wealthy, Independence and freedom†¦ In 1987 when I was born my parents escaped from Vietnam to United State of American to explore a new life with a standard living but they failed and I was named â€Å"My† to chase my parents dream. I and my Parents had shared about â€Å"American dream† since I was 10 years old. I always dreamed of get out of my small village to fulfill my family dream and make a better life to help my parents who had sacrifice themselves to raise us to become good persons. Even how hard they are we still go through school. I was always study very hard at school and look for a chance to study aboard in the promising land American. Time went by and even how hard my parents and I tried we still could not afford for going aboard. But I still kept thinking about this dream until one day I had got a chance to take risk to work aboard as a technician specialist named Chartered Semiconductor in Singapore. The day I left my country and my family was a gloomiest day that I never forget. I was very excited to explore about Singapore at the first time I came there. I heard that Singapore is a very high standard country. Living and working in this country I don’t have to suffer from any obstacle. But dream is always dream and when I started to work I knew that it is never easy to get what you want without skills and experiences. Things never come the way I expected. It s so much can be say for living and immersing myself in another country and multicultural. I had to face with a lot of horrible experiences at work. Especially it was so difficult for me to adjust to speak Sing-English. Co-worker made fun of my English. I was hurt like a deep wound cut inside. I was cried some nights and even I was mad at myself. But 2 weeks later I told myself not to be discouraged because I left my homeland for this and there was no excuse for me to give up. Slowly I tried to join at work, make friends and ask them whatever I didn’t understand. I found my own way to get help. I gradually created my life with a fully eye-open experience. I built a lot of intangible skills. Each situation was a stepped stone thread through to my life with so many little things teaches me independence, management, organization and the best is self-confidence. I also found my love destiny here. I met my husband at work who was a nice, thoughtful and caring Vietnamese-American. He helped and supported me during the time I was struggle and suffer at work and the new life here. Through him I had come to God and believed in God. God had leaded me the way to go further and fulfill my dreams. We married after 3 years dating. One Year later we moved to Germany because of my husband work and we stayed there for 1 year and 4 months. From this time, I was really enjoy my life. I has chances to experience plenty of new things with my flesh eyes which I had read in books and surfed on Internet. I knew more about amazing country over the world and I was so interested to learn so many things about social, history, custom, religious about Germany and European. I had built a very good relationship here. I will never forget about this wonderful period of my life. And I, now finally, am here in New York. Enjoy my second winter. My dream about American for a long time had come true. To me, New York was a far-away and strange land at the first time. I was scared and lonely for almost 3 months. I and my husband moved to New York last winter in October 2011 and we experienced 2 terrible storms then we settled up everything to get ready for a lot of plans. I could not forget the first time my husband teach me to drive. My heart was bumping and my palm was sweat. I tried to get my driver license other way I had to stay at home. And now I can I drive to library every week, found a good job, made good friends and had plenty of good relationships, and the best thing is I will be Baptism next month to become a Catholic Christian. Thanks God blessed for me onmy life. I had so many goals and I had made them come true. I was on phone with my Mum on my 27th birthday. She said she is so proud of about me that I made her happy and the most important she asked me â€Å"What are you going to do next?† Five years living aboard is such a long time, but it goes so fast. I did not let any hardship hold me back and I am going to go through another bigger goal which is go to college and I will never stop to achieve my dreams. I was interested in Health filed and I always wished to become a helpful nurse when I was very young. Being a Vietnamese girl learn English to become a nurse is my first and forehead goal I want to do in this coming year. I would love to care about people and make them happy. My motivation is 4 year college and then go to study beyond later if I have a chance because education never stop. There are a lot of things to do in this country. I still want to have a good future with a solid stepped stone in life and a loving family. I will raise my children to become a successful person. They will use my experience story as a role for them to work hard and to be successful in their lives. And I have to say my heart was burning when I found Empire State Community college. I really want to get my degree here so desperately. Empire State community college offer the course which I interested in with flexible study option and it have great faculty, also a warm and diverse community and interesting traditional according to students. I can decide how, where and when I sturdy to complete my education.That’s great. I have a long way to go but I will do my best to reach my goals. Yes! Everyone have a story-history that has made them the way they are to make a happy life! And that is who am I!

Barack Obama - Speech to a Joint Session of Congress on Health Care Reform (9 September 2009)

Barack Obama Speech to a Joint Session of Congress on Health Care Reform delivered 9 September 2009 Madam Speaker, Vice President Biden, members of Congress, and the American people:When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression. We were losing an average of 700,000 jobs per month. Credit was frozen. And our financial system was on the verge of collapse.As any American who is still looking for work or a way to pay their bills will tell you, we are by no means out of the woods. A full and vibrant recovery is still many months away. And I will not let up until those Americans who seek jobs can find them until those businesses that seek capital and credit can thrive; until all responsible homeowners can stay in their homes. That is our ultimate goal. But thanks to the bold and decisive action weve taken since January, I can stand here with confidence and say that we have pulled this economy back from the brink. I want to thank the members of this body for your efforts and your support in these last several months, and especially those whove taken the difficult votes that have put us on a path to recovery. I also want to thank the American people for their patience and resolve during this trying time for our nation. But we did not come here just to clean up crises. We came here to build a future. So tonight, I return to speak to all of you about an issue that is central to that future and that is the issue of health care. I am not the first President to take up this cause, but I am determined to be the last. It has now been nearly a century since Theodore Roosevelt first called for health care reform. And ever since, nearly every President and Congress, whether Democrat or Republican, has attempted to meet this challenge in some way. A bill for comprehensive health reform was first introduced by John Dingell Sr. in 1943. Sixty-five years later, his son continues to introduce that same bill at the beginning of each session. Our collective failure to meet this challenge year after year, decade after decade has led us to the breaking point. Everyone understands the extraordinary hardships that are placed on the uninsured, who live every day just one accident or illness away from bankruptcy. These are not primarily people on welfare. These are middle-class Americans. Some cant get insurance on the job. Others are self-employed, and cant afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer. Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or too expensive to cover. We are the only democracy the only advanced democracy on Earth the only wealthy nation that allows such hardship for millions of its people. There are now more than 30 million American citizens who cannot get coverage. In just a two-year period, one in every three Americans goes without health care coverage at some point. And every day, 14,000 Americans lose their coverage. In other words, it can happen to anyone. But the problem that plagues the health care system is not just a problem for the uninsured. Those who do have insurance have never had less security and stability than they do today. More and more Americans worry that if you move, lose your job, or change your job, youll lose your health insurance too. More and more Americans pay their premiums, only to discover that their insurance company has dropped their coverage when they get sick, or wont pay the full cost of care. It happens every day. One man from Illinois lost his coverage in the middle of chemotherapy because his insurer found that he hadnt reported gallstones that he didnt even know about. They delayed his treatment, and he died because of it. Another woman from Texas was about to get a double mastectomy when her insurance company canceled her policy because she forgot to declare a case of acne. By the time she had her insurance reinstated, her breast cancer had more than doubled in size. That is heart-breaking, it is wrong, and no one should be treated that way in the United States of America. Then theres the problem of rising cost. We spend one and a half times more per person on health care than any other country, but we arent any healthier for it. This is one of the reasons that insurance premiums have gone up three times faster than wages. Its why so many employers especially small businesses are forcing their employees to pay more for insurance, or are dropping their coverage entirely. Its why so many aspiring entrepreneurs cannot afford to open a business in the first place, and why American businesses that compete internationally like our automakers are at a huge disadvantage. And its why those of us with health insurance are also paying a hidden and growing tax for those without it about $1,000 per year that pays for somebody elses emergency room and charitable care. Finally, our health care system is placing an unsustainable burden on taxpayers. When health care costs grow at the rate they have, it puts greater pressure on programs like Medicare and Medicaid. If we do nothing to slow these skyrocketing costs, we will eventually be spending more on Medicare and Medicaid than every other government program combined. Put simply, our health care problem is our deficit problem. Nothing else even comes close. Nothing else. Now, these are the facts. Nobody disputes them. We know we must reform this system. The question is how. There are those on the left who believe that the only way to fix the system is through a single-payer system like Canadas where we would severely restrict the private insurance market and have the government provide coverage for everybody. On the right, there are those who argue that we should end employer-based systems and leave individuals to buy health insurance on their own. Ive said I have to say that there are arguments to be made for both these approaches. But either one would represent a radical shift that would disrupt the health care most people currently have. Since health care represents one-sixth of our economy, I believe it makes more sense to build on what works and fix what doesnt, rather than try to build an entirely new system from scratch. And that is precisely what those of you in Congress have tried to do over the past several months. During that time, weve seen Washington at its best and at its worst. Weve seen many in this chamber work tirelessly for the better part of this year to offer thoughtful ideas about how to achieve reform. Of the five committees asked to develop bills, four have completed their work, and the Senate Finance Committee announced today that it will move forward next week. That has never happened before. Our overall efforts have been supported by an unprecedented coalition of doctors and nurses; hospitals, seniors groups, and even drug companies many of whom opposed reform in the past. And there is agreement in this chamber on about 80 percent of what needs to be done, putting us closer to the goal of reform than we have ever been. But what weve also seen in these last months is the same partisan spectacle that only hardens the disdain many Americans have towards their own government. Instead of honest debate, weve seen scare tactics. Some have dug into unyielding ideological camps that offer no hope of compromise. Too many have used this as an opportunity to score short-term political points, even if it robs the country of our opportunity to solve a long-term challenge. And out of this blizzard of charges and counter-charges, confusion has reigned. Well, the time for bickering is over. The time for games has passed. Now is the season for action. Now is when we must bring the best ideas of both parties together, and show the American people that we can still do what we were sent here to do. Now is the time to deliver on health care. Now is the time to deliver on health care. The plan Im announcing tonight would meet three basic goals. It will provide more security and stability to those who have health insurance. It will provide insurance for those who dont. And it will slow the growth of health care costs for our families, our businesses, and our government. Its a plan that asks everyone to take responsibility for meeting this challenge not just government, not just insurance companies, but everybody including employers and individuals. And its a plan that incorporates ideas from senators and congressmen, from Democrats and Republicans and yes, from some of my opponents in both the primary and general election. Here are the details that every American needs to know about this plan. First, if you are among the hundreds of millions of Americans who already have health insurance through your job, or Medicare, or Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have. Let me repeat this: Nothing in our plan requires you to change what you have. What this plan will do is make the insurance you have work better for you. Under this plan, it will be against the law for insurance companies to deny you coverage because of a preexisting condition. As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it the most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or in a lifetime. We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick. And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies because theres no reason we shouldnt be catching diseases like breast cancer and colon cancer before they get worse. That makes sense, it saves money, and it saves lives. Now, thats what Americans who have health insurance can expect from this plan more security and more stability. Now, if youre one of the tens of millions of Americans who dont currently have health insurance, the second part of this plan will finally offer you quality, affordable choices. If you lose your job or you change your job, youll be able to get coverage. If you strike out on your own and start a small business, youll be able to get coverage. Well do this by creating a new insurance exchange a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices. Insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers. As one big group, these customers will have greater leverage to bargain with the insurance companies for better prices and quality coverage. This is how large companies and government employees get affordable insurance. Its how everyone in this Congress gets affordable insurance. And its time to give every American the same opportunity that we give ourselves. Now, for those individuals and small businesses who still cant afford the lower-priced insurance available in the exchange, well provide tax credits, the size of which will be based on your need. And all insurance companies that want access to this new marketplace will have to abide by the consumer protections I already mentioned. This exchange will take effect in four years, which will give us time to do it right. In the meantime, for those Americans who cant get insurance today because they have preexisting medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill. This was a good idea when Senator John McCain proposed it in the campaign, its a good idea now, and we should all embrace it. Now, even if we provide these affordable options, there may be those especially the young and the healthy who still want to take the risk and go without coverage. There may still be companies that refuse to do right by their workers by giving them coverage. The problem is, such irresponsible behavior costs all the rest of us money. If there are affordable options and people still dont sign up for health insurance, it means we pay for these peoples expensive emergency room visits. If some businesses dont provide workers health care, it forces the rest of us to pick up the tab when their workers get sick, and gives those businesses an unfair advantage over their competitors. And unless everybody does their part, many of the insurance reforms we seek especially requiring insurance companies to cover preexisting conditions just cant be achieved. And thats why under my plan, individuals will be required to carry basic health insurance just as most states require you to carry auto insurance. Likewise likewise, businesses will be required to either offer their workers health care, or chip in to help cover the cost of their workers. There will be a hardship waiver for those individuals who still cant afford coverage, and 95 percent of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements. But we cant have large businesses and individuals who can afford coverage game the system by avoiding responsibility to themselves or their employees. Improving our health care system only works if everybody does their part. And while there remain some significant details to be ironed out, I believe I believe a broad consensus exists for the aspects of the plan I just outlined: consumer protections for those with insurance, an exchange that allows individuals and small businesses to purchase affordable coverage, and a requirement that people who can afford insurance get insurance. And I have no doubt that these reforms would greatly benefit Americans from all walks of life, as well as the economy as a whole. Still, given all the misinformation thats been spread over the past few months, I realize I realize that many Americans have grown nervous about reform. So tonight I want to address some of the key controversies that are still out there. Some of peoples concerns have grown out of bogus claims spread by those whose only agenda is to kill reform at any cost. The best example is the claim made not just by radio and cable talk show hosts, but by prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens. Now, such a charge would be laughable if it werent so cynical and irresponsible. It is a lie, plain and simple. There are also those who claim that our reform efforts would insure illegal immigrants. This, too, is false. The reforms the reforms Im proposing would not apply to those who are here illegally. Rep. Joe Wilson, R-South Carolina: You lie! President Obama: Its not true. And one more misunderstanding I want to clear up under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place. Now, my health care proposal has also been attacked by some who oppose reform as a government takeover of the entire health care system. As proof, critics point to a provision in our plan that allows the uninsured and small businesses to choose a publicly sponsored insurance option, administered by the government just like Medicaid or Medicare. So let me set the record straight here. My guiding principle is, and always has been, that consumers do better when there is choice and competition. Thats how the market works. Unfortunately, in 34 states, 75 percent of the insurance market is controlled by five or fewer companies. In Alabama, almost 90 percent is controlled by just one company. And without competition, the price of insurance goes up and quality goes down. And it makes it easier for insurance companies to treat their customers badly by cherry-picking the healthiest individuals and trying to drop the sickest, by overcharging small businesses who have no leverage, and by jacking up rates. Insurance executives dont do this because theyre bad people; they do it because its profitable. As one former insurance executive testified before Congress, insurance companies are not only encouraged to find reasons to drop the seriously ill, they are rewarded for it. All of this is in service of meeting what this former executive called Wall Streets relentless profit expectations. Now, I have no interest in putting insurance companies out of business. They provide a legitimate service, and employ a lot of our friends and neighbors. I just want to hold them accountable. And the insurance reforms that Ive already mentioned would do just that. But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Now, let me be clear. Let me be clear. It would only be an option for those who dont have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5 percent of Americans would sign up. Despite all this, the insurance companies and their allies dont like this idea. They argue that these private companies cant fairly compete with the government. And theyd be right if taxpayers were subsidizing this public insurance option. But they wont be. Ive insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects. But by avoiding some of the overhead that gets eaten up at private companies by profits and excessive administrative costs and executive salaries, it could provide a good deal for consumers, and would also keep pressure on private insurers to keep their policies affordable and treat their customers better, the same way public colleges and universities provide additional choice and competition to students without in any way inhibiting a vibrant system of private colleges and universities. Now, it is its worth noting that a strong majority of Americans still favor a public insurance option of the sort Ive proposed tonight. But its impact shouldnt be exaggerated by the left or the right or the media. It is only one part of my plan, and shouldnt be used as a handy excuse for the usual Washington ideological battles. To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage available for those without it. The public option the public option is only a means to that end and we should remain open to other ideas that accomplish our ultimate goal. And to my Republican friends, I say that rather than making wild claims about a government takeover of health care, we should work together to address any legitimate concerns you may have. For example For example, some have suggested that the public option go into effect only in those markets where insurance companies are not providing affordable policies. Others have proposed a co-op or another non-profit entity to administer the plan. These are all constructive ideas worth exploring. But I will not back down on the basic principle that if Americans cant find affordable coverage, we will provide you with a choice. And I will make sure that no government bureaucrat or insurance company bureaucrat gets between you and the care that you need. Finally, let me discuss an issue that is a great concern to me, to members of this chamber, and to the public and thats how we pay for this plan. And heres what you need to know. First, I will not sign a plan that adds one dime to our deficits either now or in the future. I will not sign it if it adds one dime to the deficit, now or in the future, period. And to prove that Im serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised dont materialize. Now, part of the reason I faced a trillion-dollar deficit when I walked in the door of the White House is because too many initiatives over the last decade were not paid for from the Iraq war to tax breaks for the wealthy. I will not make that same mistake with health care. Second, weve estimated that most of this plan can be paid for by finding savings within the existing health care system, a system that is currently full of waste and abuse. Right now, too much of the hard-earned savings and tax dollars we spend on health care dont make us any healthier. Thats not my judgment its the judgment of medical professionals across this country. And this is also true when it comes to Medicare and Medicaid. In fact, I want to speak directly to seniors for a moment, because Medicare is another issue thats been subjected to demagoguery and distortion during the course of this debate. More than four decades ago, this nation stood up for the principle that after a lifetime of hard work, our seniors should not be left to struggle with a pile of medical bills in their later years. Thats how Medicare was born. And it remains a sacred trust that must be passed down from one generation to the next. And that is why not a dollar of the Medicare trust fund will be used to pay for this plan. The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies subsidies that do everything to pad their profits but dont improve the care of seniors. And we will also create an independent commission of doctors and medical experts charged with identifying more waste in the years ahead. Now, these steps will ensure that you Americas seniors get the benefits youve been promised. They will ensure that Medicare is there for future generations. And we can use some of the savings to fill the gap in coverage that forces too many seniors to pay thousands of dollars a year out of their own pockets for prescription drugs. Thats what this plan will do for you. So dont pay attention to those scary stories about how your benefits will be cut, especially since some of the same folks who are spreading these tall tales have fought against Medicare in the past and just this year supported a budget that would essentially have turned Medicare into a privatized voucher program. That will not happen on my watch. I will protect Medicare. Now, because Medicare is such a big part of the health care system, making the program more efficient can help usher in changes in the way we deliver health care that can reduce costs for everybody. We have long known that some places like the Intermountain Healthcare in Utah or the Geisinger Health System in rural Pennsylvania offer high-quality care at costs below average. So the commission can help encourage the adoption of these common-sense best practices by doctors and medical professionals throughout the system everything from reducing hospital infection rates to encouraging better coordination between teams of doctors. Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan. Now, much of the rest would be paid for with revenues from the very same drug and insurance companies that stand to benefit from tens of millions of new customers. And this reform will charge insurance companies a fee for their most expensive policies, which will encourage them to provide greater value for the money an idea which has the support of Democratic and Republican experts. And according to these same experts, this modest change could help hold down the cost of health care for all of us in the long run. Now, finally, many in this chamber particularly on the Republican side of the aisle have long insisted that reforming our medical malpractice laws can help bring down the cost of health care. Now there you go. There you go. Now, I dont believe malpractice reform is a silver bullet, but Ive talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs.So Im proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine. I know that the Bush administration considered authorizing demonstration projects in individual states to test these ideas. I think its a good idea, and Im directing my Secretary of Health and Human Services to move forward on this initiative today. Now, add it all up, and the plan Im proposing will cost around $900 billion over 10 years less than we have spent on the Iraq and Afghanistan wars, and less than the tax cuts for the wealthiest few Americans that Congress passed at the beginning of the previous administration. Now, most of these costs will be paid for with money already being spent but spent badly in the existing health care system. The plan will not add to our deficit. The middle class will realize greater security, not higher taxes. And if we are able to slow the growth of health care costs by just one-tenth of 1 percent each year one-tenth of 1 percent it will actually reduce the deficit by $4 trillion over the long term. Now, this is the plan Im proposing. Its a plan that incorporates ideas from many of the people in this room tonight Democrats and Republicans. And I will continue to seek common ground in the weeks ahead. If you come to me with a serious set of proposals, I will be there to listen. My door is always open. But know this: I will not waste time with those who have made the calculation that its better politics to kill this plan than to improve it. I wont stand by while the special interests use the same old tactics to keep things exactly the way they are. If you misrepresent whats in this plan, we will call you out. And I will not and I will not accept the status quo as a solution. Not this time. Not now. Everyone in this room knows what will happen if we do nothing. Our deficit will grow. More families will go bankrupt. More businesses will close. More Americans will lose their coverage when they are sick and need it the most. And more will die as a result. We know these things to be true. That is why we cannot fail. Because there are too many Americans counting on us to succeed the ones who suffer silently, and the ones who shared their stories with us at town halls, in e-mails, and in letters. I received one of those letters a few days ago. It was from our beloved friend and colleague, Ted Kennedy. He had written it back in May, shortly after he was told that his illness was terminal. He asked that it be delivered upon his death. In it, he spoke about what a happy time his last months were, thanks to the love and support of family and friends, his wife, Vicki, his amazing children, who are all here tonight. And he expressed confidence that this would be the year that health care reform that great unfinished business of our society, he called it would finally pass. He repeated the truth that health care is decisive for our future prosperity, but he also reminded me that it concerns more than material things. What we face, he wrote, is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country. Ive thought about that phrase quite a bit in recent days the character of our country. One of the unique and wonderful things about America has always been our self-reliance, our rugged individualism, our fierce defense of freedom and our healthy skepticism of government. And figuring out the appropriate size and role of government has always been a source of rigorous and, yes, sometimes angry debate. Thats our history. For some of Ted Kennedys critics, his brand of liberalism represented an affront to American liberty. In their minds, his passion for universal health care was nothing more than a passion for big government. But those of us who knew Teddy and worked with him here people of both parties know that what drove him was something more. His friend Orrin Hatch he knows that. They worked together to provide children with health insurance. His friend John McCain knows that. They worked together on a Patients Bill of Rights. His friend Chuck Grassley knows that. They worked together to provide health care to children with disabilities. On issues like these, Ted Kennedys passion was born not of some rigid ideology, but of his own experience. It was the experience of having two children stricken with cancer. He never forgot the sheer terror and helplessness that any parent feels when a child is badly sick. And he was able to imagine what it must be like for those without insurance, what it would be like to have to say to a wife or a child or an aging parent, there is something that could make you better, but I just cant afford it. That large-heartedness that concern and regard for the plight of others is not a partisan feeling. Its not a Republican or a Democratic feeling. It, too, is part of the American character our ability to stand in other peoples shoes; a recognition that we are all in this together, and when fortune turns against one of us, others are there to lend a helping hand; a belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play; and an acknowledgment that sometimes government has to step in to help deliver on that promise. This has always been the history of our progress. In 1935, when over half of our seniors could not support themselves and millions had seen their savings wiped away, there were those who argued that Social Security would lead to socialism, but the men and women of Congress stood fast, and we are all the better for it. In 1965, when some argued that Medicare represented a government takeover of health care, members of Congress Democrats and Republicans did not back down. They joined together so that all of us could enter our golden years with some basic peace of mind. You see, our predecessors understood that government could not, and should not, solve every problem. They understood that there are instances when the gains in security from government action are not worth the added constraints on our freedom. But they also understood that the danger of too much government is matched by the perils of too little; that without the leavening hand of wise policy, markets can crash, monopolies can stifle competition, the vulnerable can be exploited. And they knew that when any government measure, no matter how carefully crafted or beneficial, is subject to scorn; when any efforts to help people in need are attacked as un-American; when facts and reason are thrown overboard and only timidity passes for wisdom, and we can no longer even engage in a civil conversation with each other over the things that truly matter that at that point we dont merely lose our capacity to solve big challenges. We lose something essential about ourselves. That was true then. It remains true today. I understand how difficult this health care debate has been. I know that many in this country are deeply skeptical that government is looking out for them. I understand that the politically safe move would be to kick the can further down the road to defer reform one more year, or one more election, or one more term. But that is not what the moment calls for. Thats not what we came here to do. We did not come to fear the future. We came here to shape it. I still believe we can act even when its hard. I still believe I still believe that we can act when its hard. I still believe we can replace acrimony with civility, and gridlock with progress. I still believe we can do great things, and that here and now we will meet historys test. Because thats who we are. That is our calling. That is our character. Thank you, God bless you, and may God bless the United States of America. Source: WhiteHouse.gov

Would you recommend a new nation adopt a presidential or parliamentary Essay

Would you recommend a new nation adopt a presidential or parliamentary system of government in the early 21st century - Essay Example One of the good consequences of this phenomenon is that people have stopped taking their political systems for granted and have begun to think of the merits and demerits of parliamentary and presidential forms of government. This spirit of questioning can be seen even in fictional representations of the nation that question the validity of the very concept like The Shadow Lines (Ghosh 2000). There are also theorists who disagree with the very idea of difference between these two very different forms of government. For instance, the political thinker Juan J. Linz, in his article, â€Å"Presidential or parliamentary democracy: Does it make a difference?† talks of the differences that do not make a change at the level of the grassroots (1994). The failure of democracies to fulfill the aspirations of people in different nation states is a cause for worry. This does not however, mean that the very idea is dropped. This needs to be the case as a better alternative is unavailable and according to most political thinkers, impossible. The natural status that democracy has been accorded may be the reason for this; however, whether it is parliamentary or presidential democracy that is good for a single nation or all nations is a question that remains unanswered. To propose any one form of government as a one-stop solution would be a mistake. This is primarily a consequence of the fact that every single nation is different from the other and requires different forms of governments. This paper shall look at four countries- the United States of America, the United Kingdom, India and Sri Lanka. These countries represent different social and political landscapes and also different forms of government. While the United States of America follows a presidential form of governance, India and the United Kingdom are followers of the parliamentary form of government. Sri Lanka has been

Literary review Essay Example | Topics and Well Written Essays - 3000 words

Literary review - Essay Example t the rate of overall walking of the people who were new dog owners largely increased through gaining possession of dogs in comparison to those people who are non-owners. In addition to the augmentation of the physical activity of the dog owners the possession of dogs also is observed to transform relationships from single to courtship (Cutt, Knuiman and Korti, 2008). Selby et al (1979) notes that the act and practice of keeping pets like dogs and cats can be referred to as a set of best practice in that it helps in rendering shelter to the innocent animals from harsh climates and other vulnerable conditions. However in that the dog owners must focus that keeping of pets does not happen to disturb the healthy climate in the surrounding areas. It is often found that keeping of dogs as pets has resulted in the growth of dog population in the neighbourhood that in turn has contributed to polluting the region with bulks of faeces and urine. The owners of the dogs when consulted of such problems reflected less interest in neutering their pets. Large groups of non-owners refer that keeping of dogs only adds to social troubles like increasing both noise and environment pollution which is again opposed by the owner groups. However the best practices that stands to this end that the dog owners must enhance their focus on the behaviour and activities of th eir dogs and thus help in protecting the natural and social environment (Selby et al, 1979, p.385-386). Vidovic, Stetic and Bratko (1999) and McKee and McKee (2007) remark that children of the households both boys and girls reflect a growing association with pets like dogs and cats. In fact the children tend to regard the pets as their playtime companions by responding to their different calls and gestures. Again it is found that the tendency of affinity to dogs and cats increases for a girl child than that for boys for the girls whether in tender age or tending towards adolescence feel the dearth for companions. It is

Philosophy of leadership Essay Example | Topics and Well Written Essays - 3000 words

Philosophy of leadership - Essay Example Leadership emanates from situations, person’s learning and knowledge, beliefs, passion and pragmatism. In the organizational context, although leaders are formed by virtue of their role and position, leadership capacity in other people cannot be ignored. This again becomes the role of the formal leader to identify leadership and nurture it for the organization’s benefit. Leadership is also situational, in the sense, leaders emerge based on situation. Identification of this quality requires high connectedness with people in order to know them well in terms of skills, attitude, behavior, talent and qualities. For example, a silent person may be very good at specific skills and can help other members of the team to develop these skills that can benefit the team as well as the organization. For this, most importantly, the leader must possess humility. Humility refers to adoption of an un-assuming nature with respect to assessing individuals or situations. Believing that individuals and situations are a product of historical moments helps in obtaining a better understanding of the current historical moment. This specifically is important for leaders to take on an unbiased approach to deal with situations and people. Arnett (1999) identifies this openness as humility, with the perspective of gaining knowledge, and not merely with the associated people and/or situations. Arnett and Arnesen (1999) define routine cynicism as the non-thoughtful attitude of people demonstrated through mistrust, non confidence, despair, suspicion, judgment, manipulation of thoughts and words meant to achieve either selfish motives, superiority, individual goals, wealth and power, or even mislead the other party. Leaders have to believe that people are their strengths who can accomplish anything. For this the leader needs to be connected with his people, and should be at individual as well

Health Maintenance Organization vs. Health Savings Account Essay

Health Maintenance Organization vs. Health Savings Account - Essay Example Contributions to the plan are tax deductible and interest can effectively be accrued whilst the plan operates on a 'roll over' basis. The first point of view we shall look at here is from someone who opted for the Health Savings Account health plan. The individual here was actually in their mid-twenties and decided to take out the HSA plan at this relatively early stage in order to build a suitable sum of money that they could use to cover health costs at a later stage. However, less than a year later they found themselves in a position where the money was needed. The medical bill they incurred amounted to approximately $2000, however, due to the nature of the plan they were only liable for around 1400 of that. In addition, their employer had thus far contributed $560 and the remaining $840 could be deducted from taxes. Overall the individual only had to pay $168 on top of the annual premium which, given the circumstances, they felt was a good result. Moreover, the individual was imp ressed by the fact that the money could effectively cover aspects such as prescriptions, glasses and even visits to the dentist. The second account we shall deal with here also comes down on the side of the HSA plan as far as saving money is concerned. Their main point is how the fact that the contributions to the plan that are deducted from an individual's wages are actually done so at the pre-tax stage.

The speed-up in the growth rate of the U.S. economy since 1995 Essay

The speed-up in the growth rate of the U.S. economy since 1995 - Essay Example This is opposed to a hard landing, which involves the slowing down of the economy without also causing a recession. Soft landings give economies the chance to improve themselves. It allows for moderate growth, but for low inflation. Hand-in-hand with the soft landing, the growth rate of the United States sped up due to business inventories rising relatively compared to sales. As well as the former, the costs of exporting goods and supplies to other countries have dropped considerably. In 1995, the Federal Reserve was not as active as it had been in previous years. At the beginning of 1995, it did raise interest rates, which pushed up the federal funds by half of a percentage, moving the rates to six percent. The interest rates dropped remarkably. The cut of the federal rates allowed them to decline, though they also leveled-off, rose a bit, but then declined once again. â€Å"Growth is no longer concentrated in consumption.† (Taylor) Investment in equipment grew, assisted by the expensing provisions of legislation, while orders and shipments data are signaling further gains. Interest rates have been the lowest since the 1960s, sparking a record pace of new home sales and allowing automakers to boost sales by offering generous financing and discounts. The productivity growth for 1995 was well ahead of the average it held between 1973 and 1995. A strong platform for expansion was set up by flexible labor, low inflation, goods and capitol markets, and the growth in productivity. The goal in this, to keep the growth rate increasing, involves adopting the right economic policies (Taylor). There are certain methods to be taken in to account when it comes to controlling something as growth rates of an economy, any economy. The amount of tax cuts and the decrease of unemployment has aided the growth rate of the United States economy. Prior to 1995, rates were unstable -

Educational Needs Analysis Research Paper Example | Topics and Well Written Essays - 750 words

Educational Needs Analysis - Research Paper Example The hospital is situated in the centre of the city and hence it has quite a lot of incoming traffic in its emergency ward as compared to other things. In total they offer health service in cancer; women related health issues, burn center, and diabetes center and as well as anesthesia and pain management center. It also has a huge blood bank and one of the biggest facilities that they offer is the walk in Huntington disease facility. This is one of the few hospitals to do so. Since the above mentioned facilities are the specialties of the hospital therefore they offer specialized training for the nurses. EDUACTIONAL NEED ANALYSIS Their hiring process is quite a comprehensive one. They hire nurses when they have done their basic education only. This is their only requirement; rest of the selection is dependent upon the assessment center alone. The Assessment center contributes a lot to the assessment of educational needs if they exist. In the assessment center they have a series of pro cess that an applicant has to go through there are in all five practical steps and the sixth and the final one is the written test. The written test comprises of five multiple choice questions and the second part of the written test is an essay. The essay has three parts in total, the first part is about what field the applicant wants to choose for specialization, the second part talks about why and what made them choose it and the final part of the essay talks about the applicants existent knowledge about the field. Once the applicant is selected, they are given the curriculum of the whole course and then they are to fill out a form in which they have to mention what they felt would be required and is not mentioned in the curriculum. This method is extremely helpful as the applicants are from all over states and as well as international students, they all come with their own background knowledge and insights and this helps expand the curriculum to be more broader and as well as com prehensive. If some if the things that have been mentioned cannot be included in the curriculum then they are given as additional training to the students (Deb, 2006). The needs for education or training was determined by conducting a full fledge study. It has been learned through previous experience is that if trainings are forced upon the nurses then they tend to feel like rebels and they do not pay full attention and it ends up as a waste of money and resources and time on the part of the nurses. The training and development department of the HR department of the hospital conducts annual searches word wide and as well as locally so as to gather information about any new trainings and courses that are trending and then they put it up on the notice boards, if the training is very necessary then every nurse has to attend it and then they are paid overtime for the hours that they spend in learning. Similarly some of the courses are put up and the interested nurses voluntary sign in t heir names. They are given credit through bonuses and special recognition rewards, this motivates them (Deb, 2006). The other method that is used is through the doctors. The doctors are inquired as to what they feel further that the nurses should be equipped with and then necessary trainings are identified and the nurses are trained. The main restraining factors in the case of further training or certificate courses

Community and Population Health Essay Example for Free

Community and Population Health Essay Introduction I currently reside in Denver County, Colorado. I have chosen to assess and analyze this community for this assignment. Denver, Colorado is located east of the Eastern Foothills of the Rocky Mountains. Denver County is centrally located within the city of Denver, Colorado and includes the Denver International Airport located north-east of the city. The elevation of this county is 5,277 feet and therefore is nicknamed the â€Å"Mile-High City†. Denver County contains 154.9 square miles of land with a large amount of parks and rivers, of which 1. 4 miles is water. (City and County of Denver, 2011). Population Economic Status According to the 2010 census, Denver County has a population of 600,158 people with a median age of 33.7 years old (U.S. Census Bureau, 2010a). Denver County’s population is approximately 50% male and 50% female (U.S. Census Bureau, 2010a). The ethnicity of Denver County is predominately White (52.2%), with Hispanic (31.8%) and Black (9.8%) ethnic groups comprising the next largest population groups (U.S. Census Bureau, 2010a). The median household income in Denver County from 2008-2012 was is $49,091; compared to $58,244 for the entire state of Colorado (U.S. Census Bureau, 2010b). From2008-2012, 18.9% of households were at or below poverty; compared to an average of 12.9% for the entire state of Colorado (U.S. Census Bureau, 2010b). The average reported unemployment rate for persons ages 16 + in Denver County was 8.6% (with a +/- 0.4% margin of error) (U.S. Census Bureau, 2010a). Denver County has a high percentage of educated workforce. In 2008-2012, 36.7% of the population age 25 + had obtained their Bachelor’s Degree, or a higher level of education; compared 28.5% for the entire US (U.S. Census  Bureau, 2010b). Although Denver County has a large percentage of educated residents, it also has a high number of homeless residents. In a survey taken in January 2013, an estimated 11,167 people were homeless in Denver (including employed homeless) (Metro Denver Homeless Initiative, 2013). Of those individuals, 43% were women and 62% were adults with children (Metro Denver Homeless Initiative, 2013). The birth rate in Denver County in 2012 was 9,236 (Colorado Department of Public Health and Environment, 2012). This was average compared to the previous two years – in 2011 there were 9,431 births compared to 2010 where there were 9,584 births (Colorado Department of Public Health and Environment, 2012). Denver County’s death rate in 2012 was 4,220 (Colorado Department of Public Health and Environment, 2012). This number was average compared to the previous two years as well – in 2011 there were 4,156 deaths and in 2010 there were 4,210 deaths. The number one cause of death in Denver County from 2010 – 2012 was cardiovascular disease (Colorado Department of Public Health and Environment, 2012). The majority of deaths related to population was individuals age 85+ (Colorado Department of Public Health and Environment, 2012). Denver County offers two primary basic food assistance programs. These programs are called SNAP (Supplemental Nutrition Assistance Program) and WIC (Women, Infants, and Children). For the fiscal year of 2013, Colorado had an average of 47,636,090 persons from a total of 23,052,396 households were signed up for SNAP benefits (USDA, 2014a). This number had increased by approximately 1,027,016 persons from 2012 fiscal year (USDA, 2014a). For the fiscal year of 2013, Colorado had an average of 8,662,591 persons (including women, infants, and children) were receiving supplemental nutrition from the WIC program (USDA, 2014b). This number decreased by 245,249 persons from 2012 fiscal year (USDA, 2014b). Cultural Assessment The population size and sex of the cultural group I interviewed was of twenty white women. Out of the twenty women I interviewed, ten women were between the ages of 20-29 years old and ten women were between the ages of  30-49 years old. All twenty women are currently registered nurses on the internal medicine/oncology floor at the hospital I am currently employed at. The amount of nursing experience these individuals have ranges from two years to 29 years of experience. All twenty individuals interviewed have health insurance. The attitudes toward age and aging of the twenty individuals surveyed varied with a similar goal of staying healthy to prevent the onset of diseases. The younger group interviewed felt it was important to eat healthy and exercise to promote internal health and longevity of life in general. The older group interviewed were more specific with their answers and felt it was important to maintain low stress lifestyles to promote good mental and physical health, to exercise to promote strong bones/balance, to perform mental exercises to help prevent the onset of dementia, and to regularly attend appointments. Both groups agreed that positive vs. negative attitudes directly affect physical health and one’s quality of life. When I asked both groups of their opinions regarding what age adolescents are considered adults, I received drastically different answers. The younger group felt as if ages 18-19 years old are considered adults related to society’s description of an adult, the independency promoted with high school graduation, and the onset of college. The older group felt as if ages 22-23 years old are considered adults primarily related to maturity, life experiences, and the beginning of an entry level career after completion of a college degree. Both groups felt as if college education was an expectation. All of the individuals interviewed currently have their degree in nursing with an active nursing license. Approximately one-third of those interviewed have their Bachelor’s Degree in Nursing and several of those interviewed possess recognizable specialty healthcare certifications. As an entirety, the group interviewed is healthy. Over half of those interviewed have no prior diagnoses regarding their state physical of health. The most obvious physical characteristic that both groups share is being overweight with eleven out of the twenty women interviewed currently being overweight according to their projected BMI. The entire population interviewed shared the mental challenge of overcoming the stress presented at work regarding difficult/challenging patients and all women interviewed believed they have compromised their safety while caring for a patient at one time or another in their career. When I asked this group what the usual sources of stress are, work was number one for all twenty women interviewed. The younger population interviewed stated that children/family and educational goals are some of their secondary sources of stress. The older population interviewed stated that aging/retirement and the health of other family members are their secondary sources of stress. Both groups primarily use the mountains/nature and outdoor activities, such as skiing and hiking, to cope with stress. Five of the individuals drive nearly sixty miles to work (one-way) daily, related to owning a home in the mountains to escape the â€Å"rush and chaos† of the city and helping to find a â€Å"balance in life†. Out of all twenty individuals interviewed, over 3/4 of the woman are married and/or have a significant other. When asked what their number one priority in life was, family was consistently number one. Most all other interests and goals were related to benefiting or bettering the family. Some of the answers named were continuing educational goals, buying a new home, having a baby, planning retirement, and helping their parents with activities of daily life. Of the cultural group identified, all of them share a team attitude while still exhibiting individualist perspectives unique to personal preferences and opinions. Neighborhood/Community Safety Denver is divided into about 80 different official neighborhoods within Denver County (City and County of Denver, 2011). Those 80 different neighborhoods have been divided into seven police and fire districts; including Denver International Airport with has its own district (Denver Police Department, 2014; Denver Fire Department, 2014). The average response time for the Denver Police Department varied in 2013 from 14.9 minutes to respond to urgent, emergency calls (from the time a 911 call was received to the time an officer arrived on the scene) to 16.9 minutes for an officer to respond to a non-emergency call (Maass, 2013). According to Lt. Matt Murray from the Denver Police Department, these slow response times  have been directly correlated with a lack of officers (Maass, 2013). According to Murray, the Denver Police Department can have as many as 1,426 officers and as of October 3, 2013, the Denver Police Department had only 1,350 officers (Maass, 2013). A new class of 70 recr uits are currently in training in hopes to decrease the department’s response times in 2014 (Maass, 2013). The Denver Fire Department maintains 34 different fire stations that are strategically split into seven districts (Denver Fire Department, 2014). Firefighter’s each work an average of three 24-hour shift with an average of 180 firefighter’s on-duty per shift (Denver Fire Department, 2014). The Denver Fire Department responds to a variety of calls including Fire Suppression, Rescue Operations, Hazardous Materials Response, Technical Rescue, Urban Search and Rescue, Water and Ice Rescue, High Angle Rope Rescue, Confined Space and Trench Rescue, Wildland Firefighting, and Emergency Medical Services. They also perform thousands of building inspections annually, daily training and certifications, public and community education, school fire drills, and organize other special events (Denver Fire Department, 2014). According to the Denver Fire Department 2012 Annual Report, there were a total of 101,531 alarms/calls made in 2012 that required the response of the fire department team (Maass, 2013). Out of those 101,531 calls made to the fire department, 54,350 were for medical calls, 8,103 were for auto accidents, 2,248 were for fires, and approximately 37,000 calls required other services or rescues (Maass, 2013). Denver County has a significant amount of violence, crime, and gang activity within the community. In January/February 2014 there were a total of 7,268 crimes captured by the National Incident-Based Reporting System (NIBRS) (Denver Police Department, 2014). According to this reporting system, the crimes are broken down into four categories; (1) crimes against persons, (2) crimes against property, (3) crimes against society, and (4) all other offenses (Denver Police Department, 2014). The top two offenses in Denver County per category included (1) simple assault and aggravated assault, (2) larceny and criminal mischief/damaged property, (3) drug/narcotic violations and prostitution, and (4) disorderly conduct/disturbing the peace and  criminal trespassing (Denver Police Department, 2014). These figures are slightly elevated from a total of 6,822 crimes in January/February 2013 (Denver Police Department, 2014). There is a variety of different gang activity in Denver County. In 2003, Denver police estimated that there were 14,000 gang members in Denver who were affiliated with 220 different gangs (Gang activity in Denver, 2013). The Denver Police Department has since created gang prevention programs including education, a gang hotline, outreach programs for former gang members, crime stoppers anonymous tips hotline, and the Denver Police Department Gang Bureau (Denver Police Department, 2014). Even with gang prevention involvement in the community and with these prevention programs in place, from January-September 2013 there was a total of 143 total crimes that could be directly related to gang activity (Gurman, 2013). These crimes included homicides, sexual assault, robberies, and aggravated assault (Gurman, 2013). Denver County is also populated with a high level of alcohol and drug abuse. The availability of marijuana with the recent legalization of recreational marijuana makes marijuana the most widely abused drug in Denver County (Mendelson, 2014). Alcohol, methamphetamines, heroin, cocaine, and prescription drugs are all found within the city limits of Denver as well (Mendelson, 2014). Denver County is centrally located between two interstates; I-25 and I-70. These interstates have many different entry and exit points to and from the city that provide easier access for drug trafficking and other illegal activities. Denver County has many different programs protecting its air and water quality. The Environmental Quality Division (EQD) is responsible for a variety of measures including conducting compliance inspections of air emissions, monitoring pollutant levels, issuing permits, and constructing models of air pollutant levels in the Denver area (Department of Environmental Health, 2014a). In February 2014 Colorado became the first state to regulate methane emissions from hydraulic fracking (Kroh, 2014). This new regulation will directly increase water quality and decrease smog in the Denver area. The Department of Environmental Health (DEH) is responsible for monitoring the quality of water in Denver’s lakes and  streams. The DEH collects an average of 13,000+ water samples and conducts more than 50,000 tests annually to ensure that Denver’s drinking water is clean and safe (Department of Environmental Health, 2014c). The goal is for the city of Denver to have fishable and swim mable waters in all the lakes and streams by 2020 (Department of Environmental Health, 2014c). Denver’s Departments of Environmental Health, Public Works, and Parks and Recreation are all work together to ensure that the City meets this goal (Department of Environmental Health, 2014c). Denver’s current number one pollutant is trash and litter. Urban Drainage and Flood control district alone collects approximately 100 tons of trash from the streams and rivers in Denver annually (Department of Environmental Health, 2014b). There are several health risks living within Denver County. These risks include earthquakes, hazardous materials, winter storms, and severe thunderstorms with hail, lightening, tornados, and/or flooding (Office of Emergency Management, 2014b). Hit and run injuries have become an epidemic in Denver County with an increase in fatal crashes in Denver County. Denver police reported 18,662 hit-and-run accidents, both sustaining injuries and sustaining no injuries, during 2011-2013 (Hubbard, 2014). At least one person in Denver metro area is injured every day by a hit-and-run driver and nearly three times a month a pedestrian is fatally injured by a motorist who flees the scene (Hubbard, 2014). Colorado legislators have recently increased the potential prison sentence for hit-and-run cases resulting in bodily injury and/or death. They have also formalized an alert program to inform the public on suspects, vehicles, and/or license plate numbers in an attempt to help in track down perpetrators (Hubbard, 2014). Disaster Assessment and Planning The state of Colorado and city of Denver has worked hard to organize a variety of disaster and emergency preparedness plans within the community. One source of information, READYColorado, offers a variety of data sources for the community. Their website, READYColorado.com, offers awareness and disaster preparedness for a variety of natural disasters, technological disasters, and human caused disasters. The website also contains statistics, facts, and a calendar list of current events and training exercises. It offers links for volunteer opportunities regarding community involvement and educational classes and it also lists ways to stay informed of emergencies  from such sources such as radio, television, text, live twitter feeds, and blogs. Three critical facilities in Denver County include three specific venues; Coors Field with 50K capacity, The Pepsi Center with 19K capacity, and Sports Authority at Mile High Stadium with 76K capacity (City and County of Denver, 2011). The most vulnerable populations to these disasters are the 22.3% of households with children less than 18 years of age, the approximately 23,000 individuals 65+ that live independently, and the residents in 51 long term care facilities within Denver County (City and County of Denver, 2011). The primary disaster of concern for the Denver County is winter weather. Winter weather is an expectation living in Colorado. READYColorado contains information for home and vehicle preparation, emergency communications planning, proper dress for indoors and outdoors to protect the body from hypothermia, and hypothermia/frostbite warning signs. One can also find more information at Ready.gov, Colorado Department of Transportation, NOAA watch, and the American Red Cross regarding winter weather and the risks involved. Avalanches are of great threat to the mountainous regions of Colorado but do not pose a threat within Denver County. The risk of earthquakes is low in Denver County. However if an earthquake was to occur, the city would be very susceptible to extensive damage. Residencies and some of the older buildings in Denver are not made to withstand earthquakes and would most likely suffer damage to their structures (Office of Emergency Management, 2014b). Severe thunderstorms bringing hail, lightening, and tornados pose threats to the Denver County annually. Residents of the Colorado’s Front Range area are located in the heart of â€Å"Hail Alley† which begins mid-April and lasts through mid-August. The Front Range and Denver County receives a high frequency of large hail annually, averaging three to four hailstorms a year, and costing at least 25 million dollars in insured damage for each event (READYColorado and the State of Colorado, 2014b). Lightening poses the greatest threat to areas where the mountains and plains intersect (READYColorado and the State of Colorado, 2014b). Three deaths related to  lightning strikes have known to occur in Denver since 2001 (National Weather Service, 2011). Tornados pose a threat to all areas of Colorado; however tornados to not typically get high intensity ratings within Denver County (City and County of Denver, 2011). Flying debris from high winds cause most injuries. NOAA weathe r radio, telephone alerts, and television sources provide alerts severe thunderstorms and the destructive events that they bring. Denver County also has an outdoor warning siren system consisting of 76 electro-mechanical sirens that sound when there are tornado alerts and warnings (Office of Emergency Management, 2014a). Wildfire ignition by lightning is a bigger concern rural Colorado areas compared to the city. Respiratory problems can still result from the inhalation of smoke spread by wind. Wildfires burn thousands of acres and destroy hundreds of structures annually in Colorado. These fires are generally ignited by lightening or human causes and can easily be fueled by drought conditions, insect infestations, and heat. READYColorado offers information on risk assessment, home preparation, evacuation plans, and shelter information. More information regarding wildfires can be found at Ready.gov, Ready, Set, Go!, Surviving Wildfire, The Red Cross, US Fire Administration – FEMA, and Colorado State Forest Service websites. Colorado Wildfire Risk Assessment Portal is also a useful tool in determining fire risks. Currently, Denver’s fire risk is between lowest intensity and moderate intensity risk (Colorado State Forest Service, 2014). Flooding has a big impact on Colorado and in 2013 challenged many residents in the Denver area. NOAA Weather Radio, commercial radio, television, and internet sources provide information on flood watches and warnings, including flash floods in Denver County. Flash flooding along streams such as Cherry Creek, Clear Creek, and Harvard Gulch pose the greatest threats within the Denver area. The Corps of Engineers, Colorado Department of Public Health and Environment, and the Urban Drainage and Flood Control District websites provide 2013 flood information, current projects, and resources for flooding preparation and damage control in Colorado. Health risks involved from flooding include contamination from bacteria (ie. E.coli), parasites (ie. giaria), and viruses (ie. Hepatitis A), respiratory infections from mold and other irritants, and bodily injury from swiftly moving currents, electricity hazards, and hypothermia. It is very important for all Denver County residents to be up to date with Tetanus  vaccinations. Terrorism poses a rather unpredictable threat to Denver County. Denver County has a large metropolis population and houses both government buildings and military installations, contains large sports stadiums and an international airport. It is known that failure of the Cherry Creek Dam would cause catastrophic damage to both life and property within Denver County (City and County of Denver, 2011). There have been known international and domestic terrorist groups identified in Colorado during previous years (City and County of Denver, 2011). Education regarding the â€Å"eight signs of terrorism† can be found at multiple terrorism related websites including READYColorado.com. Denver also has specialized units including Denver Police Department Mounted Patrol, S.W.A.T.(Special Weapons And Tactics) who’s primary objective deals with hostage negotiation, drug busts and counterterrorism (City and County of Denver, 2011). Hazardous material spill have an increase potential in Denver County related to the many different companies storing hazardous materials within city limits. There are approximately 400 facilities storing reportable quantities of hazardous materials on properties located throughout the county (Office of Emergency Management, 2014). Each company is regulated by law to hold emergency plans that would go into effect if an accidental release of substance was to occur. The interstates bring added risk to Denver County related to the traffic along I-25 and I-70. These two interstates pass through densely populated areas of Denver County Denver fire and police have Hazardous Materials Response teams in place that are trained to respond to such an event(s). Denver County has nearly a dozen different hospitals with a vast amount of public transportation options such as bicycle, RTD bus and light rail services, taxi cabs, car2go, and Lyft services. Denver County has excellent communications and response teams in the event of a disaster with a vast amount of online education; however this information is published mostly in the English language. With such a large population of homeless in Denver County and 18.9% of all households at or below poverty level (U.S. Census  Bureau, 2010), the internet is not a good primary option for learning. Also, approximately 28% of all households speak a language other than English (City and County of Denver, 2011). Community Diagnosis Denver County is a very strong community regarding the number of educated workforce, median household income, number of hospitals, amount of public ground transportation, the protection of air and water quality, and the number of fire and police with specialty training teams and programs operating within the community. There is a very small percentage of residents 65+ who live independently and slightly over 1/5 of all households have children less than 18 years of age. The primary language is English and the community culture has a good overall team mentality. Denver County’s birth rate double the death rate with the leading cause of death cardiovascular disease in a primary death rate existing in the population 85+ (Colorado Department of Public Health, 2012). Denver County has many open avenues regarding opportunities and readiness attitudes within community. The population of Denver County is approximately 50% male and 50% female with a median age of 33.7 years old (U.S. Census Bureau, 2010a). This provides the community with the opportunity to explore young ideas and diversity among sexes. Denver County has a large number of homeless population with approximately 1/5 of the total population at or below poverty. These numbers exceed the national average. Denver County has two specific food programs being utilized greatly; SNAP and WIC benefits. There is a high number of crime, violence, and gangs within Denver County. There is a high level of alcohol and drug abuse within the community as well. Specialized police teams and community resources/programs assist with deterring these types of activities and assist in recovery efforts for those individuals. Colorado has recently legalized recreational marijuana which could be positive in terms of tax revenue for the state and future funding of programs and resources for the community. There could also be negative consequences regarding adolescent drug use and the increase of impaired drivers on the streets; however these statistics have not yet been measured and studied. Denver County is  contains a 100% urban population. This is both a strength and weakness to the city in terms of emergency evacuation. There are three critical facilities that exist in Denver County at specific venues with a capacity between 19K and 76K (City and County of Denver, 2011). Denver County is centrally located between I-25 and I-70 which can be an opportunity for evacuation or a barrier regarding avenues for drug trafficking and other illegal activities. There is a high ratio of hit-and-run injuries and fatalities within Denver County. Colorado legislators have recently increased potential prison sentences for hit-and-run cases resulting bodily injury and/or death. They have also formalized an alert program to inform and involve the public as an attempt to help track down perpetrators. The formulation of a city-wide educational program focusing on the prevention of hit-and-run occurrences may be beneficial in reducing these numbers as well. It is important for the Denver Police Department to have quicker response times to both emergent and non-emergent calls. Hopefully with the addition of new recruits for the force who are currently in training, Denver County will see quicker response time to all calls made. This will also hopefully decrease the amount of gang-related crimes and deter community activity in general. It is evident that Denver County has a large trash and litter problem. The initiation of more trash cans and recycle containers parallel with city-wide education would be beneficial in decreasing this problem. It would also be of benefit to the community and the court systems to enact a community service program that revolved around helping clean up the neighborhoods and streets. Denver County has good disaster and emergency preparedness plans within the community; however educational resources to the public need to be explored with a variety of different materials and other languages for maximum effectiveness. The primary educational method is by internet with most of the materials written in the English language only. Nearly 1/3 of all households in Denver County speak a language other than English. References City and County of Denver. (2011, Oct). Hazard Identification and Risk Assessment. Retrieved March 8, 2014, fromhttp://www.google.com/url?sa=trct=jq=esrc=ssource =webcd=1ved=0CCUQFjAAurl=http%3A%2F%2Fwww.denvergov.org%2FPortals%2F428%2Fdocuments%2FDenver%2520Hazard%2520Identification%2520and%2520Risk%2520Assessment.pdfei=AvEtU6etF8OJogSh5oDwDwusg=AFQjCNEEQhg_2-JDt_OVeX3pIyYSKGcx9gbvm=bv.62922401,d.cGU Colorado Department of Public Health and Environment. (n.d.). Health Statistics: 2012. Retrieved March 10, 2014, from http://www.google.com/url?sa=trct=jq=esrc=s source=webcd=1ved=0CCUQFjAAurl=http%3A%2F%2Fwww.chd.dphe.state.co .us%2FResources%2Fvs%2F2012%2FDenver.pdfei+I14tU9zPA-SNygGZ-IDYBwus G=AFQjCNH_VbyYxdRvmxNekgRu-y0LhIgrzwbvm=bv.62922401,d.aWc Colorado State Forest Service. (2014). Colorado Wildfire Risk Assessment Portal. Retrieved March 10, 2014, from http://www.coloradowildfirerisk.com/map Denver Fire Department. (2014, January 7). In Wikipedia. Retrieved March 9, 2014, from http://en.wikipedia.org/wiki/Denver_Fire_Department Denver Police Department. (2014, January 6). Reported Offenses In The City And County Of Denver By Month. Retrieved March 8, 2014, from http://www.denvergov.org/police/ PoliceDepartment/CrimeInformation/CrimeStatisticsMaps/tabid/441370/Default.aspx Denver’s Water Quality Program. (2014, February 14). Sampling Results. Retrieved March 9, 2014, from https://www.facebook.com/DenversWaterQualityProgram?sk=app_190322 544333196app_data Department of Environmental Health. (2014a). Air Quality Program: Our Role In Protecting Air Quality. Retrieved March 9, 2014, from http://wwwdenvergov.org/environmental Health/EnvironmentalHealth/EnvironmentalQuality/EnvironmenatlAssessmentPolicy AirQuality/tabid/444649/Default.aspx Department of Environmental Health. (2014b). Water Quality Program: Trash and Litter. Retrieved March 9, 2014, from http://wwwdenvergov.org/environmentalhealth/ EnvironmentalHealth/EnvironmentalQuality/WaterQuality/tabid/444650/Default.aspx Department of Environmental Health. (2014c). Water Quality Program: Water Quality In Lakes and Streams. Retreived March 9, 2014, from https://wwwdenver.gov.org/environmental health/EnvironmentalHealth/EnvironmentalQuality/WaterQuality/tabid/444650/Default. Aspx Gang activity in Denver. (2013, August 17). In Wikipedia. Retrieved March 9, 2014, from http:// en.wikipedia.org/wiki/Gang_activity_in_Denver Gurman, Sadie. (2013, October 15). The Denver Post. Denver Police: Gang violence rises this year, involves more victims. Retrieved March 9, 2014, from http://www.denverpost.com /breakingnews/ci_24309448/denver-police-gang-violence-rises-this-year?source=rss Hubbard, Brent. (2014, Feburary 17). Rocky Mountain PBS. Hit-and-run fatal crashes rising in Colorado. Retrieved March 10, 2014, from http://www.coloradoan.com/article/201 40217/WINDSORBEACON01/302170069/Hit-run-fatal-crashes-rising-Colorado Kroh, Kiley. (2014, February 24). Climate Progress: Colorado Become The First State To Regulate Methane Emissions from Fracking. Retrieved March 9, 2014, from http:// thinkprogress.org/climate/2014/02/24/3322651/Colorado-methane-fracking/ Maass, Brian. (2013, October 3). CBS Denver. Denver Police Response Times Worsen, Complaints Rising. Retrieved March 9, 2014, from http://denver.cbslocal.com/2013/ 10/03/denver-police-response-times-worsen-complaints-rising/ Mendelson, Bruce. (2014, Feburary). National Institute on Drug Abuse. Drug Abuse Patterns and Trends in Colorado and the Denver/Boulder Metropolitan Area – Update: Jan 2014. Retrieved March 9, 2014, from http://www.drugabuse.gov/about-nida/organization/work groups-interest-groups-consortia/community-epidemiology-work-group-cewg/meeting- reports/highlights-summaries-january-2014-4 Metro Denver Homeless Initiative and National Law Center on Homelessness and Poverty. (2013, January). The Gathering Place – Homelessness and Poverty Statistics. Retrieved On March 8, 2014, from http://www.tgpdenver.org/homelessnessfaq?printable National Weather Service. (2011, June 21). Colorado and National Lightning Casualty Statistics. Retrieved March 10, 2014, from http://www.crh.noaa.gov/pub/?n=/Itg/Itg_stats_index. php Office of Emergency Management. (2014a). Alert and Warning Systems. Retrieved March 10, 2014, https://www.denvergov.org/AlertandWarning/tabid/391430/default.aspx Office of Emergency Management. (2014b). Potential Threats. Retrieved March 9, 2014, from http://www.denvergov.org/Redirect_404/tabid/391429/Default.aspx? READYColorado and the State of Colorado. (2014a). Retrieved March 10, 2014, from https:// www.readycolorado.com/ READYColorado and the State of Colorado. (2014b). Severe Weather/Thunderstorm. Retrieved March 10, 2014, from https://www.readycolorado.com/hazard/severe-weatherthunder storm READYColorado and the State of Colorado. (2014c). Tornado. Retrieved March 10, 2014, from https://www.readycolorado.com/hazard/tornado READYColorado and the State of Colorado. (2014d). Wildfire. Retrieved March 10, 2014, from https://www.readycolorado.com/hazard/wildfire

Inequalities Within Healthcare Interactions in New Zealand

Inequalities Within Healthcare Interactions in New Zealand KENT JOSEPH PACA INTRODUCTION Inequality is commonly defined as the quality or condition of being relatively unequal and basically there is imbalance or disparity within the circumstance. In the healthcare setting, there are several factors to consider in order for every individual to attain wellness, demonstrate the acquisition and promotion of holistic well-being on all aspect of human life such as physical, social, psychological and spiritual. Knowingly, disparities within healthcare could greatly affect and a considerable factor for it to be a hindrance towards achieving optimum health through all individual. Considering that New Zealand is a multi-cultural country in which the most percentage of its population are immigrant people from all over the world with different ethnic identity, cultural orientation, religion and outlook in life towards healthcare whom each one of these individual most likely are concern with their health status and well-being. These differences are important areas needed to be taken into great consideration as it would probably have a huge impact towards the issue of inequality with regards to healthcare interactions. In this paper, common inequality issues in healthcare interaction being experienced by every pacific islanders, Maori people and immigrants in New Zealand will be provided with interventions and resolutions to somehow reduce inequality and further promote equality among every individual living in this country. BODY In New Zealand, one important dimension of inequality regarding health promotion and any other healthcare situations is ethnic identity considering its differences when it comes to health beliefs, knowledge and ideas regarding improvement of health. It is a proven fact that every individual has his/her right to health, he/she has the right to acquire full healthcare access and quality services and most importantly has the right to have proper information and be given the knowledge and ideas regarding prevention of illness thus promote wellness within oneself. But because of the one determinant to health considered as a barrier for people achieving good health which is communication and professional interaction among healthcare providers to their clients, disparity or unequal treatment are being experience to most people living in this country especially among the pacific islanders and Maori people. Despite the fact that technology is proven to be adequate in terms of resources and fu nding are provided to every individual, the issue of inequality still linger and must be taken seriously as a problem towards achieving optimum health. Inequality in healthcare interaction could widely be affected looking into a person’s socio-economic status and its stability in life. It is a proven fact that inequality roughly limits the opportunities of an individual’s full potential and its capabilities. That is the reason why equality is desirable. With people having a less outlook towards good health and negative perception on it, this could probably affect its concern towards proper well-being. In fact most people having this negative outlook towards health are those individual who are unfortunate enough in terms of socioeconomic status because this will hinder the proper accumulation of the right pattern towards acquisition of equality towards health. These people because of their stability status mostly didn’t have the proper education thus the knowledge and accurate ideas towards prevention of illness, promoting of good health are not properly sustained. Almost all people especially individual living in New Zealand have different outlook towards health. Maori people have their own health beliefs as well as other ethnic people living in this country. These factors are often referred as determinants to health which greatly affect the quality of healthcare for the people. Factors are categorized into two (2); unchangeable and changeable factors. The unchangeable factor refers to the hereditary implications, age and sex to the Maori and pacific islanders in which most of these are growing into an obese individual without any care and concern regarding their dietary intake. Through this factor these individual should be provided with the right information and knowledge regarding the benefit of having a good and balance health condition. Also, they should be given an input on the consequences of having too much of everything especially with their dietary consumption. The changeable factor that would be the most important factor in order fo r this determinant of health to be regulated consists of; Individual lifestyle, social and community influences and working condition. These changeable factors determine an individual’s way of life, on how they survive on a daily basis and its influences socially and in the community. To be specific individual lifestyle of most Maori individual often times associate oneself to daily vices such as the use of prohibited drugs, commonly most of them use cigarette as part of their vices as maybe being influence by their older relatives and ancestors. All of this conditions and factors are negative impacts towards health promotion and such actions on the latter part of life could greatly affect health status of an individual thus consequences of having these vices which are contributing factors leading to bad health behaviour will conclude one’s life if not being manage properly and implementations of reducing such doings will not be applied. Another vital component which plays a role in determining health outcomes is the social environment. The impact of the social environment on health can be seen in the extremely powerful and enduring relationship between health and social and economic inequalities (Dew and Kirkman 2002). The environment surrounding an individual and its social interaction plays a vital role and demonstrate an impact can have on people and their health outcomes. An area that is considered to be a high risk for diseases and infection could be a threatening environment for individual living in the place and somehow promotion of good health outcomes to the people will outweigh the brighter side of its objectives. Most Maori people and other ethnic groups living in New Zealand have different perspective in life concerning health outcomes with most of them rely on their health beliefs in managing health. It is also a concern to some of these people of being non-compliant to treatment plan despite the fact o f having all the access towards quality service of healthcare being provided by the New Zealand government. This attitudes could also somehow are in connection to influential attributes from their ancestors regarding health issues and how to manage such health condition leading to ineffective and disparity towards health. According to the New Zealand Ministry of Health in reducing health inequalities they have provided a framework that entails an implementing and widely comprehensive strategies that will help in overcoming such inequalities in healthcare in this country. They have also proposed some principles for every activity needed to be implemented for inequality issues to be taken into consideration. The proposed framework made by the ministry of health developed four (4) levels in which they foresee these strategies would be beneficial in overcoming inequalities of healthcare. The first level of the strategy is the Structural level. In this strategy the healthcare organization as well as the ministry of health determines the root cause of every inequality experienced by every people in New Zealand. Inequality with regards to socio-economic, ethnical, cultural beliefs and other factors that affects health outcomes are being considered as determinant factors then through these factors planning fo r the implementation will be based on the given and factors being distinguished. Secondly, are the intermediary pathways which target every material, tool needed that intervene every impact that affects health. Next is Health and disability services in which we all know that here in New Zealand policy regarding disability issues are being made in order to compensate every disabled individual in the country. In this way it also promotes equality of healthcare being provided to every individual living in New Zealand especially to individual with disability to Pacific Islander and Maori people. The government promoted different policy on the issue to disability thus giving every individual regardless to its culture, race and ethnicity the rights to live with great lives despite their condition. The last level of strategy to help reduce inequality to healthcare is the Impact. Minimising the impacts or every determinant of healthcare outcomes, disability and illnesses will greatly improv e the quality of life and further develop and promote equality of healthcare. Another factor that influences the reduction of inequality on healthcare is the current implementation of Partnership within New Zealand. This partnership was first represented way back the year 1840 where the signing of partnership Treaty of Waitangi (Te Tiriti o Waitangi) took place. During the sequence of events the Maori people’s leaders signed the treaty that enable the British people take authority of the native lands and resources in accordance and in return the Maori people are guaranteed the full right and ownership of their lands and that they will provide security and development to every resources. Maori people are also given the right and privilege to all British subjects. In this recent time, New Zealand is aiming to the principles of partnership; participation and protection for the people of New Zealand attain equality especially in response to Healthcare delivery system. The New Zealand government fully ensure its commitment to good relationship and bond with other Non-government organization (NGO) or the community sector and in partnership with international healthcare organization in the development and promotion of good health for their people. They tend to adhere on policy to better promote social inclusion of its people thus law-making body provide ideas and knowledge to implement growing strategies and methods for social change on the behaviour of every individual leading to improvement and lifestyle modification aiming for community development. One objective of the ministry of health in New Zealand is to promote people’s rights. This includes the full right of gaining access towards quality healthcare, the provision of the ideas and knowledge pertaining health issues must be provided to every individual seeking medical management. Respect is a value also being emphasized for every individual in the country knowing its multi cultural and diversity among people living in the country. It is known that with different culture a nd religion along with it are different beliefs from its religion regarding health but through respecting their own beliefs and take consideration, embracing their way of managing health issues could also be a significant area to reduce inequality of healthcare interaction. People in the healthcare sector should also take full consideration that New Zealand is a melting pot for immigrants with different races and ethnicity. Having a little bit of idea regarding their culture, beliefs and practices is one way of trying to respect them. Healthcare providers should not be complacent in providing quality care basing on their nationality because in providing an equal care to individual is regardless if a person is black or white. And it is important that holistic care should be an important value in the promotion of wellness to every people. CONCLUSION As all things being considered, disparity and inequality in Healthcare especially the interaction between people living in New Zealand could somehow can be greatly discuss as it becomes an issue in healthcare that needs to be given implementation for it to be intervene and promote equality within the promotion and achievement of well-being to every individual in New Zealand. Knowingly, New Zealand is a country recognised to be a melting pot of ethnic group, races and different people living in. With cultural differences in a country it is prominent to have difficulties in terms of interaction to people especially in the healthcare setting. The value of partnership and respect to all rights of individual in New Zealand are values and tool in which inequality issue can be address and resolve. Predominantly, inequality is one of the common issue being experienced by people especially immigrants, Pacific Islanders and Maori people living in New Zealand but nonetheless, the government is taking action and promote strategies overcoming this issues and making this one of their priority concern. Although this will be for a long term process for it to be fully implemented and shows good result regarding the reduction of such barrier of healthcare outcome but still actions were already implemented and every strategy and plans are widely considered for the better of every individual in New Zealand. Several policy regarding promotion of health are made by the New Zealand Ministry of Health in response to quality delivery of the Healthcare system and development towards healthcare such as the Policy for Health management to Maori people and Disability policy to provide care and associate every disabled individual to the community and giving them equal rights to every person in the country. This group of individual are in need of equal treatment and access to healthcare and through this policies they are given the opportunity to achieve and promote wellness despite the condition they are having. REFERENCE Electronic References: He Korowai Oranga | Ministry of Health NZ. (n.d.). Retrieved from http://www.health.govt.nz/our-work/populations/maori-health/he-korowai-oranga DHB MÄ ori Health Plans and Health Needs Assessments | Ministry of Health NZ. (n.d.). Retrieved from http://www.health.govt.nz/our-work/populations/maori-health/dhb-maori-health-plans-and-health-needs-assessments Health and Pacific Peoples in New Zealand. (n.d.). Retrieved from http://www.stats.govt.nz/browse_for_stats/people_and_communities/pacific_peoples/pacific-progress-health/influences-on-health-well-being.aspx The Treaty in brief The Treaty in brief | NZHistory, New Zealand history online. (n.d.). Retrieved from http://www.nzhistory.net.nz/politics/treaty/the-treaty-in-brief Journal References: Adams,J., Witten,K., Conway,K. (2009). Community development as health promotion: evaluating a complex locality-based project in New Zealand.Community Development Journal. doi:10.1093/cdj/bsm049 Harris,R., Tobias,M., Jeffreys,M., Waldegrave,K., Karlsen,S., Nazroo,J. (2006). Racism and health: The relationship between experience of racial discrimination and health in New Zealand.Social Science Medicine. doi:10.1016/j.socscimed.2006.04.009 Ajwani, S., T. Blakely, B. Robson, M. Tobias and M. Bonne (2003) Decadesof Disparity: Ethnic Mortality Trends in New Zealand 1980–1999, Ministry of Health and University of Otago, Wellington. Matheson,A. (2005). Engaging Communities to Reduce Health Inequalities: Why Partnership?