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Empowerment discussion question

Empowerment discussion question.

Empowerment is power sharing, the delegation of power or authority to subordinates in an organization (Daft, 2016). Increasing employee power heightens motivation for task accomplishment because people improve their own effectiveness, choosing how to do a task using their creativity. Empowering employees involves giving them four elements that enable them to act more freely to accomplish their jobs: information, knowledge, power, and rewards.Employees receive information about company performance. In companies where employees are fully empowered, all employees have access to all financial and operational information (Daft, 2016).Employees have knowledge and skills to contribute to company goals. Companies use training programs to help employees acquire the knowledge and skills they need to contribute to organizational performance (Daft, 2016).Employees have the power to make substantive decisions. Empowered workers have the authority to directly influence work procedures and organizational performance, often through quality circles or self-directed work teams (Daft, 2016).Employees are rewarded based on company performance. Organizations that empower workers often reward them based on the results shown in the company’s bottom line (Daft, 2016).Empowerment can mean encouraging workers’ ideas while managers retain authority, or it can mean employees have the freedom and power to make decisions and exercise initiative. Current methods fall along a continuum from no discretion for workers to full empowerment where workers participate in formulating strategy (Daft, 2016). How does empowerment provide the two conditions (vitality and learning) for a thriving workforce that are described in the chapter? Do you see any ways in which a manager’s empowerment efforts might contribute to demotivation among employees? Discuss.200 words please
Empowerment discussion question

CIS 315 Bellevue Univ Security Implications Of ipv6 on ipv4 Networks Discussion.

Review the NIST document Guidelines for the Secure Deployment of IPv6. Find and use at least one other qualified source on IPv6 security.For this assignment, Tom Pierce from Harry & Mae’s has asked that you provide him with a background paper on IPv6. He wants to understand what it’s about, how it’s different from IPv4, and how it’s more secure than it’s predecessors. Include an explanation of 2-3 risks associated with IPv6 and it’s deployment.Save your description to a Microsoft Word document as CYBR515 Assignment 9_3 _yourname and attach it to this assignment. Your paper should be about 1500 words (+- 10%) using standard APA formatting, citations, and references.
CIS 315 Bellevue Univ Security Implications Of ipv6 on ipv4 Networks Discussion

I only need 600 words in this paper. I need support with this Management question so I can learn better.

Prepare and present a report and contribute to a discussion that demonstrates mastery of the course material and its relevance to your academic specialization.

Members will prepare and share with their team a brief (600 word) report that examines whether, how, and why strategic management is/could/should be relevant and important for the specialization they have pursued in this degree program.

My degree will be in is Supply Chain Management
I only need 600 words in this paper

The Ukrainian Revolution of 2014 Essay (Article)

Nowadays, it represents a commonplace assumption among many people that the so-called ‘independent press’ in the West, is by definition concerned with covering international events in the most objective manner. This assumption, however, cannot be considered discursively valid, because the very paradigm of how privately owned ‘free’ Media operate, creates a number of objective preconditions for the covered events to reflect the politically engaged points of view, on the part of the concerned journalists (Borjesson 3). In this paper, I will explore the validity of the above-stated, in regards to how the different aspects of the so-called Ukrainian Revolution of 2014/ ‘Maidan uprising’ have been covered by the newspapers: Irish Times (Ireland), Wall Street Journal, Europe (Belgium), Daily News (Sri-Lanka) and University Wire (USA). In his article Ukraine’s Revolution: Triumphant – and Wary (Wall Street Journal, Europe), Matthew Kaminski strives to provide readers with an in-depth insight into what can be considered the actual motivations behind the earlier mentioned Revolution, which culminated on February 22, 2014 (the date when President Yanukovych was deposed). The author indeed needs to be given a credit for the fact that in this article, he succeeded in exposing a number of the thoroughly impartial reasons, which predetermined the development in question. For example, Kaminski mentions that, ever since Ukraine became an independent nation in 1991, the country’s economy continued to deteriorate, which in turn contributed towards the creation of the situation when, as of today, Ukraine can be well discussed in terms of a ‘failed state’. The author also points out to the fact that Ukraine can be the least referred to as a ‘unified nation’, since a good half of its population consists of Russians, who happened to be much more loyal to Russia than to the country of their formal citizenship. Nevertheless, there are many idiosyncratic overtones to how Kaminski discusses the subject matter. For example, according to the author, one of the reasons why throughout the month of February, the Ukraine’s capital Kiev continued to be affected by the violent confrontations, is that protestors could not find anything better to do but to preoccupy themselves with destroying the cultural legacy of the Soviet Union: “Across Ukraine, statues of Lenin are falling” (13). The fact that, while destroying the statues of Lenin, the much praised ‘peaceful protestors’ have often been reported flying flags with swastikas (I refer to the live-coverages by CNN and BBC), Kaminski prefers to dismiss as the part of the ‘Kremlin propaganda’: “Vladimir Putin’s television channels call this awakening ‘neo-fascism’ and ‘ultranationalism’ and a threat to Russians here. The Kremlin won’t accept the fluidity and diversity of Ukrainian identity” (13). Thus, even though that Kaminski’s article does contain many analytical insights into what caused the outbreak of the revolutionary violence in Ukraine, it cannot be referred to as being thoroughly objective. After all, while writing it, the author made a deliberate point in trying to represent the depicted events, as such that should benefit Ukraine in the long run – without giving any consideration to the fact that that there may be other points of view, in this respect. There is even more – the manner in which Kaminski reflected upon the events of February 22, implies the author’s strong affiliation with the specifically American geopolitical agenda, which has always been concerned with the U.S. trying to weaken Russia. Kaminski is quite frank about it: “The Maidan uprising stopped the Kremlin from steering Ukraine away from the European Union” (13). This once again suggests that the discussed article is a rather biased journalistic piece. Another example of how seemingly an objective article can nevertheless serve the purpose of promoting its author’s subjective points of view, can be well regarded the cover-story Deposed President Reported to be in Russia (Irish Times) by Shaun Walker. In it, the author goes about informing readers that Yanukovych, which was ousted from the office on February 22, 2014, ended up finding a refuge in Russia. Nevertheless, there is so much more to this specific article than merely the author’s intention to keep readers informed, as to what is going in the world. The reason for this is that, while discussing the event in question, which can be considered the Ukrainian Revolution’s climaxing point, Walker promotes the idea that Yanukovych can no longer be considered the legitimate President. The validity of this suggestion can be illustrated, in regards to the following line from the discussed article: “Mr. Yanukovych said he continues to believe he is the legitimate president of Ukraine… The deposed president called the current session of Ukraine’s parliament – which among other things is electing a new government – ‘illegitimate’” (11). Even a brief glance at this sentence reveals it to be psychologically manipulative, as it contains the rhetorical device of an ‘appeal to ethos’. The sentence’s first part aims to convince readers that Yanukovych is indeed illegitimate, because nobody else but himself believes in his legitimacy. The sentence’s second part strengthens this impression even further, because it implies that the legitimacy of the Ukrainian ‘revolutionary’ government is a well-established fact. The author, however, does not bother to substantiate the validity of the above-quoted suggestion logically. Get your 100% original paper on any topic done in as little as 3 hours Learn More The reason for this is quite apparent – it could not be done, by definition. After all, according to the Ukrainian Constitution, there may be only three possible circumstances, in light of which the country’s acting President could be relieved of his duties – his death, his mentally incapacitating illness or his impeachment. What it means is that, formally speaking, Yanukovych continues to remain the thoroughly legitimate President of Ukraine. Apparently, while promoting the ‘Maidan uprising’, as such the reflected the Ukrainian citizens’ adherence to the ideals of democracy, Walker exposed himself as an individual who is not aware of what allows people to enjoy democracy, in the first place – namely, their willingness to live according to the provisions of an impersonal/secular law. Thus, it will not be much of an exaggeration, on our part, to suggest that even though this article was published in the Irish newspaper, there are strongly defined hypocritical overtones to it, which in turn implies that the author happened to be affiliated with the cause of ‘Pax Americana’. The rationale behind this suggestion is that, as it was illustrated earlier, Walker tends to treat the notion of democracy as the practical tool of geopolitics, rather than an abstract ideal. In this respect, the article Revolution in Ukraine: Take Two (University Wire) by James Bradbury is much different, as it strives to provide readers with an analytical (non-biased) insight into the actual causes of the ‘Maidan uprising’. For example, in this particular article the author goes to show that what is happening in Ukraine right now, cannot really be described within the context of ‘good vs. evil’ – the apparent split between citizens in the country’s Western and Eastern regions has been predetermined historically. As Bradbury pointed out: “A country (Ukraine) that had always been divided between an industrial Eastern half with historical and linguistic ties to Russia and a largely agricultural Western half that leaned more towards Europe, now saw that division etched permanently” (5). It is needless to mention, of course, that the above-quoted suggestion implies that, contrary to how many Western journalists view it, the Ukrainian Revolution of 2014 is more geopolitically than politically motivated. This, of course, gives the author a credit on the account of his willingness to explore different aspects of the issue at stake. What also contributes to the article’s discursive value, is that in this article, the author was able to expose the Ukrainian Revolution of 2014, as such that has been triggered by the former government’s reluctance to sign the Association Agreement with the EU. As he noted: “When Yanukovych announced the suspension of the Association Agreement talks in November, it was at first established opposition parties that called for protests in Kiev” (5). This, of course, naturally prompts readers to think of the followed ‘people’s uprising’ in terms of a ‘punishment’, imposed upon Yanukovych for his unwillingness to act in the manner, prescribed to him by the EU and America. Consequently, readers begin to suspect that, while lending their support to the ‘peaceful Ukrainian protesters’ (armed with automatic weapons), the European and American top-officials were the least concerned with trying to observe the international law’s most fundamental principles. Walker leaves only a few doubts as to the fact that, contrary to how many people in the West tend to think of it, the most recent Ukrainian Revolution will not establish the precondition for the living standards in Ukraine to begin improving. Quite on the contrary – the article implies that, due to the recently occurred ‘people’s uprising’, it is only the matter of time, before the Ukrainian economy will find itself on the threshold of a complete collapse: “What will happen to Ukraine’s economy? The West will not provide as substantial of a financial assistance package as Russia offered in December” (5). Thus, the article Revolution in Ukraine: Take Two can be considered generally critical of what is going on in Ukraine. Initially, this state of affairs with the discussed article may appear somewhat illogical, because it was published in the US-based newspaper. Yet, as we are well aware of, the America’s governmental officials wholeheartedly supported the ‘Maidan uprising’ from its very beginning. Nevertheless, the mentioned inconsistency can be well explained, once we take into consideration the fact that the newspaper University Wire, which contains the concerned article, is expected to appeal to the intellectually advanced readers, capable of understanding what accounts for the relationship between causes and effects. Given what has been said earlier, we can well conclude that in the realm of journalism, the notion of ‘objectivity’ is synonymous to the notion of ‘analyticalness’. We will write a custom Article on The Ukrainian Revolution of 2014 specifically for you! Get your first paper with 15% OFF Learn More The article Defeat Neocon Conspiracy in Ukraine! (Daily News) by the anonymous author, can well regarded as another example of a strongly biased journalistic piece. However, in the case with this particular article, the biasness of the contained themes and motifs is strongly anti-Western. The reason for this is that the article’s author refers to the Ukrainian Revolution of 2014 in terms of an anti-constitutional coup, financed and supported by the American neo-conservatives (neocons). According to him/her, the events of February 22 (2014) in Kiev were nothing but yet another instance of how the U.S. goes about violating the international law under the excuse of helping the cause of democracy: “The disposal of the Ukrainian government of President Viktor Yanukovych last week by neocon operatives from within the US state department… breached Articles 2(4) and 2(7) of the UN Charter” (1). As such, this article promotes the idea that the ‘Maidan uprising’ was only formally concerned with the citizens’ willingness to get rid of the corrupted government of Yanukovych. It simply reflected the American imperialism’s true agenda – to spread chaos throughout the world, as the mean of maintaining the commercial appeal of the U.S. treasury bonds. The article also exposes the actual mechanism of how the U.S. is able to meddle in the domestic affairs of foreign countries – this is being done by the mean of building the network of the so-called ‘Non-Governmental Organizations’ (NGOs) across the world, which in turn provide the official ‘roof’ for the CIA operatives: “The neocon maneuverings leading up to the coup… showed that the so-called ‘protests’ were conceived, financed and orchestrated by the US… with the connivance of a number of so-called NGOs operated by the US state department and the CIA” (1). In order to substantiate the validity of this suggestion, the anonymous author refers to some secret documents (which supposedly confirm the America’s involvement), obtained by the Russian intelligence. However, he/she does not specify what accounts for these documents’ actual content. Nevertheless, even though that, as it was shown above, the discussed article can indeed be considered strongly anti-American, it does mention a number of the de facto proofs of the contained claims’ legitimacy. For example, the article refers to the recently leaked conversation between the U.S. State Secretary Victoria Nuland and the American ambassador in Ukraine, in which both individuals refer to the Ukrainian ‘democracy-supporting’ politicians as being nothing short of lowly puppets, who are expected to act as they are told. Another reference has been provided to one of Nuland’s recent speeches, in which she bragged about the Ukrainian Revolution’s actual cost: “In a speech to the National Press Club on December 13, 2013… Nuland boasted that the US has ‘invested’ $5 billion in ‘organizing a network’ to give Ukraine ‘the future it deserves’”. (1). Thus, there is a certain paradox – even though the article Defeat Neocon Conspiracy in Ukraine! is indeed strongly opinionated, there can be only a few good reasons to think of it, as such that does not deserve to be read. Apparently, it is also possible to for a newspaper-article to be simultaneously biased and yet highly informative. I believe that the provided earlier line of argumentation, as to how the mentioned articles ‘generate history’, is fully consistent with the paper’s initial thesis. In light of what has been said in the paper’s analytical part, there appears to be indeed very little reason to think that the journalism’s actual aim is concerned with seeking the objective truth about what is going on in the word. Rather, it is concerned with ‘creating’ such a truth. Works Cited “Defeat Neocon Conspiracy in Ukraine!” Daily News. 2014: 1. Print. Borjesson, Kristina. Into the Buzzsaw: Leading Journalists Expose the Myth of a Free Press. Amherst: Prometheus Books, 2004. Print. Not sure if you can write a paper on The Ukrainian Revolution of 2014 by yourself? We can help you for only $16.05 $11/page Learn More Bradbury, James. “Revolution in Ukraine: Take Two.” University Wire. 2014: 5. Print. Kaminski, Matthew. “Ukraine’s Revolution: Triumphant – and Wary.” Wall Street Journal, Europe. 2014: 13. Print. Walker, Shaun. “Deposed President Reported to be in Russia.” Irish Times. 2014: 11. Print.

Westcliff University Process of the Entrepreneurship for a Business Plan Discussion

java assignment help Westcliff University Process of the Entrepreneurship for a Business Plan Discussion.

Question 1Please express your understanding of Entrepreneurship by providing the answers to the following questions:
Describe the process of moving from an idea to a business plan.
Discuss the components of a sound business model.
Identify and discuss the features of three types of startup firms.Question 2Please provide your understanding of Establishing a New Venture by answering the following questions:
Describe the major differences between a partnership and a corporation
Discuss the differences between a subchapter S corporation and a regular corporation?
Explain what a trade secret is and how it differs from a patent.
Westcliff University Process of the Entrepreneurship for a Business Plan Discussion

New York University Wk 6 Simple Linear Regression Paper

New York University Wk 6 Simple Linear Regression Paper.

IMPORTANT NOTE REGARDING WORD LIMIT REQUIREMENTS:Please note that each and every assignment has its own word limit. The purpose of this assignment is to apply your understanding of simple and multiple linear regression.For this assignment, use the “Example Dataset” to complete a simple linear regression using SPSS. Select one dependent variable, one primary independent variable, and one potential confounding variable. You will need to recode string variables into numeric variables to use them in the regression analysis. Prepare a Word document that includes all SPSS outputs.Based on the results, create a second Word document and answer the following questions in 500-750 words.State your research question and hypotheses.Run the regression again without the potential confounding variable and discuss the impact on the coefficient of the primary independent variable. Did it change? If so, to what extent did it change? Based on this, do you think the added variable confounds the association between the independent and dependent variables?Export both regression output tables as part of the Word document containing the SPSS outputs.Provide your regression equation based on the results of the full regression model.Interpret the results by (a) stating the reason the study or test was done; (b) presenting the main results, including coefficients on the main independent variable and significance levels; (c) explaining what the results mean; and (d) making suggestions for future research. Submit both Word documents to the instructor. General RequirementsYou are required to cite at least FIVE sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the discussion question criteria and public health content.Prepare this assignment according to the guidelines found in the APA Style Guide. An abstract is not required.While APA style is required, solid academic writing is expected as well, and documentation of sources should be presented using APA formatting guidelines.This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. PLEASE make sure APA citation and permalink for articles are complete and correct. PLEASE add the links/sites below to the reference list if you use any of these readings and make sure everything is in proper APA format.https://apastyle.apa.org/learn/quick-guide-on-refe… Read Chapter 14 in Using and Interpreting Statistics: A Practical Text for the Behavioral, Social, and Health Sciences.URL: http://www.gcumedia.com/digital-resources/macmillan-learning/2016/using-and-interpreting-statistics_a-practical-text-for-the-behavioral-social-and-health-sciences_ebook_3e.php View the Linear Correlation tutorial in the SPSS Tutorials media.URL: http://lc.gcumedia.com/psy380/spss-tutorials/v1.1/ View the following calculations in The Visual Learner: Statistics media.Coefficient of VariationLinear RegressionLinear CorrelationNon-Parametric Test ‘Chi-Square’URL: http://lc.gcumedia.com/hlt362v/the-visual-learner/the-visual-learner-v2.1.html Read “Regression Modelling and Other Methods to Control Confounding,” by McNamee, from Occupational & Environmental Medicine (2005).URL: http://oem.bmj.com/content/62/7/500Read “How to Control Confounding Effects by Statistical Analysis,” by Pourhoseingholi, Baghestani, and Vahedi, from Gastroenterology and Hepatology From Bed to Bench (2012).URL: https://www-ncbi-nlm-nih-gov.lopes.idm.oclc.org/pmc/articles/PMC4017459/ MUST have 500 to 750 WORDS and at least 5 citations with the page numbers and 5 references in APA format.(The List of References should not be older than 2016 and should not be included in the word count.) Be sure to support your postings and responses with specific references to the Learning Resources.It is important that you cover all the topics identified in the assignment. Covering the topic does not mean mentioning the topic BUT presenting an explanation from the context of ethics and the readings for this class I am a stickler for good organization in everything. I do not want to have to dig for your answers. For instance, if an assignment asks you to provide three examples of something, I suggest that you number them 1-3 so I can find them easily. I also expect that when you submit something as a narrative, you pay attention to how you organize your thoughts: use paragraphs with a topic sentence and supporting sentences; and change paragraphs whenever you introduce a new idea. Also, if there are multiple parts to an assignment, use sub-heads within the paper to organize them. To get maximum points you need to follow the requirements listed for this assignments 1) look at the word/page limits 2) review and follow APA rules 3) create subheadings to identify the key sections you are presenting and 4) Free from typographical and sentence construction errors.REMEMBER IN APA FORMAT JOURNAL TITLES AND VOLUME NUMBERS ARE ITALICIZED.
New York University Wk 6 Simple Linear Regression Paper

Health Care Financing in Pakistan

Share this: Facebook Twitter Reddit LinkedIn WhatsApp Group members: Zubia Qureshi Musa Ali Irfani Rawal Insaf Shahid Qazi Ayesha Sheikh Kashif Ali Contents List of Acronyms: Abstract 1- Introduction: 2.1- Health care financing 2.2- Functions of health care financing 3.1- International comparison of funding system source 3.2- Health system models 3.3- Healthcare financing in 2009 3.4-Healthcare financing in 2010 4- Health care financing of Pakistan 5- What makes the health system complex? 6- Challenges: 7- Recommendations: 8- Conclusion List of Acronyms: AFR African Region AMRRegion of the Americas CERFCentral Emergency Response Fund DALYs Disability-adjusted life years EUEuropean Union EUR European Regions FATAFederally Administered Tribal Areas GDPGross Domestic Product KPKKhyber Pukhtoonkhwa MDGsMillennium Development Goals NHSNational health system OECDOrganization for Economic Cooperation and Development SEARSouth East Asian regions OOPOut Of Pocket USAUnited State of America WHOWorld Health Organization WPR Western Pacific Region Abstract Pakistan’s health care system is inadequate, inefficient, and expensive. Health is the neglected sector in Pakistan. Pakistan spends only 2% budget for health. It is insufficient for the population. The private sector is playing a vital role in the health care service delivery in Pakistan but majority of services are out of pocket payment. Every country raise its funds for health but Pakistan is in the list of those who decline there health budget. Donors support Pakistan and other developing countries but unfortunately not properly utilization of funds. It seems Pakistan government has no interest in improving the health of nation. There is lack of proper planning, implementation, monitoring and evaluation system. It is strongly recommended that adopt universal health care coverage to reduce OOPS and to make the nation healthy and wealthy. 1-Introduction: Health can be promoted and prevented by different ways, which lies either inside or outside the health sector. Health care delivery system and support system such as education, housing, food and employment all impact on health. All these cannot be achieved, without a well-functioning health financing system.[1] In 2005, Member States of the World Health Organization (WHO) developed the health financing systems to increase the access of services and to reduce the financial hardship paying for them.[2] Health financing is a key function of the health care system, and is a complex issue. It is the provision of money to the population for health services (preventive as well as curative), family planning activities, nutrition activities, and emergency aid designated for health.[3] Strong survival of a health system requires efficient financing policy. Without sufficient funding health system can’t work. The six building blocks framed by WHO interrelated and directly related to health care financing. Fair financing is also included in three main objectives of the healthcare system. Remaining two include improving the health status of the community and responding the people’s expectations. The later objectives are directly dependent on healthcare financing. In the absence of enough financing and resource allocation there won’t be proper service delivery, purchase of medicines, vaccines, lab tests etc as everything is dependent on funds. Increasing community awareness for health care, dependency on technology and diagnosis resulted in increasing need of finances. The rising of costs as the technology advances alarms the health policy makers to devise a sustainable financing approach. As a corollary it seeks to help the planners or policy makers to devise a sustainable approach accordingly. The proper healthcare financing helps to identify the areas which are over or under emphasized. The health financing is simply an exchange between health consumers (population) and the healthcare service providers. 2-HEALTH CARE FINANCING The term healthcare financing refers to the ways in which money is raised to fund health activities as well as how it is used (that is, the allocation of funds).[4] The definition signifies three important points i.e. Mobilization of funds for health care Allocation of funds to the regions and population groups and for specific types of health care Mechanisms for paying health care (Hsaio, W and Liu, Y, 2001) Thus, financing means mobilizing, allocation and accumulation of finances that cover the health needs of the population. 2.2-Functions of health care financing 1-Revenue Collection Raise sufficient and sustainable revenues in an efficient and equitable manner to provide individuals with both a basic package of essential services and financial protection against unpredictable catastrophic financial losses caused by illness and injury. Level of income, tax-base and fiscal space, tax incidence, transaction cost, the size of the informal sector is major key issues. 2- Pooling Manage these revenues to equitably and efficiently pool, health risks allowing for subsidies from healthy to unhealthy, rich to poor, and productive workers to dependents. Risk management, how to extend coverage to the informal sector, fragmented pools etc. 3- Purchasing Assure the purchase of health services is strategic and both allocatively and technically efficient (for whom to buy, what services to buy, from whom to buy, and how to pay) Performance-based payments help to promote quality and efficiency, equity and social protection. 3- International comparison of funding system source The following are the three broad categories of the health care providers: Public Provider Private Provider Non-Government Organization providers/Non-Profit Institutions 3.1- Mechanism/Methods of healthcare financing There are various methods of healthcare financing. Most of the healthcare systems operate on mix of the funding methods. These can broadly be discussed under following five headings, Taxation (general and earmarked) Social insurance Private insurance premiums Community financing Out of pocket payments Each method has its own peculiarities. Taxation has been an important source of healthcare funding. It can be general in United Kingdom or earmarked as in France. Earmarked taxes have more advantage over general tax being more specific. It subsequently reduces the resistance to taxation among the public. Social insurance works as a shared approach. Any agency, most likely governmental, pools the risks and responds them accordingly. This mechanism has its own pros and cons. The Social health insurance is more transparent and eventually more acceptable to the public. It has advantage over private insurance and risk rated insurance. Its disadvantages include reluctance of the employees to contribute to the insurance agency. Moreover, being an individual body, it is more prone to the political interference. Private insurance premiums do not have major contribution in healthcare financing yet it cannot be ignored. Its focus remains narrow as it covers only a minority of population and that some of the health related conditions do not come in its circle. Out of pocket spending has been a curse especially in the developing countries like Pakistan. The out of pocket spending in health is inversely proportional to the better healthcare system. 3.2-HEALTH SYSTEM MODELS National health system model (NHS) Financed through general revenues, covering whole population, care provided through public providers or contracting. The state provides the health care. (Examples: Denmark, Greece, Italy, New Zealand, Portugal, Turkey, and the United Kingdom.) Social Health Insurance Publicly mandated for specific groups, financed through payroll taxes, semi-autonomous administration; care provided through own, public, or private facilities (e.g., Germany, Japan) Community Based Health Insurance Not-for-profit prepayment plans for health care, with community control and voluntary membership, care generally provided through NGO or private facilities (e.g., US) Private Health Insurance Financed through private voluntary contributions to for- and non-profit insurance organizations, care reimbursed in private and public facilities Mixed systems Contain elements of both traditional sickness insurance and national health coverage. (Examples: Switzerland, and the United States.) 3.3- Universally accepted models The functioning of health care depends mainly on the level and method of financing. Countries choose between different models. Bismarck’s model The Bismarck’s model was introduced in 1883, Named for the Prussian Chancellor Otto von Bismarck, who invented the welfare state as part of the unification of Germany in the 19th century. It uses an insurance system — the insurers are called “sickness funds” — usually financed jointly by employers and employees through payroll deduction. The Bismarck model is found in Germany, of course, and France, Belgium, the Netherlands, Japan, Switzerland, and, to a degree, in Latin America. Beveridge’s model Named after William Beveridge, the daring social reformer who designed Britain’s National Health Service. In this system, health care is provided and financed by the government through tax payments. Countries using the Beveridge plan or variations on it include its birthplace, Great Britain, Spain, Cuba, most of Scandinavia and New Zealand. Hong Kong still has its own Beveridge-style health care. Residual model The residual model, called the X model, rejects or seriously limits public responsibility for allowing citizen access to health care. Health care services are financed with voluntary individual premiums, thus the private sector has the dominant role.The area of public health is thus separated from individual health care, and the health care sector is regarded as an open field for economic activity. Financing of services is based on private insurance or on individual direct financing. The residual model includes the public sector which covers only persons in special need, including very poor or old people. Siemaszko’s model In the Central and Eastern Europe, the Siemaszko’s model (or the budget model) has been functioning since early 20th century. The principles of its functioning were developed by MikoÅ‚aj Siemaszko (the health care commissar in the Soviet Union in 1930s). It is based on the financing of benefits by the state budget, provides permanent control of the state and equal access to all the benefits for citizens. The choice of a specific financial model entails certain impact on all of the system’s participants.[5] 3.3- Healthcare financing in 2009 In 2009, the world spent a total of US$ 5.97 trillion on health at exchange rates. The geographical distribution of financial resources for health is uneven. OECD countries with less than 20% of the world’s population spend over 80% of the world’s resources on health as compared to 6.5% to the AFR and 3.7% in SEAR regions of WHO respectively. Linking this to epidemiology, the figure shows that though the poorer WHO regions like AFR and SEAR account for the largest share of the global burden of disease (over 50% of global DALYs) and 38% of the world’s population, they spend only 2.5% of global health resources. The WPR without the four OECD Member States, Australia, Japan, New Zealand, and the Republic of Korea, accounts for 24% of the world’s population (dominated by China), about 16% of the global burden of disease but only 4.8% of the world’s health resources. The region of the AMR and EUR, excluding the OECD countries, account for 12.7% of the world’s population, 11% of the global burden of disease and spend only 7% of health resources. Richer countries with smaller populations and lower disease burden use more health resources than poorer countries with larger populations and higher disease burden. This highlights the absolute need for additional resources for many poor countries and raises questions of efficiency in health spending in richer countries[6]. 3.4-Healthcare financing in 2010 Health expenditure as a percentage of GDP in 2010 was 4.5% in the Asian region. This indicator varied from 2% in Myanmar to up to 10.1% in New Zealand. Between 2000 and 2010, the share of GDP allocated to health increased between 0.4-0.7 percentage points in Indonesia, Thailand, the Philippines and China, while it declined by 0.4 percentage points in India. During the same period, Japan and the Republic of Korea reported an increase of 1.8 and 2.5 percentage points respectively. Note that between 2009 and 2010 the share of GDP allocated to health remained stable in the Philippines, Japan and Republic of Korea, while it showed a slight decline for China, India and Thailand, and a slight increase in Indonesia. This means that the share of health care expenditure in total expenditure continues to increase. Only Brunei, Darussalam and Pakistan showed a slight decline in the annual average growth rate in health spending per capita as compared to an increase in income per capita. In China, health spending has grown at a higher rate than overall economic growth over the past ten years.[7] 4-Health care financing of Pakistan Pakistan has been facing serious issues in health system regarding accessibility, availability, affordability, efficiency, governance, and accountability. 49 % of Pakistan’s population faces multidimensional poverty with high level of deprivation[8]. Milestone of health in the form of MDGs deadline is approaching near, Pakistan is far away from the achievements of the MDGs. In Pakistan, The National Finance Commission (NFC) Award is an arrangement through which the federal government transfers funds to provincial governments. The NFC Award has been remaining the cause of disagreement between provinces because of their respective shares. The provinces differ on the criteria set for the Award. Sindh has demanded the share based on revenue collection. Punjab stresses for a population basis while NWFP and Balochistan are insisting on the area and backwardness to be made the basis for the Award. It is assumed that the new NFC Award would be based on a revised Divisible Pool allocation formula. The new formula might be extended beyond the criterion of population to include area or the Human Development Index (HDI). In 2002 Pakistan health expenditure was 3.0 % of GDP than this amount declined to 2.9 % GDP for the years of 2003 and 2004. The health expenditure further declined to 2.8% of GDP in 2005 and 2006, then 3.0 % in 2007 which increased to 3.3% of GDP in 2008[9]. Now only 2% budget is for health. This may be the worst thing a country can do to its citizens other than out rightly murdering them.[10] It is, therefore, not surprising that public expenditure on health in Pakistan is less than that in India, Bangladesh, Sri Lanka, and Nepal[11]. 4.2 Funding by donor agencies The allocation of funds by donor agencies for health in middle and low income countries has gained prominent attention around the world. Billions of dollars are offered for improving health. But these funds are not used in an efficient and effective way that is why we far away from our target in health care.[12] The Commission has been funding humanitarian aid in Pakistan since the 1990s. In 2012, the Commission was the largest humanitarian donor in Pakistan covering some 35% of the humanitarian funding for 2012. The European Commission’s 2013 humanitarian assistance in Pakistan provided a total of € 52 million. EU humanitarian aid to Pakistan totals almost € 440 million since 2009[13]. The UN system contributes 5% of total health sector investment. The amount to be made available to the health sector is $ 161.6 million, which is more than 26 percent of the United Nation’s financial commitment to Pakistan for this period. Of this allocation, WHO and UNICEF, together provides as much as 78 percent. Pakistan is the fifth-largest recipient of CERF funding, at a total of $158 million. 4.3-Donation of the year 2013 Humanitarian partners in Pakistan have so far received $191 million since January 2013 for essential humanitarian operations in KP and FATA. The CERF has provided $13.9 million for the emergency in KP and FATA. Donors have so far pledged more than $420 million in support of the Fund, bringing the total amount contributed to CERF since March 2006 to more than $3.2 billion.[14] The UAE Project to Assist Pakistan (UAEPAP) has launched over US$17.1 million for its project to construct seven healthcare projects in Pakistan’s Bajaur, Khyber Pakhtunkhwa province, and South Waziristan. It said that the hospital in Bajaur has been completed while the other six facilities are expected to open before the end of this year.[15] 5-WHAT MAKES THE FINANCIAL SYSTEM COMPLEX Population growth Relentless burden of diseases,, Scarce resources Troubles with alternative mechanisms Unregulated private sector Weak administration And Inefficient use of available health budget 6-Challenges: Epidemiological transition Financial constraints Allocatively inefficiency of health sector resources Lack of management capacity Proper allocation of funds, according to need Monitoring and evaluation Out of pocket (OOP) expenditure is high which increases poverty and reduces access to quality services The budget allocation is geared towards tertiary care and 50% of the expenditure are at the provincial level (mostly tertiary care), as a result the secondary and primary care services suffer from a serious lack of resources Establishment of evidence based policy Generation of fund resources 7- Recommendations: Efficiency of service delivery Some of the recommendations are: Raising more funds for health care system Improving efficiency and equity A combination of financing methods may be adopted as a part of financial strategy, including tax revenue; community financing; social insurance and private insurance. OOP payments can be reduced by the standardizing fee structure Allocation of donor funds, according to locally determined needs Start employes social security schemes 8-Conclusion Pakistan is spending very low of its budget on health which is not sufficient to fulfill the needs of population. With very low levels of health care financing countries cannot ensure universal access to even a very limited set of health services. On the other hand, higher levels of funding might not translate into better service coverage or improved health outcomes if the resources are not used efficiently or equitably. The key to a successful healthcare system in Pakistan lies in top management, leadership support and commitment; strong financial methods for improving consumer information, making services or products more affordable through some form of subsidy and creating alternatives for the consumer to access services at a lower cost.[16] Risk pooling arrangements, proper resource allocation, equity based distribution of services and better decision making power leads towards goal. ——————–THE END———————— 1 [1] Closing the gap in a generation – health equity through action on the social determinants of health. Geneva, World Health Organization, 2008 (http://whqlibdoc.who.int/hq/2008/WHO_IER_CSDH_08.1_eng.pdf, ac­cessed 23 June 2010). [2] Resolution WHA58.33. Sustainable health financing, universal coverage and social health insurance. In: Fifty-eighth World Health Assembly, Geneva, 16–25 May 2005. Geneva, World Health Organization, 2005 (http://apps.who.int/gb/ebwha/pdf_files/WHA58/WHA58_33-en.pdf, accessed 23 June 2010) [3] Health Organization National Health Account database, World (http://apps.who.int/nha/database/DataExplorerRegime.aspx for the most recent updates). [4] (CMH, WG 3, 2002) [5] Pol Merkur Lekarski. 2012 Dec;33(198):309-12 [6] Globalô€€ƒHealthô€€ƒExpenditureô€€ƒDatabaseô€€ƒ(GHED) [7]– HEALTH AT A GLANCE: ASIA/PACIFIC 2012 © OECD/WHO 2012 [8] Human Development Report 2012 [9] ;WORLDBANKINCOMEGROUP:–;DATASOURCE:–;RESIDENCEAREATYPE:–;WEALTHQUINTILE: [10] http://getup.org.pk/issues/HealthcareForAll.html [11] (World Bank, 2012). [12] [Health Affairs 26, no. 4 (2007): 950–961; 10.1377/hlthaff.26.4.950] [13] European Commission Press release, Brussels, 24 June 2013 [14]Report from UN Office for the Coordination of Humanitarian Affairs Published on 19 Aug 2013 WAM ISLAM ABAD, 14th September 2013 (WAM) [15] Report from Emirates News Agency Published on 14 Sep 2013 [16] Lippincott Williams