Healthcare Rationing Debate

Healthcare Rationing Debate Commentary on â€Å"The Rationing Debate†, Rationing health care by age Covering Statement: This paper aims to comment on Alan Williams’s article of â€Å"The rationing debate1† published in BMJ, 15th March 1997 volume 314. In this commentary I will try to explain different points of argument he raises in his article with the comments on each under the same heading. For the better perception and reflection I will try to suggest an alternative model to his main proposition of this article. The main position of my commentary is favoring the position of Alan about â€Å"Age the criterion to benefit people† I will try to critique him in different aspects of his argument with the induction of my own suggested model and will try to figure out in order to remove the dependency on age for calculating benefit we have to intervene5 differently with some different aspect. Rationing debate: This article is all about the criteria for the priority setting in health care specifically focused on â€Å"Age1† which he mentioned is only the predictor for any health related issue not the cause; he also argued about the main context on benefits extract out of health care in relation with age. In the initial part of his article he tries to figure out the relation between adaptation and adjustment of human body in response to â€Å"diseases†. Here, I want to use more true meaning of this word â€Å"disease† which means not normal, instead of any pathology. He also explains the increased level of risks with increase ages along with more supportive and rehabilitative therapy needed in later ages. Being an â€Å"Old Age Person† he contextualized his argument in contrast with young age and compares why recoveries are fast in young age and that also the importance of recoveries in young ages. Up to my level of understanding, his use of ‘age’ explaining about the different aspects of wellness is more towards own contextualization, being a middle age man I can argue the whole concept of his article in a different aspect and that is level of degenerative changes in human body. Before I explain further I would like to explain a bit about medical notion of generative and degenerative part of Human body. Broadly, our life consists of two major cycles of structural formation i.e. generative and degenerative. Initially we all spent life for the generation of a proper structure of our body including physical and mental construction and then after that we spent rest of our life on that structure, which we can call degenerative part of life. Degenerative part is mainly relying on how well organized generative structure is formed. Up to 30 years of age is considered as a part of generative phase while after that it is all degenerative. Now I can argue, or suggest Mr. Allan an alternative ground to his concept of Age1, which is we will evaluate generative and degenerative health issues to his concept of benefits in comparison of his age based model of benefits. So contextualizing this alternative, infections or acquired disease can be treated as the reflection of body, like in generative phase the estimation of benefits can be different than the degenerative one similarly the developmental disorders. This alternative context can be applicable to public or individuals on the same way like the Age based one; the reflection of body to any external effects. Desire of Living: Alan uses a term of â€Å"vain pursuit of immortality1†, desire of living forever which indeed become more important in later ages of life. So as he explains how the outcomes of smaller health related issue considered more in old-aged and why the expectation get higher in this age. He points out the curability or treatability of any health related issue is not the only option in this age groups, there are so many other ways to work in this issue even out of the parameters of health services (like beyond NHS-UK). Considering the above argument in context with the alternative idea, there won’t be any expectation issues because for degenerative un-wellness expectations will be low. The terms of curability and rehabilitation will not be in competition with each other for instance. Ethically it will be easier to justify the alternative one as both the components of this idea are of equal span which will be focusing more on consequences and outcomes; I would not like to say that this will be the maximizing welfare concept or true utilitarian4 based model except within the degenerative based group benefits of health care issues. Quality of Life: Other important aspects of his article he suggests about the shift of context from the term of â€Å"cure† to â€Å"quality of life†. He also supports this argument of his by relating it with the values of persons own self-care. Though he stresses that by focusing on quality of life the contemporary approach on new interventions5 (especially at life threatening levels) will be restricted but still he argues â€Å"Quality of Life1† is less costly. The above argument of Alan is basically the further explanation of our context of alternative idea in which regenerative phase is more focused for the cure with individual choice and distributive to maximal liberty of the individual. Quality of life is only focused to the improvement of degenerative part of health care benefits according to the needs and burdens equalizing resources4 (egalitarian4). So the alternative way can be the modified egalitarian view of health care setting. Being the part of egalitarian nature it can be assume that priority will be set for the high tech innovations in medical sciences which will benefit both the generative as well as degenerative on the same grounds and quality. Limits: In second portion of his article he tries to explain another aspect of defining limits for the health care benefits, he explains that keeping an eye on this divine principle of â€Å"every soul will taste death2† it is better to keep a limit before any stress full situation encounters and those limits should be justified on humane grounds according to age, expectations should also be considered according to age. He means to say that age can be considered for benefits though it is not a criterion. In explanation of above argument to alternative context, expectation will be different for different phases; fulfillment of that expectation would be more justified or in equitable manner. I do agree with this divine principle of life and the relation of its context in our life and building capacity to the alternative way will not effects any change on overall morality4 of priority health care setting. For this argument I would like to second the thoughts of Alan, health care model should have the parameters for defining the limits in advance, so that the issues like social utility4 or medical utility4 could not be raised. The extent of limits can differ in our alternative context of design. Health of the nation: In the further explanation of his own proposition of benefit related health care objectives when talk about broader view like â€Å"health of the nation1†, he counter argues that this favors against the old age because priorities should be given to those who will benefit more, so the young will get more and also in old age benefits are more diminished and that this is morally unjust that smaller benefits of older should be preferred on larger benefits of young. In support of his argument he explains that older can be considered more beyond the benefit because they have paid more taxes in their lives, but contrarily he replied that usually health care systems are social insurance kind of system in which lucky one gets more. He also supports this argument that elders value more to their small improvements while young focus more to different aspects if talk about their benefits in that case the rationale of health care settings as a social insurance setup wi ll be in jeopardy and private entities will be focus more. When we deal with the civic virtues and solidarity or community values than the paradigm of priority setting for health care become difficult up to one model application. There are different references points to be deal at this level like, effectiveness, efficiency, legitimacy and distributive justification. If we change the notion of health of nation to the context of alternative idea of this paper than it will be easier to measure effectiveness as regenerative will be given priority. Economically7, the degenerative phase will consume more and it will justify the social insurance based argument of Alan that any person who pays in his regenerative phase will get in his degenerative part. Politically, there will be marked difference in both the scenarios. For example, instead of spending major share on long term care facility government have to build community rehabilitation services centers which will be utilized by all age groups. There won’t be any much difference of values of benefits of elders and young, though there will be difference in values of benefits but that will be equitable to widen age groups. Fair Innings: In later part of the article he explains his proposition as a â€Å"fair innings1 7†, in which he tries to explains that any person who lives his lifelong is kind of a fair cricket innings where he plays his innings saving his wicket throughout his life and (using resources of health care for life) build it up till old age (threescore ten is 70 years3), while the one who gets out in young age or live a painful kind of life is an unfortunate one and who has been denied opportunities. So the quality of life should be more focused whatever age it is and how many years of life are left. This argument is almost similar for the alternative context of this paper where someone who spend his regenerative phase of life well and get some tragic death will considered unlucky. So quality of life does not depends on health facilities available, age spans, exposure of the person, economic situations and so many other variant and non-related factors can be considered. In the end: Concluding his whole proposition, Alan explains that Age is important in determining the benefits and ultimately explains the disadvantages7 of being elder and low value benefits. As the age increase the value of your benefits decreases. He admits in his conclusion that he would have been preferring younger person benefits6 over his. Similarly, age matters a little bit in our alternative model but not as much that it can change the decisions. If our health care system is based on the suggested model of this paper, the criterion for determining the values of benefits would have been very different. Some preference could have been involved due to age but within the rationale of main phase either generative or degenerative. Conclusion: In this commentary I try my best to reflect my understanding of Alan’s debate, although he counters argue his own position many times but within the connotation of Age as criterion to determine health benefits. Reflexivity of his theme can appear to my suggested model of health care setting, where I am trying my best to create a parallel theme to Alan’s argument in order to get more grasp on his ideas. Concept of suggested model for health care setting based on generative and degenerative treatments, divine references about death and limits of life is my personal conception and believes. Within the explanation I have tried to create a parallel context for comparison. References: Williams, A (1997). The rationing debate. Rationing health care by age. BMJ: British Medical Journal, 314(7083), 820. The Holy Quran. The Holy Bible. T. L. Beauchamp, J. F. Childress. (2013) Principles of biomedical ethics, (7th ed.). New York: Oxford University Press. Rivlin, M. M. (1995). Protecting elderly people: flaws in ageist arguments. BMJ: British Medical Journal, 310(6988), 1179. Hunt, R. W. (1993). A critique of using age to ration health care. Journal of medical ethics, 19(1), 19-27. Evans, J. G. (1997). The rationing debate. Rationing health care by age. BMJ: British Medical Journal, 314(7083), 822.

Computer Processors :: essays research papers fc

Processors: Which is the best ?   Ã‚  Ã‚  Ã‚  Ã‚  A processor is the chip inside a computer which carries out of the functions of the computer at various speeds. There are many processors on the market today. The two most well known companies that make processors are Intel and AMD. Intel produces the Pentium chip, with the most recent version of the Pentium chip being the Pentium 3. Intel also produces the Celeron processor (Intel processors). AMD produces the Athlon processor and the Duron processor (AMD presents).   Ã‚  Ã‚  Ã‚  Ã‚  Processor speeds are measured in megahertz (MHz) and now come in speeds of up to 1000 MHz (1 GHz), which is very fast. This is almost ten times faster than the speed of most home computers, which average from 133 MHz to 166 MHz. Intel and AMD have been in a race to break the 1 GHz speed barrier, and the number of megahertz in the newest processors is not as significant as it was in earlier processors. For example, the difference between a 133 MHz processor and a 166 MHz processor is rather large, but the difference between a 533 and a 566 is barely noticeable. This is because the companies are becoming more concerned about the number of megahertz in a processor that the actual speed is not keeping up with the megahertz number (AMD/Intel).   Ã‚  Ã‚  Ã‚  Ã‚  So, which processor is the best? It depends on what the computer is being used for. The AMD Athlon processor is the best processor when it comes to 3D games and handles games quite well (Athlon Processor Quotes). The Pentium 3 processor is not quite as good at handling games. From personal experience with a Celeron 566 processor, the Celeron does not do a very good job at handling 3D games and will often freeze during a game, but otherwise is a very good processor. The Pentium 3 is the best processor for handling office applications, but the Celeron and the AMD do a good job as well. In consideration of the price, the Celeron processor is the best priced processor and offers good performance (P3 vs. Celeron 2). The Celeron is about half the price of the Pentium 3 processor (P3 vs Celeron 2).

Compare and contrast new buying used car vs new car Essay

Purchasing a car in today’s economy can be very difficult, whether you’re looking into a new or used car there are a lot of things to consider. Ensuring that you’re getting the best no matter the amount you’re spending, is difficult in its own way. Taking your time to collect information is very important. You never want to something that you know nothing about, because you will never know what you are truly purchasing .Asking yourself these questions will help you no matter what route you go in the car buying world. First question being what type of car do you want? It is Very important to purchasing a car that fits your life style. Next, how much are you willing to spend? Setting a budget will help you not spend over what you can afford. Finally, how long do you plan on keeping this car? If you are looking for a car for a couple months, you don’t want to exhaust all you funds into a temporary situation. Recently I’ve sold one of my cars and have been on the search for a new one. Buying a new car can be a very troubling thing to do. I’ve had to consider a lot of things when choosing the right car, and how to go about buying a new or used car from a dealership or buying a used car from a private owner. Being a young adult in this tough economy with a family to support, ensuring that I’m getting the best deal with a used cash car or a low interest rate and monthly payment on a new one. Making sure that a car payment fits into my house hold budget with now worries. Purchasing a used car from a private owner is one option I have been considering. Although the price can be very reasonable, you don’t have to worry about dealer fees, Monthly payments or being approved for financing. You will never truly know how well the car was taking care of, not to mention that the car will not come with any type of warrantee or return policy. Due to the extreme circumstances and series of unfortunate events: throughout, the world today with the weather and c rime. You can never be too cautious, with the credibility of a stranger. If something goes wrong with the car after the Purchase date. You are responsible for the cost of repair. However purchasing a new car or used car is slightly easier in terms of getting the exact vehicle you want, yet there are still some difficult steps in the process as well. One being the cost of the cars are more expensive depending on what year, make, and model you want. Prices can range from  20,000 to 100,00 dollars , not including dealer fees. Therefore, Finding a finance company if you don’t have all the money to buy the car out right can be nerve racking .You may be able to budget your finances to the exact dollar every month , but do you have enough income each month to the lenders standers. Fortunately, you don’t have to worry about the conditions of the cars, because every dealerships new cars have been inspected before shipped to the actual lot. The used cars have been put to a series of diagnostic test to ensure they have no major problems and are marked certified pre owned, also ensuring you that they have been well maintained. All the cars come with some type of free warranty or extended warranty that you’re able to purchase at that time. In the event something dose go wrong you are not responsible for the cost of repair, not to mention if it was a new car you could return that vehicle within a certain amount of time. We all know that cars need regular maintenance. Another added benefit is that depending on the dealer you buy from some may even offer free, discounted or half price regular maintenance for a limited amount of time. In my experience searching for the perfect car to fit my lifestyle was very difficult. It seems that although the cars at the dealership are a little more costly, spending the extra money to ensure that you’re buying a quality vehicle could be worth it. On the other hand you can run into some of the same issues as if you are buying from a private owner. Doing Research and really taking my time in considering every options pros and cons definitely helped. We seem to live in a world where money is the root of all evil, so you have to have a lot of trust in whoever you decided to buy from. It can be very hard to find a creditable seller and not someone who is only looking to benefit from you no matter the cost, or lies they tell just to sell you a car.

Annotated Bibliography On Patient Care Essay - 1242 Words

Annotated Bibliography on Patient Proning One of the key topics now that is going on in the ICU where I am doing my practicum as to do with Proning position. Prone positioning in ARDS patients is for improvement of oxygenation. Here are a list of articles retrieved from the Walden Library related to the advantages of Proning. Guà ©rin, C. (2014). Prone ventilation in acute respiratory distress syndrome. European Respiratory Review: An Official Journal Of The European Respiratory Society, 23(132), 249-257. doi:10.1183/09059180.00001114 As noted in this article prone position are done in patient with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). After study done there is enough evidence to support that proning position improves mortality in patients with severe ARDS and that it should be used as a first-line therapy in patients with severe ARDS. Presently due to the amount of successful patient outcome with proning at the hospital I am doing my Practicum they are looking in to manually prone due to the high cost for the beds use to assist. Beitler, J. R., Guà ©rin, C., Ayzac, L., Mancebo, J., Bates, D. M., Malhotra, A., Talmor, D. (2015). PEEP titration during prone positioning for acute respiratory distress syndrome. Critical Care, 191-6. doi:10.1186/s13054-015-1153-9 There are several important physiological changes occur with proning such as increased ventilation-perfusion matching, optimized chest walls mechanics, decreased pleuralShow MoreRelatedA Annotated Bibliography On The Field Of Nursing1600 Words   |  7 PagesAn annotated bibliography is used to assess other written works of information related to the topic you are discussing. This assignment is to help students learn how to deal with one of the many communication concerns they may come across in the field of nursing. 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