The Great Wave by Katsushika Hokusai Essay Example For Students

The Great Wave by Katsushika Hokusai Essay The Japanese masterpiece, The Great Wave, was created by Katsushika Hokusai, when he was approximately 70 years old. It was part of his popular ukiyo-e series Thirty-six Views of Mount Fuji, which was created between 1826 and 1833. The print was made using colour woodblock printing called ukiyo-e. Hokusai ukiyo-e transformed the art form one focused on people, to one that explored landscapes, plants, and animals. Ukiyo-e means pictures of the floating world in Japanese. It is a genre of woodblock printing and painting that was popular in Japan from the 17th through 19th centuries. Making woodblock prints was a three-stage process as follows: (1) The artist would paint the design with ink (2) The design would then be carved onto wooden blocks, and finally (3) Colored ink would be applied to the blocks after which sheets of paper could be pressed on them to print the design. Once the blocks were completed, it was easier to make reproductions of the same design. Outline generally what you see happening in the image Hokusai captures a dramatic moment in his artwork by contrasting a giant and turbulent wave in the foreground about to consume three fishing boats, against the small and stable Mt Fuji in the background. We will write a custom essay on The Great Wave by Katsushika Hokusai specifically for you for only $16.38 $13.9/page Order now The boats tumble in submission to the force of the wave. The tiny fishermen in the boats huddle and cling to the sides, as the cusp of the wave curls its claws down upon them. The sky is eerily pale. The white frost of the wave cap mimics the snow covered top on Mount Fuji. The waves are large, towering, turbulent and menacing. They look powerful and heavy and about to come thundering down to consume the three fishing boats. They are dark blue and curl with shades of lighter blue and extend to white frothy wave tips. They are surrounded by softer sprays of white mist. The power of the waves is captured in the wave caps that look like menacing claws, adding to the impact of the strength and dominant power of the waves. The curling down of the claws makes the waves appear as though they are ready to pluck the fishing boats and their unfortunate sailors out of the sea. Huddled, small, inconsequential, panicked, hopeful, supporting eachother, scared, frightened, clinging, crouched in fear, terror, vulnerable, helpless. The colors and tones are deliberate and intense. The menacing wave is dark blue and ghostly in colour forming curls of white froth and claws of pale blue and white. The sky is an eerie pale tan colour contrasting against the bold blue of the wave. The white frost of the wave cap mimics the snow covered top on Mount Fuji. The range of colours is limited to reflect nature. The lines of the wave are clear and precise. The colour of the boats is light brown and this color reinforces their insignificance against the bright blues and white of the waves. The fishermen in the boats are dark blue with white heads. The bubbles of water mist are white and sparkling. The horizon is a muddy brown colour with blurred tones suggesting doom. The wave seems menacing and ghostly. The scene is dramatic with nature’s power being exerted against the vulnerable fishermen. There is an element of apprehension in the capture of the giant powerful and turbulent wave as it curls toward the small, submissive boats. The waves commanding presence in the foreground, dwarfing the peaks of Mount Fuji, highlights the wave’s strength and dominance. The small fishermen are almost defenceless, huddled and clinging to the sides of their boats. .uadd6045062fa6af4090c743d1793cf4b , .uadd6045062fa6af4090c743d1793cf4b .postImageUrl , .uadd6045062fa6af4090c743d1793cf4b .centered-text-area { min-height: 80px; position: relative; } .uadd6045062fa6af4090c743d1793cf4b , .uadd6045062fa6af4090c743d1793cf4b:hover , .uadd6045062fa6af4090c743d1793cf4b:visited , .uadd6045062fa6af4090c743d1793cf4b:active { border:0!important; } .uadd6045062fa6af4090c743d1793cf4b .clearfix:after { content: ""; display: table; clear: both; } .uadd6045062fa6af4090c743d1793cf4b { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .uadd6045062fa6af4090c743d1793cf4b:active , .uadd6045062fa6af4090c743d1793cf4b:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .uadd6045062fa6af4090c743d1793cf4b .centered-text-area { width: 100%; position: relative ; } .uadd6045062fa6af4090c743d1793cf4b .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .uadd6045062fa6af4090c743d1793cf4b .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .uadd6045062fa6af4090c743d1793cf4b .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .uadd6045062fa6af4090c743d1793cf4b:hover .ctaButton { background-color: #34495E!important; } .uadd6045062fa6af4090c743d1793cf4b .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .uadd6045062fa6af4090c743d1793cf4b .uadd6045062fa6af4090c743d1793cf4b-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .uadd6045062fa6af4090c743d1793cf4b:after { content: ""; display: block; clear: both; } READ: Master of Fine Arts Thesis Exhibition EssayTheir anxiety, fear and panic rings out from this artwork. The lines, direction and scale of the artwork creates a sense of movement. Hokusai positions the viewer looking up into the menacing curl of the giant wave. And this is in contrast to the fishermen who turn away and are too terrified to face nature’s fury. This creates a sense of movement of the wave crashing downwards. Additionally, the usually towering Mount Fuji is set in the background, small, motionless and framed by the giant wave in the foreground. The contrast of Mount Fuji so still in the background highlights the thunderous movement of the wave. The position of Mt Fuji almost in the centre, but perfectly balanced in the frame, and the clear lines of its triangular peak draws the viewers attention to the movement going on around it. The lines are clear, vigorous and bold. This adds to the movement of the artwork. The line curvature of the wave and curls of the cusps, highlights the rise, curl and sweep of the moving wave, creating a sense of movement.

Increasing of Medicaid Cost

Increasing of Medicaid Cost Introduction Medicaid cost has been increasing gradually in the past four decades and projection shows that, the trend might overtake growth of the United States’ economy. Since the inception of the Medicaid program in 1965, its cost has increased from 0.4% of Gross Domestic Product (GDP) to 2.7% of GDP in 2009, which is quite alarming given that economic growth is slow and susceptible to economic crises.Advertising We will write a custom proposal sample on Increasing of Medicaid Cost specifically for you for only $16.05 $11/page Learn More Although increased Medicaid cost is attributable to expansion of eligible beneficiaries, medical care and services have increased significantly, thus causing Medicaid cost to increase faster than the growth of GDP. According to Truffer, Klemm, Wolfe, and Rennie (2010), projection shows that, annual growth rate of Medicaid cost is 8.3%, which is unusually high when compared to the annual growth rate of GDP that stan ds at 5.1% (35). The federal and state governments are now grappling with the increasing Medicaid cost for it consumes significant part of already constraint budget in the face of economic difficulties. The increasing cost of Medicaid is unsustainable and, thus threatens the livelihood of the 60 million beneficiaries who entirely rely on Medicaid to access health care and medical services. Given that there is a high growth rate of Medicaid cost as compared to GDP growth, it is predictable that Medicaid expenditure is unsustainable; therefore, program evaluation is necessary to give appropriate recommendations that are robust in enhancing the sustainability of the Medicaid program. Problem Statement The increasing cost of Medicaid relative to GDP predicts that, Medicaid program is quite unsustainable if there are no effective reforms to change its legislations and policies as means of enhancing its sustainability. The gradual increase in Medicaid cost, in the past four decades since its inception, indicates that, the cost is going to increase exponentially in future unless appropriate comprehensive reforms are in place to reverse or slow the trends. Even though the increasing trends of Medicaid cost are attributable to expansion of eligible beneficiaries, health care and medical services are also increasingly becoming expensive, thus placing an extra burden on health care system, state, and federal government.Advertising Looking for proposal on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More Zommorrodian and Matei (2010) argue that, program evaluation is necessary as it helps many organizations to formulate and implement programs that are cost-effective and efficient in delivery of services people (979). Hence, for the state and federal government to enhance the effectiveness and efficiency of Medicaid program, recommendations of program evaluation are central in conducting comprehensive refor ms. Therefore, this research paper seeks to conduct program evaluation with a view of increasing cost of Medicaid to enhance effectiveness, efficiency, and accountability of Medicaid program. Purpose of Study The purpose of the study is to evaluate Medicaid program to ascertain its effectiveness, efficiency, and accountability in delivery of health care and medical services to the poor people. The study seeks to assess and evaluate roles of Medicaid in providing health care and medical services to the poor people in health care system with a view of formulating appropriate recommendations to enhance effectiveness, efficiency, and accountability of Medicaid program. Given that, since its inception in 1965, medical costs have been increasing gradually and are threatening to overtake the annual growth rate of GPD, the study will examine factors that contributed to the steady increase in Medicaid costs in the past four decades. Even though increasing Medicaid cost is seemingly proportio nal to expansion of eligibility criteria of beneficiaries, there may be other confounding variables, which contribute to the skyrocketing cost of Medicaid. Hence, the study will assess whether current policies and legislations are functioning effectively and efficiently in a cost-effective. Since Medicaid is a long-term program that helps the poor to afford and access health care and medical services, the study will also assess its sustainability.Advertising We will write a custom proposal sample on Increasing of Medicaid Cost specifically for you for only $16.05 $11/page Learn More Although Medicaid is currently serving over 60 million poor people, DeParle (2000) argues that, sustainability is a serious challenge because it requires a substantial deal of resources that federal and state government cannot offer in future due to increasing Medicaid cost that gives escalating pressure on economic resources (26). Thus, the study seeks to examine whether curren t policies and legislations of Medicaid provide for long-term utilization of health care and medical services by the poor as a way of determining sustainability of the program. Moreover, the study will assess if eligibility criteria of selecting beneficiaries is fair and objective to prevent unnecessary recruitment of the rich people who are able to access and afford health care and medical services. Thus, the study needs to establish if eligibility criterion is effective and efficient in selecting appropriate beneficiaries of Medicaid. The study will also conduct a survey to examine whether Medicaid beneficiaries receive health care and medical services, which are commensurate to the state and federal funding of Medicaid. In the survey, the study will assess if health care services that beneficiaries receive are proportional to medical cost that Medicaid pay. Assessment of health care services is critical as it depicts how Medicaid spends money and how beneficiaries receive health care services. Existence of inconsistencies will indicate that Medicaid is not using its funds effectively and efficiently in providing medical services to the poor. Thus, the study will carry out a comparative analysis of funds and medical services that Medicaid beneficiaries receive in health care system. Moreover, the study will evaluate the quality of medical services that Medicaid beneficiaries get from health care system relative to medical services that the rich obtain from health care system. Disparity in medical services that the poor and the rich get from the health care system will indicate the effectiveness and efficiency of Medicaid program.Advertising Looking for proposal on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More Hypotheses The study hypothesizes that increasing cost of Medicaid is partly due to expansion of eligibility criteria, which has some deficiencies and thus requires appropriate reforms to streamline it. The inclusion of unnecessary beneficiaries into Medicaid overstretches the budge, which is already constrained by the economic meltdown. Furthermore, the study hypothesizes that federal and state funding of is ineffective because there is differential expenditure on Medicaid across states. Truffer, Klemm, Wolfe, and Rennie (2010) argue that the federal government spends about 7% of its budget on Medicaid, while the state government spends about 21% of its budget on Medicaid (33). Hence, government spending does not consider the disparity in the needs of poor people in various states, thus a challenge in the provision of health care services by Medicaid and health care system. The study also hypothesizes that, there is poor provision of health care and medical services by health care system despite the fact that Medicaid spends billions of dollars yearly. Thus, overall, the study assumes that there are inefficiencies in Medicaid program that need evaluation and assessment to obtain recommendations, which will form the basis of comprehensive reforms essential in enhancing efficiency and effectiveness of Medicaid and delivery health care services to the beneficiaries. Limitations of the Study The study will have a general assessment of policies and legislation of Medicaid to establish the extent of their implementation in Medicaid program; thus, the findings will be more of generalization rather than specific. Concerning the eligibility criteria, the study examines the eligibility of the poor and low-income earners, and this factor limits the application of the findings because it does not consider eligibility of disabled people, pregnant women, and people living with HIV. The study also assess and evaluate Medicaid from both federal and state level without exami ning specified state; thus, the findings may not reflect specified disparities that exist in various states. Since study will collect data from one state, the findings will have limited application within the state, for they have low external validity that makes extrapolation of the findings impossible. Ultimately, the findings have limitation because the study will only assess effectiveness and efficiency of Medicaid based on data from beneficiaries, Medicaid records, and health care system. Delimitations The study will not examine specified policies and legislations that different states employ when implementing Medicaid program. Given that there are different groups of Medicaid beneficiaries, the study will not assess people living with HIV, pregnant women and people with severe disability because they do not forma significant part of beneficiaries relative to the poor people. The study will not also evaluate effectiveness and efficiency of Medicaid in different states, but rat her examines one state as a model of other states. Moreover, the study will seek to assess quality of health care services that Medicaid beneficiaries receive, but will not examine disparities that exist from one state to another. Importance of the Study Due to the increasing Medicaid cost, assessment and evaluation of Medicaid program, in terms of its efficiency and effectiveness, in delivery of health care services to the poor, is crucial in the formulation and implementation of policies and legislation in a cost-effective manner. Given that increasing cost of Medicaid depicts that Medicaid program is unsustainable with its current policies and legislations, program evaluation is going to give appropriate recommendations that are essential in conducting comprehensive reforms that enhance sustainability of the program. The formulation and implementation of comprehensive reforms are critical because, unsustainable Medicare spells doom to the over 60 million beneficiaries most of wh ich are poor people relying on Medicaid to access and afford health care services. Thus, it is imperative to conduct a study to assess efficiency, effectiveness and accountability of Medicaid program with a view of giving robust recommendations that will reverse or slow trends of increasing cost of Medicaid and improve the quality of health care services that the poor obtain from health care system. Literature Review The Congress established Medicaid in 1965 as a health program to enable the poor people access and afford quality health care services that they require. Given that significant number of the poor did not have the capacity to access and afford quality health care services, congress established Medicaid as a social and health program that promotes health of the poor and elderly. From 1965, Medicaid has been expanding gradually because criteria for eligibility has expanded and included distinctive groups such as people living with HIV, pregnant women and people with disabi lities amongst other exceptional groups. Expansion of eligibility criteria has caused tremendous increase in the number of Medicaid beneficiaries, which consequently resulted into increasing cost of Medicaid. Increasing cost of Medicaid is detrimental to state and federal budgets because it constitutes about 7% and 21% of their respective budgets. Egert (2003) asserts that, Medicaid cost has increased exponentially in the past five years and severely strain state budget, making every state experience fiscal crisis (4). Thus, reforms are essential to provide means of alleviating the impact of the increasing number of Medicaid beneficiaries on state and federal budget. Medicaid started as a health program with noble objectives of helping the poor to afford and access quality health care services, and has currently expanded and included other notable groups, which are also unprivileged in society. Although the expansion of Medicaid has helped many people to afford and access quality he alth care services by creating equality in health care system, it has cost the state and federal government a fantastic deal of resources since Medicaid cost is increasing faster than the rate of economic growth of the United States. According to Dorn (2004), conservative policymakers are against expansion of Medicaid because it will not only increase pressure on state and federal budget but also increases share of the federal government on health care system that has increased from 9% to 33 % within a period of four decades (2). Thus, conservative policymakers want Medicaid to benefit only the poor because expansion will create many complications in terms of policy formulation and implementation as well as funding. Moreover, after the expansion of Medicaid criteria for eligibility, it caused unprecedented increase in the number of beneficiaries and concomitantly increased the cost of Medicaid. Expansion of the eligibility criterion to include people living with HIV has helped about 44% of their population in that; about 90% of children and 55% of adults are Medicaid beneficiaries. Therefore, it means that children form a significant part of beneficiaries who are living with HIV. Moreover, the eligibility criterion has expanded and included people with disability. Sheldon (2005) argues that, people with a disability are eligible to become Medicaid beneficiaries in spite of their levels of income because Medicaid is their primary health care insurance (5). Thus, a significant population of people with disabilities is eligible for Medicaid. Overall, expansion of eligibility criteria has impacted negatively on efficiency and effectiveness of Medicaid program in delivering quality health care services to its beneficiaries, particularly to the poor as anticipated early during the inception of the program. Therefore, Medicaid program is experiencing challenges in terms of formulation and implementation of policies and legislations to keep in tandem with increasing n umber of beneficiaries as well as cost of Medicaid. Since the cost of Medicaid seems to be unsustainable, comprehensive reforms are essential to streamline policies and legislations regarding eligibility criteria, management of funds and delivery of quality health care services to the increasing number of beneficiaries. Currently, it is predictable that Medicaid cost is going to overtake the growth of the United States economy unless appropriate reforms are in place to reverse or slow the ever-increasing cost of Medicaid (Levy 2008: 7). Thus, evaluation of Medicaid program is timely to provide robust recommendations that are essential in averting predictable health care crisis that may affect Medicaid beneficiaries. Methodology Scope and Purpose The purpose of the study is to evaluate Medicaid program by determining its efficiency, effectiveness, and accountability in delivering health care and medical services to the poor. To achieve its purpose, the study will examine the extent t o which Medicaid has implemented its policies and legislations towards achieving its objective of helping the poor to afford and access quality health care and medical services. Thus, to evaluate the effectiveness and efficiency of Medicaid program, the study will explore and collect primary data from Medicaid officials with a view of assessing the extent to which they have implemented relevant policies and legislations relative to expectations of the program. Moreover, the study will assess whether program activities are still in the program theory by evaluating process indicators of Medicaid program. Given that, Medicaid program is experiencing a challenge of increasing cost that seems to threaten its sustainability; the study will assess cost-effectiveness of its activities in delivering quality health care to the poor. To ascertain the impact of the program, the study will assess outcome indicators by collecting primary data from the poor, who are Medicaid beneficiaries. Evaluat ion Questions The study will conduct a survey, which targets two kinds of participants: Medicaid officials and beneficiaries. Medicaid officials will give information that is necessary in evaluating the extent to which Medicaid has implemented its policies and legislations. Moreover, they will also provide information that will enable researchers to examine process indicators and evaluate their effectiveness and efficiency in delivery of quality health care and medical services to the poor. Medicaid officials will also provide data regarding cost-effectiveness of Medicaid given that its cost is increasing gradually while threatening sustainability of the program. Hence, the following questions target Medicaid officials: Has Medicaid program implemented its policies and legislations according to its objectives? Is Medicaid program keeping in tandem with the program’s theory of helping the poor to access and afford health care and medical services? What are the recent reforms that Medicaid has done to improve delivery of health care and medical services to the poor? Since Medicaid cost is increasing gradually and is threatening the sustainability of the program, what are the cost-effective measures that are in place to reverse or slow increasing trends of cost? Is an eligibility criterion reliable in selecting beneficiaries who are low-income earners? Does Medicaid has contingency measures of coping with unprecedented increase in beneficiaries and subsequent Medicaid cost? What reforms are essential to enhance sustainability, effectiveness, and efficiency of Medicaid program? Additionally, the study will target Medicaid beneficiaries to collect formation that is necessary to assess outcomes or impact of Medicaid program on the poor. Thus, the study seeks to answer the following questions. Do you obtain quality health care and medical services through Medicaid Program? Does heath care system gives you quality health care and medical services as the rich p eople who have other insurance covers. Are you happy being a beneficiary of Medicaid? Has Medicaid effectively relieved your financial expenditure on medical bills? Since you became a beneficiary, has Medicaid improved or degraded quality of services that it offered with time? Since Medicaid expanded its eligibility criteria, has quality of health care and medical services changed for better or for worse? If you were in a position of influence, what are the recommendations that you would give to improve the delivery of quality health care and medical services? Target Populations The study will target Medicaid officials who are at the state level, who have vast experience regarding the formulation and implementation of policies and legislations that critical in enhancing Medicaid program to achieve its objectives. Medicaid officials are appropriate participants of the study because they can provide critical information concerning formulation and implementation of policies and legisl ations. Moreover, Medicaid officials know challenges that Medicaid is experiencing, for instance expansion of eligibility criteria, increasing number of beneficiaries and the rising cost that threatens the sustainability of the program among other related challenges. Fundamentally, Medicaid officials are appropriate participants because they can offer firsthand information to study that is critical in assessing and evaluating the efficiency and effectiveness of Medicaid program in providing quality health care and medical services that are not only accessible, but also affordable to the poor. Thus, the study will target Medicaid officials who manage Medicaid program at state levels. To assess outcome or impact of Medicaid program, the study will target Medicaid beneficiaries who obtain health care and medical services from local health centers. Medicaid beneficiaries will provide relevant information concerning quality of health care and medical services, which health care system of fers to them as beneficiaries of Medicaid. The quality of health care and medical services is a parameter that measures whether Medicaid program is delivering services to the poor as envisaged by its objectives. Since the Medicaid objective and program theory is to help the poor access and afford quality health care and medical services, Medicaid beneficiaries have relevant feedback, for they are consumers of services that Medicaid program offers. Therefore, Medicaid beneficiaries are appropriate participants of the study because they know quality of health care and medical services that Medicaid provide to the poor, and thus provide reliable information that is robust in assessment of Medicaid outcomes. Sampling Frames The study will sample 50 participants from Medicaid officials who are managing Medicaid program at the state level. A criterion of sampling is that the participants must be in managerial positions with experiences of more than 10 years when serving under Medicaid. Si nce Medicaid officials are remarkably few compared to Medicaid beneficiaries, 50 participants will give sufficient information that is critical in assessing the extent of implementing policies and legislations, program theory and other process indicators. Since there are various Medicaid offices within a state, the study will ensure that at least every office gets a chance to participate in the study. Sampling of participants from every Medicaid office within the state will enhance representation of Medicaid officials and improve external validity of the findings. The 50 participants are significant for the study to collect primary data, which is reliable and can give robust recommendations that are applicable to other states through extrapolation. Thus, the study will rely on primary data from the sample of 50 participants who represent Medicaid officials. Since the study also targets Medicaid beneficiaries, it will sample 150 participants. The study will sample 150 participants to enhance external validity of the study as well as considering the availability of resources to conduct an extensive survey. The study will sample participants based on the number of years that they have benefitted from Medicaid as eligible beneficiaries. The study will sample beneficiaries who have more than five years in utilizing Medicaid services in various health care centers. Medicaid beneficiaries, who have been relying on Medicaid services for over a period of five years, are appropriate because they understand long-term variation in quality of health care and medical services. Moreover, the study will also sample Medicaid beneficiaries who are married so that they can give essential information regarding how their family members have been receiving health care and medical services. Hence, 150 participants must be having over five years as Medicaid beneficiaries and must be married. Program Design To assess process indicators of Medicaid program, the study will conduct a qua litative study by administering open-ended questionnaires to 50 participants, who are Medicaid officials. The questionnaires will contain evaluation questions that seek to assess the effectiveness and efficiency of Medicaid program in delivering quality health care and medical services to the poor. Researcher will visit various Medicaid offices within the state and administer questionnaires to participants. The study will continue for a period of one week to ensure that all participants answer their questionnaires effectively. The questionnaires have evaluation questions that will enable researchers to collect robust data for assessing the efficiency and effectiveness of Medicaid program through process indicators. The study will also conduct a qualitative study to assess outcome indicators of Medicaid program by administering open-ended questionnaires to 150 participants derived from Medicaid beneficiaries. Given that the 150 participants have more than five years in utilizing Medi caid services, their vast knowledge regarding variation in quality of health care and medical services is an asset to assessment of Medicaid outcome or impact on the poor. Hence, open-ended questionnaires are appropriate in assessing quality of health care and medical services that Medicaid deliver to the poor. Hence, feedback from 150 participants is reliable in assessing quality of Medicaid services and their impact on the lives of the poor, who entirely rely on it as the only medical insurance available to them. Data Collection and Processing The study will collect qualitative data using open-ended questionnaires by administering them to 50 participants. The 50 participants are Medicaid officials sampled from various Medicaid offices. These participants have extensive experience of over 10 years serving under Medicaid, and currently, they hold managerial positions where they influence formulation and implementation of policies. To collect appropriate data, researchers will visit numerous Medicaid offices to administer open-ended questionnaires to the 50 participants. The researchers will have a period of one week to administer the questionnaires to participants and ensure that they complete their questionnaires appropriately. After administering questionnaires and collecting relevant data, the researchers will then analyze the data and provide it in summary form. Likewise, the study will collect qualitative data from 150 participants, who are Medicaid beneficiaries. To collect qualitative data, the study will employ open-ended questionnaires, which seek to answer evaluation questions that are critical in assessing quality of health care and medical services, which Medicaid offers to the poor. To access 150 participants who are married and who have been relying on Medicaid for more than five years, the researchers will visit various health care centers where participants usually obtain health care and medical services. As in the case of Medicaid officials, t he researchers will administer the questionnaires for a period of one week to ensure that all participants complete their questionnaires and eventually summarize the data for further analysis. Data Analysis The study will analyze data in terms of process indicators and outcome indicators. To assess the effectiveness and efficiency of Medicaid policies and legislations in delivery of quality health care and medical services, the study will analyze qualitative data by examining whether Medicaid have achieved significant progress through process indicators. The study will assess whether Medicaid policies and legislations are in tandem with program theory, and logic model of helping the poor to access and afford quality health care and medical services in the health care system. Additionally, to assess whether Medicaid is delivering quality services to the poor, the study will analyze and summarize questionnaires to derive relevant information regarding Medicaid impact using outcome ind icators. Outcome indicators will show if Medicaid beneficiaries are receiving quality health care and medical services as per the program theory. Thus, comprehensive analysis of the data will give robust recommendations that are critical in reforming Medicaid to achieve its noble objectives in providing quality health care to the poor. Conclusion Medicaid is a health program established by the Congress in 1965 to enhance accessibility and affordability of health care services to the poor and unprivileged in the society. It has gradually grown with time due to expansion of eligibility criterion of selecting beneficiaries. The eligibility criterion has included pregnant women, people living with HIV and disabled people among other distinct groups who need medical services. Due to increase in beneficiaries, Medicaid cost has been increasing faster than growth of GDP, hence threatening the sustainability of the program. Thus, to enhance sustainability, the study proposes to evaluate Med icaid program by assessing effectiveness and efficiency of implementing policies and legislations. Moreover, the study proposes to assess the quality of health care and medical services that Medicaid offers to the poor. Reference List DeParle, Nancy-Ann. 2000. A Profile of Medicaid. U.S. Department of Health and  Human Services, 1-87. Dorn, Stan. 2004. Medicaid Coverage for Poor Adults: A potential Building Block for Bipartisan Health Reform. Economic and Social Reform Institute, 1-25. Egert, Beau. 2003. Medicaid Issues and Challenges. Texas Public Policy Foundation, 4-11. Levy, Elliot. 2008. Gifted and Medicaid. Journal of Finance and Accountancy, 1-8. Sheldon, James. 2005. Medicaid and Persons with Disabilities: A Focus on Eligibility, Covered Services and Program Structure. School of Industrial and Labor Relations Employment and Disability Institute, 1-24. Truffer, Christopher, John Klemm, Christian Wolfe, and Kathryn Rennie. 2010. Actuarial Report on the Financial Outlook for Medicaid. Centers for Medicare Medicaid Services, 1-39. Zommorrodian, Asghar, and Lucica Matei. 2010. Program Evaluation: Its Significance and Priority for Shaping and Modification of Public Policies: A comparative Analysis. American Society of Business and Social Sciences 17, no.1 (February): 979-996.

Impact of piracy on movie and music industry of UK Dissertation

Impact of piracy on movie and music industry of UK - Dissertation Example This "Impact of piracy on movie and music industry of UK" work research if the piracy killing this industry. . It is estimated that in the year 2008 almost 40 billion songs were illegally downloaded from the internet (Vandiver, Bowman and Vega, 2008). Every year 95 percent of the songs are downloaded without payment and referring to the copyright owner of the songs and movies (Vandiver, Bowman and Vega, 2008). In recent years the sales of the CD have skyrocketed and the blame has been placed upon Peer to Peer (P2P) file sharing of songs. Internet has become one of the most celebrated democratising medium (Meissner, 2012) that renders traditional individual gatekeepers who controlled the access of information to the traditional media but also allows greater choice of information (Meissner, 2012). Audience have a greater choice for viewing a movie which has been released lately without the fear of being supervised by the gatekeepers. Prior to the internet, Movie viewing was only availa ble through movie theatres, DVD and cable television network. The availability was finite and certain movies were not released in certain countries (Meissner, 2012). Ethics and value have changed and the consumer perception on audio visual piracy has changed. There has been a significant increase in the rise of digital piracy which reflects that consumer attitudes does not always translate into purchase intentions even though unauthorized downloading of music and piracy is prohibited (Vida et. al., 2012). 2.2 Purpose of the study The main purpose of the study is to analyze the impact of piracy on the UK movie and music industry. The study will also analyze the damage caused by file sharing and piracy on these industries and ethical values of the consumers. The study will also emphasize on the consumer attitude towards audio visual piracy and violation of copyright act. 2.3 Research Objectives The objectives of this research study are ascertained in line with the purpose of the st

Financial analysis of a company Assignment Example | Topics and Well Written Essays - 2250 words

Financial analysis of a company - Assignment Example It is extensively relied on the notion of â€Å"Celebrity Endorsement† to advertise its leading brands. Major events that occurred during the last 4 fiscal years The purchase of Rocca In 2008, Damiani Group acquired â€Å"Rocca†, a high end jewelry and watch chain leader in Italy. Rocca will represent as the first distribution brand of Damiani and it will help sell all the leading brands of the company. The acquired company has its strong footprints in the Italian market. Commercial and licensing agreements During the year 2009, the Group has signed commercial and licensing agreements for the creation, design and distribution of jewelry lines with the prestigious brands. Balance Sheet *Balance Sheet (In thousand Euros) 2008 2009 2010 2011 Inventories 94,713 121,192 106,108 96,192 Trade receivables 65,794 54,551 42,971 31,232 Tax receivables 394 5,571 3,661 2,788 Other current assets 14,718 12,619 9,777 11,401 Current financial receivables       - 1,074 Cash and cash equivalents 52,813 9,542 7,332 10,217 TOTAL CURRENT ASSETS 228,432 203,475 169,849 152,904 Goodwill 5,002 5,002 4,984 4,984 Other Intangible Fixed Assets 7,056 9,204 7,504 5,596 Tangible Fixed Assets 14,698 26,626 20,397 17,590 Investments 169 169 167 167 Financial receivables and other non current assets 2,663 4,655 4,479 3,493 Deferred tax assets 12,229 18,552 19,807 19,854 TOTAL NON CURRENT ASSETS 41,817 64,208 57,338 51,684 TOTAL ASSETS 270,249 267,683 227,187 204,588                Current portion of long term financial debt 5,162 9,681 10,040 7,861 Trade payables 65,305 70,923 57,945 54,673 Short term borrowings 16,229 2,593 1,964 5,965 Income tax payables 2,752 8,977 2,399 2,425 O ther current liabilities 5,090 6,350 4,819 4,862 TOTAL CURRENT LIABILITIES 104,675 88,387 77,167 75,786 Long term financial debt 16,631 22,029 34,356 26,316 Termination Indemnities 4,223 4,868 4,693 4,325 Deferred Tax liabilities 2,608 4,227 864 1,131 Risk reserves       649 1,431 O t her non current liabilities 2,441 2,046 431 493 TOTAL NON CURRENT LIABILITIES 25,903 33,170 40,993 33,696 TOTAL LIABILITIES 137,845 114,290 118,160 109,482 Share Capital 36,344 36,344 36,344 36,344 Reserves 102,742 96,691 89,438 71,890 Group net income (loss) for the period 15,127 (4,709) (18,242) (14,525) TOTAL GROUP SHAREHOLDERS' EQUITY 154,213 128,326 107,540 93,709 MINORITY SHAREHOLDERS' EQUITY             Minority share capital and reserves 1,571 1,668 1,513 1,422 Minority net income (loss) for the period 175 (156) (26) (25) TOTAL MINORITY SHAREHOLDERS' EQUITY 1,746 1,512 1,487 1,397 *As on 31 March of each FY Income Statement Income Statement (In thousand Euros) 2008 2009 2010 2011 Revenues from sales and services 164,919 149,289 145,365 143,323 Other recurring revenues 683 502 390 226 Other non-recurring revenues 8,506          TOTAL REVENUES 174,108 149,791 145,755 143,549 Costs of raw materials and consumables (69,898) (71,090) (82,595) (79,476) Costs of servi ces (53,719) (55,847) (50,226) (46,229) Personnel cost (24,249) (28,251) (27,017) (24,821) Other net operating (charges) incomes 2,397 6,518 843 903 Amortization and depreciation (2,503) (4,191) (5,886) (4,884) TOTAL OPERATING EXPENSES (147,972) (152,861) (164,881) (154,467) OPERATING INCOME (LOSS) 26,136 (3,070) (19,126) (10,918) Financial Expenses (3,312) (2,651) (3,065) (2,926) Financial Incomes 2,153 2,277 350 377 INCOME (LOSS) BEFORE INCOME TAXES 24,977 (3,444) (21,841) (13,467) Income Taxes (9,675) (1,421) 3,573 (1,083)

HR Training and Development Essay Example | Topics and Well Written Essays - 250 words

HR Training and Development - Essay Example should be to make sure that the employees follow a certain standard operating procedure within the workplace and they must not adhere to any other specifications than what have been told by the organization. The training procedures need to be elaborate covering all necessary details in such a manner that there is enough learning for everyone. The training regimes therefore bank on the experience which has been gained and which shall be used for the betterment of the employees in the long run (McCracken, 2005). The effectiveness of the training programs is significant and this can be gauged through the productivity shown by the employees once they implement these training realms within their respective quarters. This means that the different tangents behind these training modules would ask for a better understanding of the employees as per their work measures and how they are able to showcase their strengths and weaknesses as and when

The Representation Of Disabled People In Film

The Representation Of Disabled People In Film The purpose of this assignment is to critically analyse the stereotypical portrayals of disabled people in the media. It is mainly concerned with the misrepresentation of disability in films, especially the horror genre. It aims to consider the effect that the media has o disabled identity, highlighting the power of body image and personal experience on the development of both individual and group identity. In examining the mechanisms of how we read film, the exchange of looks, of identification, and of pleasure offered and obtained, we find that notions of masculinity and femininity predominate spectator text relations. Media often turns people into objects and this can bring terrible consequences as self-image can be deeply affected with their interpretations of what is acceptable and visually pleasing in contemporary bodies. Girls self-esteem plummets during adolescence partly because they cannot escape the message that their bodies are objects and imperfect ones at that. Girls of all ages get the message that they must be flawlessly beautiful and, above all these days, they must be thin. Even more destructively, they get the message that this is possible, that with enough effort and self-sacrifice, they can achieve this ideal. The glossy images of flawlessly beautiful and extremely thin women that surround us would not have the impact they do if we did not live in a culture that enc ourages us to believe we can and should remake our bodies into perfect commodities. Women are especially vulnerable because their bodies have been objectified for so long. According to Clarkes (1995) media representations of embodiment show how the computer-generated body of the hyperreal world also persist in negating a disabled embodiment. The use of body doubles in films and commercials makes it even less likely that we will see real womens bodies. Davies (1997:1) writes, People with disabilities have been isolated, incarcerated, observed written about, operated on, instructed , implanted, regulated, treated, institutionalised, and controlled to a degree probably unequal to that experienced by any other minority group. Oliver (1990: 1) writes, Throughout the twentieth century disabled people continue to be portrayed as more than or less than human, rarely as ordinary people doing ordinary things. The world is fast becoming a global market place controlled not by individual governments but by transnational conglomerates interested only in profits (OShaughnessy, 1999). The influence of these huge and powerful corporations on the media leads to a pernicious kind of censorship. The problem is exacerbated by the fact that many of these corporations own and control the media. The medias development has been affected by commercial interests that recognise that the media are potentially highly profitable industries (OShaughnessy, 1999:2). This point helps to demonstrate that media representations are not always genuine or accurately reflecting reality. The media uses visual images to tell a particular story ant these experiences often help guide opinions and values. The consumption of the media, and in particular media forms such as TV and film, has become extremely popular. Not only do the media reflect societal values, but it can be assume that it also encourages certain ideals. Stigma, Stereotyping and Prejudice There is no established single theory of stigma, which is not surprising as stigma embodies a complex interaction between medicine, political affairs, social science, history, psychology, anthropology (Smith, 2002). Smith goes on to state that the significant stage in the generation of stigma is the perception of difference and for stigmatisation to take place, the differences observed will be related to undesirable traits. Smith used the example of people suffering from a mental illness being stereotyped as being violent and unpredictable. Marks (1997, p.86) draws attention to the moving image media representations, that divide the able bodied and people with impairments. According to Sarfan (1998) much has been written on the damaging, stereotypical representation of people with all manner of impairments in film. Wahl (1995) states that films with disability themes stigmatise those with similar characteristics as: infantile; savants; sexually abnormal and bitter; deviant and violent and dependent and pitiable. According to Whittington- Walsh (1997) people with a variety of impairments have been exhibited for amusement and gain as freaks for countless years and it proved to be a lucrative business. Even though spectators turned away from the freak shows at the beginning of the nineteenth century images of people with impairments as entertainment did not cease to exist. Mainstream film industry has produced many films showing characters with impairments. More often than not, disabled people in film are portrayed as pitiable and pathetic such as John Merrick, paraded as a freak in The Elephant Man (1980, David Lynch, Uk), or as victims an objects of violence such as Suzy Hendrix who was blind and intimidated by drug dealers in Wait until Dark (1967, Terrance Young, USA) or as asexual such as the disabled war veteran, Ron Kovic, in Born on the 4th of July (1989, Oliver Stone, USA). These are but a few of the distorted portrayals of disabled people in the media. According to Marks (1997, p.86) these individuals are presented as Other who are completely different from us. Very rarely are disabled people accurately shown as leading ordinary lives. Stigmatised individuals and groups frequently lack power to alter such views and as such their status diminishes further. Our opinions about different groups of people are often totally irrational. They are influenced by factors such as our membership of a group (ethnocentrism) and by our experience, no matter how small, of that group. Some of these ideas may be positive and some may be negative but often these opinions or attitudes are based on very little information. The process of grouping people together and believing that they are all the same is known as stereotyping. The term stereotype was introduced by Walter Lippmann in 1922 (cited in Brown, 1986) and was defined as being an oversimplified view of the world that satisfies our need to see the world as more understandable and manageable than it really is. What he actually meant was that if we can attribute a whole set of characteristics to something, we will not have to analyse the thing each time we meet it in order to know about it. Stereotyping involves classifying people according to a set of pre-established criteria and this kind of classification is usually made on the basis id something as superficial as their appearance. What the person is actually like is totally irrelevant because we simply attribute all sorts of characteristics to them on the basis of the group that we have put then with. According to Tajfel (1982), the process of trying to give ourselves some kind of positive identity seems to explain why people have what are known as in group preferences. If we are assigned to a group, any group, either by birth or by design, we instantaneously seem to feel a kind of innate, automatic preference for that group and give the group a higher status than other groups. The in group bias is merely a method of increasing our own self-esteem. If a group believes it is less worthy than others, it will be more likely to accept any prejudice shown to them without objection because they believe it is justified. The nature of social power dynamics and group hierarchy make stereotypes particularly oppressive for certain individuals and groups (Operario et al., 1998). In particular: †¦individuals whose outcomes are controlled by others, and groups low in the social hierarchy, are vulnerable to the demeaning content of their stereotypes. Conversely, individuals who control others outcomes, and groups near the top of the social hierarchy, are more likely to employ stereotypes about others †¦ (Fiske, 1993) Because of their dependence on the powerful, the powerless direct their attention up the hierarchy and do not categorise those with power. But the powerful themselves are too busy, too unconcerned with accuracy, or too dominance-orientated to pay any attention to the powerless. They, therefore, tend to categorise and form highly stereotypical impressions of those over whom they can exert power (Oakes, 2004). Powerful people simply pay less individuating attention to their subordinates- that is, they treat them less as individuals, while the reverse is true for subordinate individuals and groups. According to Operario and Fiske (2004): †¦ Not only does power perpetuate beliefs associated with social subordinates and minority groups, it also enables people to act upon stereotypical beliefs through legislation, economic policies, and institutional practices†¦ A counterintuitive finding is the tendency for the powerless and disadvantaged to show biases that justify and maintain their groups low status (that is, they accept the status quo). This helps explain why social injustice can endure within cultural contexts that outwardly endorse egalitarianism and equality. But this is not necessarily the same as internalising negative stereotypes. Members of low-status groups tend to achnowledge their groups disadvantaged status, but minimise perceptions of personal vulnerability to discrimination. In this way, they can maintain their self-esteem and personal control, and avoid feeling personally victimised (Operario and Fiske, 2004). Sometimes the attitudes we have towards a group of people are extreme and we call this kind of extreme attitude prejudice. This prejudice can be either positive or negative depending on the person holding the views. Often these extreme attitudes have virtually no foundation in reality and are based simply on some minor attribute like appearance, are influenced by factors such as the media and the way we have been socialised. Supposing someone has something about their appearance that they have no control over-how must they feel? The studies by Piliavin (1969) in the subway showed that people with ugly facial birthmarks were not helped as frequently. Were they being stereotyped on the basis of some external characteristics and consequently suffering some king of prejudice to do with the fact that their appearance was not perfect? Even when prejudices are irrational, if they are maintained or perpetuated by society they cab have vey dangerous consequences for the person concerned. The person on the receiving end is likely to develop very low self-esteem, seeing themselves as less worthy than people holding their prejudiced views. However, there is evidence to show that if you have an expectation that people will be prejudiced towards you, this may in fact lead you to perceive a situation in a different way to people who have no expectation of prejudice. This was demonstrated by a study done by Kleck and Strenta (1980) who applied make-up to their participants to make them look as if they had an extremely large, ugly facial scar. After checking their appearance in a mirror, the researchers applied some cream to set the make-up but what they actually did was remove the scar. The participants then spent some time interacting with another person and reported back on whether the scar affected their interactions. Even though there was no disfigurement, the participants reported that their appearance had influenced the way the other person behaved towards them. This suggests that people may well explain the way people behave towards them as being due to their membership of a particular group. This may help us unders tand the perceptions of minority groups who believe they are being persecuted, even when this is not the case. Freaks Around the time Todd Brownings Freaks was made the meaning of freak was changing. Ceasing to be a celebrated exotic attraction, it was becoming medicalised, developing into a scientific specimen. Freaks was perhaps the first film to use a full cast of genuine sideshow people and expose viewers to images of abnormal bodies enjoying daily life, together with their normal sensual desires. However, audiences were engaged not through empathy, but revulsion from the physical differences shown and were outraged by the Freaks avenging themselves on so called normal bodies. The 30 year ban demonstrates how deeply we share cultural ideas about disabled people and images of impaired bodies. The bodies of the actors did not match with how the dominant U.S. culture defined what a body should look like or what it should be able to do. Their bodies were considered inferior when compared with people who were considered normal. Freaks has often been criticised because of its association with the negative representation of disability within the horror film genre. Conversely, it has also been praised because its portrayal of disability was in fact far more lifelike than that portrayed in numerous other films. Whittington-Walsh (2002, p.698) states: Freaks is unique in the fact that we only see characters with disabilities in their day to day lives and we never see them in the mode of presentation used in Freak shows and other films. We only see them in their actual social identity. Fiske, S.T. (1993) Controlling other people: The impact of power on stereotyping. American Psychologist, 48(6), pp.621-628. Oakes, P. (2004) The Root of All Evil in Intergroup Relations? Unearthing the Categorisation Process. In Brewer, M. B. and Hewstone, M. (2004) (eds) Social Cognition. Oxford: Blackwell Publishing. Operario, D., Goodwin, S.A., and Fiske, S.T. (1998) Power is everywhere: Social control and personal control both operate as stereotype activation, interpretation , and response. In Wyer, R.S. (1998) (ed.) Advances in social cognition (Volume 11) Mahwah, NJ: Lawrence Erlbaum Associates. Operario, D. and Fiske, S.T. (2004) Stereotypes: Content, Structures, Processes and Context. In Brewer, M. B. and Hewstone, M. (2004) (eds) Social Cognition. Oxford: Blackwell Publishing.

End of Poverty Guide Essay

Jeffrey Sachs was a professor of Economics at Harvard for 38 years and was a major consultant for many nations. He now heads the Earth Institute. His views on the causes of poverty are very different than what is normally thought or presented. His book has 18 chapters which are broken down as follows: †¢ Chapters 1-4 present an overview of the problem and overall solutions to poverty. †¢ Chapters 5-10 details Sachs’ experience in working with Bolivia, Poland, Russia, China, India, and Africa, solving major economic problems. †¢ Chapter 11 deals with the Millennium Development Goals and 9/11 †¢ Chapter 12 deals with on-the-ground solutions, which in reality is a high priced CHE. †¢ Chapters 13-18 map out the details of his solutions. Sachs throws out the normal ways of thinking about the causes of poverty in countries, for instance that people are lazy or stupid, or the countries are not democratic, and that corruption is wide-spread. Fifty percent of the world’s population exists on less than one dollar per day. He believes that much of the problem is structural, which can only be dealt with through the help of the rich countries. Sachs believes, first of all, that all current debt owed by the poor countries should be cancelled. Secondly, if the rich countries would increase their development aid from .2% to .7% there would be enough money available to increase the economic growth so that all countries would no longer be extremely poor. If MAI is to become known as an agency which teaches a new way of dealing with poverty, then we need to become aware of this book and Sachs understanding and approach to poverty. Chapter Twelve really speaks to CHE. I have tried to review what has appeared to me to be the most salient points, chapter by chapter. All chapters are not treated equally. I primarily do this exercise for myself to help me understand the key points from the book. If they are of any help to others, then that is a plus. I have gone into more detail in the other synopsis I have done because of the possible guidance this book can give us for a new paradigm for dealing with poverty individually, locally, nationally and globally (which in reality we are already on the road in doing). Some things are both structural and governmental issues and I am not suggesting that we get involved in these, but change must begin at the village level and then we can scale up our strengths from there. Chapter One–A Global Family Portrait Sachs sets the stage for his thesis and book using examples of Malawi, Bangladesh, India, and China to show different levels of poverty. He talks abut the ascending ladder of economic development for countries. †¢ Lowest are those who are too ill, hungry, or destitute to get even a foot on the bottom rung of the development ladder. They make up the bottom 1/6 of the world’s population, or one billion people. They are the poorest of the poor and live on less than $1 a day. †¢ A few rungs up the ladder at the upper end of the low-income countries are another 1.5 billion people. They live just above the subsistence level. These two groups make up 40% of the world’s population. CHE targets both of these groups, and especially with the first group. †¢ Another 2.5 billion include the IT workers of India. Most of them live in the cities and are moderately poor. †¢ One billion or one-sixth of the world come from the rich developed countries. Sachs says the greatest tragedy of our time is that one-sixth of the world’s population is not even on the first rung of the ladder. A large number of the extremely poor in level one are caught in the poverty trap and cannot escape it. They are trapped by disease, physical isolation, climate stress, environmental degradation, and extreme poverty itself. He breaks poverty into three levels: †¢ Extreme poverty means households cannot meet basic needs for survival. This only occurs in developing countries. World Bank says their income is less than $1 a day. †¢ Moderate poverty is where needs are generally just barely met. World Bank says this represents countries where their income falls between $1 and $2 per day. †¢ Relative poverty generally describes household income level at being below a given percentage of the average national income. You find this in developed countries. He then presents the Challenge of our Generation which includes: †¢ Helping the poorest of the poor escape the misery of extreme poverty and help them begin their climb up the ladder of economic development. †¢ Ensuring all who are the world’s poor, including moderately poor, have a chance to climb higher in economic development. He believes that the following can be done: †¢ Meet the Millennium Development Goals by 2015. †¢ End extreme poverty by 2025. †¢ To ensure well before 2025, that all of the world’s poor countries can make reliable progress up the ladder of economic development. †¢ To accomplish this with modest financial help from the riches countries, which will be more than is now provided per capita. Chapter Two–The Spread of Economic Prosperity Sachs uses several graphs in this chapter. I will not go into detail on these, but I will point out some salient points: †¢ All regions of the world were poor in 1820. †¢ All regions experienced economic progress, though some much more than others. †¢ Today’s richest regions experienced by far the greatest economic progress. As an example, Africa has only grown at .7% a year while the USA at 1.7%. This may not seem much, but when compounded year-by-year, it results in the great differences between the two. †¢ The key fact today is not the transfer of income from one region to another, but rather that the overall increase in the world’s income is happening at different rates in different regions. Until the 1700’s, the world was remarkably poor by today’s standards. A major change was the industrial revolution coming to certain regions and not to others. The steam engine was a decisive turning point because it mobilized the vast store of primary energy which unlocked the mass production of goods and services. Modern energy fueled every aspect of the economic takeoff. As coal fueled industry, industry fueled political power. Britain’s industrial breakthrough created a huge military and financial advantage. But Britain also had existing individual initiative and social mobility than most other countries of the world. They also had a strengthening of institution and liberty. Britain also had a major geographical advantage–one of isolation and protection of the sea, in addition to access to the oceans for worldwide transportation for their goods and importation of other countries’ goods. Sachs then goes on to outline what has fostered major economic growth: †¢ Modern economic growth is accompanied by people moving to the cities, or urbanization. This means fewer and fewer people produce the food that is required for the country. Hopefully, food price per farmer decreases as larger plots are farmed more productively. This also means sparsely populated land makes good sense when many farms are needed to grow the crops, but sparse land makes little sense when more and more people are engaged in manufacturing in the cities. †¢ Modern economic growth fostered a revolution in social mobility which affected social ranking of people. A fixed social order depends on status quo and agrarian population. †¢ There is a change in gender roles with economic development. This affects living conditions as well as family structure. The desired number of children decreases. †¢ The division of labor increases. By specializing in one activity instead of many, producti vity increases. The diffusion of economic growth occurred in three main forms: †¢ From Britain to its colonies in North America, Australia and New Zealand. (It was therefore relatively straight-forth to transfer British technologies, food crops and even legal institutions.) †¢ A second diffusion took place within Europe that ran from Western Europe to Eastern Europe, and from Northern Europe to Southern Europe. †¢ The third wave of diffusion was from Europe to Latin America, Africa, and Asia. Sachs believes that the single most important reason for prosperity spread is the transmission of technology and the ideas underlying it. The technological advances came at different times. †¢ The first wave revolved around the invention of the steam engine which led to factory-producing goods. †¢ The second wave in the 19th century was led by the introduction of the rail and telegraph. It also included the introduction of steam ships instead of sailing ones, and the construction of the Suez Canal. †¢ The third wave was initiated by electrification of industry and urban society. Along with this came the development of the internal combustion engine. †¢ The fourth wave came in the 20th century with the globalization of the world due to new methods of communication starting in Europe. †¢ There came a time of a great rupture which took place with the start of World War I, and sidetracked economic development for awhile. This led to the Great Depression which led to World War II. †¢ A fifth wave took place right after World War II, and in 1991. It began with the massive efforts of reconstruction of Europe and Japan right after World War II. Trade barriers began to come down. There were three worlds: the first was the developed West, the second was comprised of Socialist countries, and the third was made up of undeveloped countries (which were made up of the old colony countries). The world therefore progressed on three tracks. The problem was that the second and third worlds did not share in economic growth and actually went backward. By closing their economies, they closed themselves off from economic development. So what did this mean to the poorest of the poor countries? †¢ They did not begin their economic growth until decades later. †¢ They faced geographical barriers of being land-locked †¢ They faced the brutal exploitation of the colonial powers. †¢ They made disastrously bad choices in their national policies. Chapter Three–Why Some Countries Fail In this chapter, Sachs looks at the cause of poverty and possible solutions. He first deals with, how a family’s per-capita income might increase: †¢ The first way is through savings– either in cash or similar assets like animals, etc. †¢ The second way is shifting to crops that bring a higher yield per hectare, and then adding value to the crop (which is what we teach in our PAD training). †¢ The third way is adopting new technology, which improves their productivity. †¢ The fourth way is resource boom, which means to move to a much larger and more fertile farm. The flip side of increasing their economic growth is by decreasing their per capita income which is more than just the opposite of the above factors: †¢ Lack of savings is of course one way to reduce per capita income. †¢ Lack of trade, meaning that a household hears of the new crop but cannot take advantage of it and stays with what they have. †¢ Technological reversal is when something like HIV hits an area and children lose their parents etc. †¢ Natural resource decline is where the land becomes less and less fertile producing less and less crops. †¢ Adverse Productivity Shock is where a natural disaster hits like a drought, tsunami, earthquake, typhoon, etc. †¢ Population growth lessens per capita income where the father has two hectares of land and it is divided among his five sons at his death. Now Sachs begins to get into the true heart of poverty on a country level: †¢ The poverty trap itself is where poverty is so extreme that the poor do not have the ability by themselves to get out of the mess. †¢ Physical geography plays a major role where countries are land-locked with poor or no roads, a lack of navigable rivers, or situated in mountain ranges or deserts with an extremely high transportation cost. The low productivity of the land is another factor in the geography. †¢ The fiscal trap is where the government lacks the resources to pay for the necessary infrastructure on which economic growth depends. †¢ Government failure happens when the government is not concentrating on high priority infrastructure and social service projects. †¢ Cultural or religious barriers especially as it relates to gender inequality play a significant role in dampening economic growth. †¢ Geopolitics such as trade barriers can impede economic growth. †¢ Lac k of innovation and technology plays a role if people cannot try new things because they cannot risk failure, or because they do not have funds to do so. Sachs believes that over the span of two centuries, the lack of using new technology is why the richest and poorest countries have diverged. †¢ He shows a scatter-gram graph showing there is a demographic trap as well. The higher the fertility rate, the lower rate of economic growth there is in a country. When they have too many children, they cannot invest in education, nutrition, or health, except maybe for the oldest male. One of the best ways to lower the number of children per family is through the education of the girls. Sachs then goes into detail in putting countries into different classes. He points out that none of the rich countries in North American, Western Europe or East Asia have failed to grow economically. All the problems lie in the developing world where 45 of these countries had a fall in GDP. Not all of these countries are in sub-Saharan Africa. He also points out that the oil-exporting and ex-Soviet countries, all high income countries, did not increase their economic growth evenly, primarily because of their authoritarian political structure. He also points out that the most important factor is agriculture. Those countries that used high yield cereals per hectare and that used high levels of fertilizers are the poor countries that tended to experience economic growth. In Africa, the land is much less densely populated but they use neither high yield cereals nor fertilizers and they had falling food production per capita. But they also have far less roads for transporting extra crops to markets and they depend on rainfall which is generally more erratic than high-producing agricultural countries. He also goes on to point out the following: †¢ Economic growth is rarely uniformly distributed across a country. †¢ Governments also fail in their role in allowing growth that might enrich the rich households, while the poorest living in the same area seldom seem to benefit. †¢ Another detriment to growth can be culture especially as it relates to women inequality. Chapter Four–Clinical Economics (CE) Sachs compares clinical economics to clinical medicine. He lays out five parameters for Clinical Economics: †¢ CE is made up of complex systems. The failure in one system can lead to cascades of failures in other parts of the economy. You therefore need to deal with very broad and multiple issues. †¢ CE practitioners need to learn the art of clinical diagnosis. The CE practitioner must hone-in on the key underlying causes of economic distress and prescribe appropriate remedies that are tailor-made to each country’s condition. †¢ Treatment needs to be viewed in family terms, not individual terms. The entire world is part of each country’s family. If countries work together they can have far more impact than working in isolation. †¢ Good CE practice requires monitoring and evaluation. More than just asking if the goals are being achieved, but also asking â€Å"why?† and â€Å"why not?† †¢ The development community lacks the requisite ethical and professional standards. Economic development does not take its work with the sense of responsibility that the task requires. It demands that honest advice be given. He points out where economic development practice has gone wrong: †¢ The rich countries say, â€Å"Poverty is your own fault. Be like us, have a free market, be entrepreneurial, fiscally responsible and your problems will be gone†. †¢ The IMF period of structural adjustment which supposedly dealt with the four maladies of poor governance, excessive government intervention in the markets, excessive government spending, and too much state ownership were not solved by the IMF prescription of belt tightening, privatization, liberalization, and good governance. †¢ The responsibility for poverty reduction was assumed to lie entirely with poor countries themselves. He then lays out his differential diagnosis for poverty reduction. He believes the Millennium Development Goal (MDG) goes a long way in reducing poverty. Once the diagnosis is completed, a proper treatment regime must be carried out. In doing differential diagnosis, questions must be asked in each one of the following areas: †¢ Identify and map the extent of extreme poverty– from the household level all the way up through the community to the country to the state– in all areas of life. †¢ The second set of questions deals with the economic policy framework. †¢ The third set deals with the fiscal framework. †¢ Fourth deals with physical geography and human ecology. †¢ Fifth, the questions deal with the patterns of governance. History has shown that democracy is not a prerequisite for economic development. †¢ Sixth are questions which deal with cultural barriers that hinder economic development. †¢ The last are questions that are related to geopolitics which involves a country’s security and relationship with the rest of the world. The next six chapters, five through ten, deal with specific countries that have gone through this process, and their results. His results are quite impressive. I will not deal much with each country, but an individual chapter might be of interest to the RC involved if he is interested in such things. Chapter Five–Bolivia’s High Rate of Inflation Problem: A hyperinflation rate of 3000% (30 times) between July 1984 and July 1985 with a longer term hyperinflation rate of 24,000%. Lessons Learned: †¢ Stabilization is a complex process. Ending a large budget deficit may be the first step but controlling the underlying forces that cause the budget deficit is much more complex. †¢ Macroeconomics tools are limited in their power. †¢ Successful change requires a combination of technocratic knowledge, bold political leadership, and broad social participation. †¢ Success requires not only bold reforms at home, but also financial help from abroad. †¢ Poor countries must demand their due. Chapter Six–Poland’s Return to Europe Problem: By the end of 1989, Poland had partially suspended its international debt payments. The economy was suffering from high rate of rising inflation and there was a deepening political crisis. Sachs’ approach in Poland, as in other countries, was built on five pillars: †¢ Stabilization–ending the high rate of inflation, establishing stability and convertible currency. †¢ Liberalization–allowing markets to function by legalizing private economic activity (ending price controls and establishing necessary laws). †¢ Privatization– identifying private owners for assets currently held by the state. †¢ Social net–pensions and other benefits for the elderly and poor were established. †¢ Institutional Harmonization–adopting, step-by-step, the economic laws, procedures, and institutions. Lessons Learned: †¢ He learned how a country’s fate is crucially determined by its specific linkages to the rest of the world. †¢ Again the importance of the basic guidance concept for broad-based economic transformation, not to stand alone with separate solutions. †¢ Saw again the practical possibilities of large-scale thinking †¢ He learned not to take â€Å"no† for an answer, press on with your guidance. †¢ By the time a country has fallen into deep crisis, it requires some external help to get back on track. †¢ This help may be in the form of getting the basics right which includes debt cancellation and help to bolster confidence in the reforms. Chapter Seven–Russia’s Struggle for Normalcy Problem: The Soviet Union relied almost entirely on its oil and gas exports to earn foreign exchange, and on its use of oil and gas to run its industrial economy. In the mid- 1980’s, the price of oil and gas plummeted and the Soviet Union’s oil production began to fall. Sachs suggested three actions of the West (but generally they were ignored by the West): †¢ A stabilization fund for the ruble. †¢ Immediate suspension of debt repayment followed by cancellation of their debts. †¢ A new aid program for transformation focusing on the most vulnerable sectors of the Russian economy. Lesson Learned: †¢ Despite much turmoil and rejection much went right so that eventually Russia became a lopsided market economy, still focused on oil and gas. †¢ Russia has a gigantic land mass which causes it to have few linkages with other nations of the world. †¢ Their population densities are low and agrarian and food production per hectare remains low. Over history, 90% of the population has been rural, with cities few and far between. This hinders economic growth. †¢ Without adequate aid, the political consensus around the reforms was deeply undermined, thereby compromising the reform process. Chapter Eight–China Catching Up after a Half Millennium Being Isolated Problem: China lost its economic and cultural lead that it had in its early history. Sachs points out five dates which caused this: †¢ 1434 China had been the technological superpower. This year Emperor Ming closed China to the rest of the world and stopped their advanced ship fleets from going out to the world. †¢ 1839 China finally ended its economic isolation. †¢ 1898 Several young reformers tried to gain power and were stopped. †¢ 1911 Ching Dynasty collapsed and by 1916 China was falling into civil unrest. Their military took control of the empire. †¢ 1949 the rise of the Maoist Movement. He then compares China to Russia: †¢ The Soviet Union and Eastern Europe had massive foreign debt while China did not. †¢ China has a large coastline that supported its export growth, while Russia and Eastern Europe do not. †¢ China had the benefit of large off-shore Chinese business communities which acted as foreign investors, while Russia and Eastern Europe did not. †¢ The Soviet was experiencing a drastic decline on their main export product, oil and gas. †¢ The Soviet Union had gone further down the industrialization road than China. Chapter Nine–India Market Reform Which Was the Triumph of Hope Over Fear Problem: India was controlled by a business, British East India Company, which was driven by greed, and it did everything to maximize profit for the company at the expense of the country. Though India’s population throughout history has been Hindu, vast numbers of Muslims and Christians lived in and sometimes dominated the land. India had poor political and social structures because the land was broken into many small kingdoms governed by many different leaders. In addition, India has the caste-system of stratification of peoples. With independence from the British in 1947, Nehru looked for a path to self- sufficiency and democratic socialism. The Green Revolution had a major impact on the country as high yield crops were introduced. By 1994, India now faced four major challenges: †¢ Reforms needed to be extended especially in liberalization and the development of new and better systems. †¢ India needed to invest heavily in infrastructure †¢ India needed to invest more in health and education of its people, especially the lower castes. †¢ India needed to figure out how to pay for the needed infrastructure. Lessons Learned: †¢ The 21st century is likely to be the era when this poor country’s economic development is substantially reversed. †¢ The country has announced electricity for all as well as essential health services and drinking water for everyone. These are achievable goals and the basis for much-needed investment. †¢ The Hindus did not stifle growth. The Green Revolution and then market reforms overrode the rigidness of the caste-system and the slow growth of the 1950’s and 1960’s. †¢ India has become increasingly urbanized, thereby further weakening the caste-system. †¢ Democracy is wearing away age-old social hierarchies. †¢ India has grabbed the potential of the internet and IT and is leading the way for developing nations in this regard. †¢ India’s varied geography and its miles and miles of shoreline fosters its market position for the manufacture of products. Chapter Ten–Africa and the Dying Problem: Three centuries of slave trade were followed by a century of colonial rule which left Africa bereft of educated citizens and leaders, basic infrastructure, and public health facilities. The borders followed arbitrary lines, not historic tribal lines which now divided former empires, ethnic groups, ecosystems, watersheds, and resource deposits. The West was not willing to invest in African economic development. Corruption was not the central cause for their economic failure as he showed. In the 1980’s, HIV became the worse killer of mankind. In 2001, life expectancy stood at 47 years, while East Asia stood at 69 years, and developed countries at 78 years. Sachs spends time looking at the major diseases of malaria, TB, diarrhea, and HIV. He says poverty causes disease and disease causes poverty. Lessons Learned: †¢ Good governance and market reform alone are not sufficient to generate growth if a country is in a poverty trap. †¢ Geography has conspired with economics to give Africa a particularly weak hand. Africa lacks navigable rivers with access to the ocean for easy transport and trade. †¢ Africa lacks irrigation and depends on rainfall for their crops. †¢ Farmers lack access roads, markets, and fertilizers, while soils have been long depleted of their nutrients. Chapter Eleven–The Millennium, 9/11, and the United Nations. The beginning part of this chapter deals with the Millennium Development Goals. Sachs says that the goals and commitment to reach them by 2015 convey the hope that extreme poverty, disease, and environmental degradation could be alleviated with the wealth, the new technologies, and global awareness with which we entered the 21st century. He says the first seven goals call for sharp cuts in poverty, disease, and environmental degradation, while the eighth goal is essentially a commitment to global partnership. Because you have all seen them, I am not including them here. Regarding 9/11, he says we need to keep it in perspective. On 9/11, 3000 people died for once and for all, but 10,000 people die each day from diseases that are preventable. He believes we need to address the deeper roots of terrorism of which extreme poverty is an important element. The rich world needs to turn its efforts to a much greater extent from military strategies to economic development. President Franklin Delano Roosevelt spoke of freedoms we were fighting for in WWII and for which we still should be attempting to accomplish: †¢ Freedom of speech and expression everywhere in the world. †¢ Freedom for every person to worship God in his own way everywhere in the world. †¢ Freedom from want which translates into economic development. †¢ Freedom from fear which translates into a worldwide reduction in armament, a reduction to such a point that no nation will be in a position to commit an act of physical aggression against any neighbor. One major thing he is suggesting is that the rich countries elevate their giving to .7% of their GNP from the average of .2% it is today. The rest of the chapter is about President Bush and the USA policies and actions. Chapter Twelve–On-The-Ground Solutions for Ending Poverty This chapter is really talking about CHE, but Sachs does not realize it. He says that the world’s challenge is not to overcome laziness and corruption but rather to take on geographic isolation, disease, vulnerability to climate shocks, etc. with new systems of political responsibility that can get the job done. He talks about a village of less than 1,000 in western Kenya, in a Sauri sub-location (in Siaya district in Nyanza province) that he visited, which opened his eyes. He found what we find place after place– that they are impoverished, but they are capable and resourceful. Though struggling to survive, presently they are not dispirited but determined to improve their situation. He then goes on to describe the needs of a rural African community, the same type of community that we deal with every day, as shown in the abundance of applications we receive for CHE. A major problem, he feels, is that the farmers do not have the money to buy fertilizer that would impact their crop productivity drastically. Also they have no school or clinic. He then begins to calculate what it would cost per person to bring a school and teachers, simple clinic and staff, medicines, agriculture inputs such as seed and fertilizer, safe drinking water and simple sanitation, and power transport and communication services. The total cost for Sauri is about $350,000 a year, which converts to $70 a person per year, which could revolutionize the community. If he did CHE, the total cost and per person cost would be greatly reduced. He then goes ahead and extrapolates this up for the country of Kenya to $1.5 billion. At the same time he points out that Kenya’s debt service is $600 million a year and that it needs to be cancelled. But one problem that donors talk about is corruption needing to be eliminated. If countries do not eliminate corruption, they would not be eligible for relief. Also, a budget and management system need to be designed that will reach the villages and be monitorable, governable, and scalable–a set of interventions to ensure good governance on such a historic project. The key to this is to empower village-based community organizations to oversee village services. Most of what he says in this chapter sounds like CHE to me, but we can do it at even a lower cost and we have the experience to implement it. That is why I said earlier that we need to talk to Sachs about CHE. He then goes on with this theme but changes the venue from rural to urban in Mumbai, India in a slum community built smack up against the railroad tracks, one-house deep. He points out the outstanding needs are not latrines, running water, nor safety from trains, but empowerment so they can negotiate with the government. He then mentions that several groups have been found and empowered to do this in this community. Again sounds like CHE for urban poor. Sachs says what this community needs is investments in the individual and basic infra-structure that can empower people to be healthier, better educated, and more productive in the work force. CHE deals with the individual side of the equation. He ends this chapter by discussing the problem of scale. He says everything must start with the basic village. The key is connecting these basic units together into a global network that reaches from impoverished communities to the very centers of power and back again. This, too, is what we are talking about when we describe scaling-up and creating a movement and then forming it into councils and collaborative groups. He believes the rich world would readily provide the missing finances but they will wonder how to ensure that the money made available would really reach the poor and that there would be results. He says we need a strategy for scaling up the investments that will end poverty, including governance that empowers the poor while holding them accountable. I believe CHE fits his prescription. Chapter Thirteen–Making the Investments Needed to End Poverty Sachs says the extreme poor lack six kinds of capital: †¢ Human Capital: health, nutrition, and skills needed for each person to be productive. †¢ Business Capital: the machinery, facilities, and motorized transport used in agriculture, industry and services. †¢ Infrastructure Capital: water and sanitation, airports and sea ports, and telecommunications systems that are critical inputs for business productivity. †¢ Natural Capital: arable land, healthy soils, biodiversity, and well- functioning ecosystems that provide the environmental services need by human society. †¢ Public Institutional Capital: commercial law, judicial systems, government services, and policing, that underpin the peaceful and prosperous division of labor. †¢ Knowledge Capital: the scientific and technological know-how that raises productivity in business output and the promotion of physical and natural capital. He spends several pages on charts showing income flow. He also uses the example of child survival and how it applies to the six kinds of capital. He makes the point that even in the poorest societies, primary education alone is no longer sufficient. He says all youth should have a minimum of 9 years of education. He says technical capacity must be in the whole of society from the bottom up. He talks about trained community health workers and the role they can play. Villages around the world should be helped in adult education involving life and death issues such as HIV. The main challenges now is NOT to show what works in small villages or districts but rather to scale up what works to encompass a whole country, even the world. Again sounds like CHE and where we are going. He goes through several examples where major diseases are being dealt with such as malaria, river blindness, and polio, as well as spread of family planning. He also briefly talks about the cell phone revolution by the poor in Bangladesh and how East Asia has established Export Processing Zones, all of which are improving the life of the poorest of poor nations. Chapter Fourteen–A Global Compact to End Poverty He says the poorest countries themselves must take seriously the problem of ending poverty and need to devote a greater share of their national resources to accomplish this. Many poor countries pretend to reform while rich countries pretend to help them. The chronic lack of donor financing robs the poor countries of their poverty-fighting zeal. We are stuck in a show play that is not real. There are two sides in a compact. In this compact, there should be the commitment in the rich countries to help all poor countries where the collective will to be responsible partners in the endeavor is present. For the other poor countries where authoritarian or corrupt regimes hold sway, the consequences for the population are likely to be tragic but the rich countries have their limits also. He spends time looking at several countries that have Poverty Reduction Strategies where some are working and some not. Ghana is a star in his book. He says a true MDG-based poverty reduction strategy would have five parts: †¢ A Differential Diagnosis which includes identifying policies and investments that the country needs to achieve the MDGs. †¢ An Investment Plan which shows the size, timing and costs of the required investments. †¢ A Financial Plan to fund the Investment Plan, including the calculation of the MDG financing gap, the portion of the financial needs that donors will have to fill. †¢ A Donor Plan which gives multi-year commitments from donors for meeting the MDGs. †¢ A Public Management Plan that outlines the mechanisms of governance and public administration that will help implement the expanded public investment plan. During the 1980’s and 1990’s, the IMF forced Structural Readjustment on the poor countries which did not work. The poor were asked to pay all the expenses for new services. They then moved to a compromise called Social Marketing where the poor were asked to pay a portion of the expense. But neither plan worked because the poor did not have enough even to eat, much less pay for electricity. He says a sound management plan should include the following: †¢ Decentralize. Investments are needed in all the villages and the details for what is needed needs to be established at the village level through local committees, not the national capitol or Washington DC. †¢ Training. The public sector lacks the talent to oversee the scaling up process. Training programs for capacity building should be part of the strategy. †¢ Information Technology. The use of information technology–computers, e-mail and mobile phones– needs to increase drastically because of the dramatic increase of knowledge that needs to be transmitted. †¢ Measurable Benchmarks. Every MDG based poverty reduction strategy should be supported by quantitative benchmarks tailored to national conditions, needs, and data availability. †¢ Audits. No country should receive greater funding unless the money can be audited. †¢ Monitoring and Evaluation. Each country must prepare to have investments monitored and evaluated. He then goes through the following Global Policies for Poverty Reduction: †¢ The Debt Crisis. The poorest countries are unable to repay their debt, let alone carry the interest. Therefore, for each country that agrees to the guidelines noted previously, their debt must be cancelled if there is to be true poverty reduction. †¢ Global trade Policy. Poor countries need to increase their exports to the rich countries and thereby earn foreign exchange in order to import capital goods from the rich countries. Yet trade is not enough. The policy must include both aid and trade. The end of agriculture subsidies is not enough for this to happen. †¢ Science for Development. The poor are likely to be ignored by the international scientific community unless special effort is made to include things that help the poor. It is more critical to identify the priority needs for scientific research in relation to the poor than to mobilize the donor community to spur that research forward. That would include research in tropical agriculture, energy systems, climate forecasting, water management, and sustainable management of ecosystems. †¢ Environmental stewardship. The poorest of poor nations are generally innocent victims of major long-term ecosystem degradation. The rich countries must live up to the ecology agreements they have signed. The rich countries will have to give added financial assistance to the poor countries to enable them to deal with the ecosystem problems. The rich countries will have to invest more in climate research. Chapter Fifteen–Can The Rich Afford to Help the Poor? He asks the question â€Å"Can the rich countries help the poor?†, and his answer is â€Å"Can they afford not to do so?† He gives five reasons that show that the current effort is so modest. †¢ The numbers of extremely poor have declined close to 50% two generations ago to 33% a generation ago to 20% today. †¢ The goal is to end extreme poverty, not all poverty, and to close the gap between the rich and the poor. †¢ Success in ending the poverty trap will be much easier than it appears. Too little has been done to identify specific, proven, low-cost interventions that can make a difference in living standards and economic growth (CHE does this). †¢ The rich world is vastly rich. What seemed out of reach a generation or two ago is now such a small fraction of the vastly expanded income of the rich world. †¢ Our tools are more powerful than ever, including computers, internet, mobile phones, etc. He then spends time in doing calculations to show how this can be accomplished. First he starts with the World Bank. They estimate that meeting basic needs requires $1.08 per person per day. Currently, the average income of the extremely poor is 77 cents per day, creating a shortfall of 31 cents per day or $113 per person per year. He then shows that this represents only .6% of a nation’s GNP. The MDG target which many countries have agreed to is .7% of their GNP. Later on, he shows that the USA is only spending .15% for aid to the world. Sachs then spends time on a six-step process to do a needs assessment to come up with the real number needed: †¢ Identify the package of basic needs. †¢ Identify for each country the current unmet needs of the population. †¢ Calculate the costs of meeting the unmet needs through investments, taking into account future population growth. †¢ Calculate the part of the investments that can’t be financed by the country itself. †¢ Calculate the MDG financing gap that must be covered by donors. †¢ Assess the size of the donor contribution relative to donor income. He proposes that interventions are required to meet the following basic needs: †¢ Primary education for all children with a designated target ratio of pupils to teachers. †¢ Nutrition program for all vulnerable populations. †¢ Universal access to anti-malarial bed nets for all households in regions of malaria transmission. †¢ Access to safe drinking water and sanitation. †¢ One-half kilometer of paved roads for every thousand population. †¢ Access to modern cooking fuels and improved cooking stoves to decrease indoor air pollution. He states extreme poverty (a lack of access to basic needs) is very different from relative poverty (occupying a place at the bottom of the ladder of income distribution) within rich countries, and goes through a more detailed approach of implementing the six steps. He points out that not all donor assistance is for development. Much is used for emergency relief, care for resettlement of refugees, geopolitical support of particular governments, and help for middle-income countries that have largely ended extreme poverty in their country. Also, only a small portion of development aid actually helps to finance the intervention package. Much of it goes for technical assistance which is not part of the MDG numbers. He spends time on the question, â€Å"Can the USA afford the .7% of their GNP?† He responds with a deafening â€Å"Yes!† He does this in multiple ways, one of which is to show that the increase is only .55%, which would be hardly noticed in the US’s average 1.9% increase year-by-year of its GNP. Chapter Sixteen–Myths and Magic Bullets This is an interesting chapter because Sachs shoots down commonly held beliefs concerning the causes and solutions for poverty. He uses Africa as his case to do so:. †¢ Contrary to popular conception, Africa has not received great amounts of aid. They receive $30 per person per year but only $12 of that actually went to be used in development in Africa. $5 went to consultants of donor countries, $3 went to food and emergency relief, $4 for servicing Africa’s debt and $5 for debt relief. In reality, in 2002, only six cents per person went to development. †¢ Corruption is the problem which leads to poor governance. By any standard of measure Africa’s governance is low, but not due to corruption. African countries’ governance is no different than other poor countries in the rest of the world. Governance improves as the people become more literate and more affluent. Secondly, a more affluent country can afford to invest more in governance. †¢ There is a democracy deficit. This is also not true. In 2003, 11 countries in Africa were considered free, with 20 more partially free, and 16 not free. This is the same as is found in other regions of the world. Democracy does not translate into faster economic growth. †¢ Lack of modern values. Again, this is also false. Virtually every society that was once poor has been castigated for being unworthy until its citizens became rich and then their new wealth was explained by their industriousness. He traces this trend in multiple countries. One major factor that does cause change is the change in women’s position in society as their economic situation improves, which accelerates the growth. †¢ The need for economic freedom is not fully true. Generally market societies out perform centrally planned economies. This leads to the thought that all is needed is that the people must have the will to liberalize and privatize which is too simplistic. He shows that there is no correlation between the Economic Freedom Index and annual growth rate of GDP. †¢ The single idea of Mystery of Capital put forth by Hernando de Soto which relates to the security of private property including the ability to borrow against it is also incorrect. Most poor hold their assets such as housing and land. †¢ There is a shortfall of morals which is thought to be the main cause of HIV in Africa. A study shows that Africa men are no different in the average number of sexual partners they have than any other part of the world. â₠¬ ¢ Saving children only to become hungry adults leads to population explosion. Actually it has been shown that the best way to reduce the fertility rate is to increase the economic status. In all parts of the world (except the Middle East) where the fertility rate is over 5 children, those countries are the poorest ones. As children survive, the parents feel less of a need to have more children which is a result of improved economic conditions. †¢ A rising tide lifts all boats. This means extreme poverty will take care of itself because economic development will pull all countries along to improvement. A rising improvement does not reach the hinder lands or mountain tops. †¢ Nature red in tooth and claw means that economic improvement is based on survival of the fittest and those who cannot compete fall behind. This is a Darwin thought which seems to still prevail throughout the world. Competition and struggle are but one side of the coin which has the other side of trust , cooperation, and collective action. He rejects the doomsayers who saying that ending poverty is impossible. He believes he has identified specific interventions that are needed as well as found ways to plan and implement them at an affordable rate. Chapter Seventeen–Why We Should Do It There are several fallacies which affect the USA’s giving: †¢ The American public greatly overestimates the amount of federal funds spent on foreign aid. The US public believes that the government is providing massive amounts of aid. A 2001 survey by the University of Maryland showed that people felt that US aid accounted for 20% of the federal budget versus the actual of .15%. That is 24 times smaller than the actual figure. †¢ The American public believes that the US military can achieve security for Americans in the absence of a stable world. This has been proven untrue especially with 9/11. †¢ There is a fallacy in belief that there is a war of cultures. For many, this relates to Biblical prophesy of Armageddon and end times. The problem in the US is not opposition to increased foreign aid but a lack of political leadership to inform the public how little the US does supply, and then asking the US public to supply more. Hard evidence has established a strong linkage between extreme poverty abroad and threats to national security. As a general proposition, economic failure (an economy stuck in a poverty trap, banking crisis, debt default or hyper-inflation) often leads to a state failure. A CIA Task force looked at state failures between 1954 and 1994 and found that the following three factors were most significant in state failure: †¢ Very high infant mortality rate suggested that overall low levels of material well-being are a significant factor in state failure. †¢ Openness of the economy showed the more economic linkages a country had with the rest of the world, the lower chance of state failure. †¢ Democratic countries showed fewer propensities to state failure than authoritarian regimes. He then reviews what the US government has committed to since 9/11: †¢ Provide resources to aid countries that have met national reform. †¢ Improve effectiveness of the World Bank and other development banks in raising living standards. †¢ Insist on measurable results to ensure that development assistance is actually making a difference in the lives of the world’s poor. †¢ Increase the amount of development assistance that is provided in the form of grants, not loans. †¢ Since trade and investment are the real engines of economic growth, open societies to commerce and investment. †¢ Secure public health. †¢ Emphasize education. †¢ Continue to aid agricultural development. In reality, little progress has been done by the US to the accomplishment of these goals. But he does spend time discussing where plans were established and that funds were flowing where massive amounts of aid were provided by the USA: †¢ End of World War II with the Marshall Plan which revitalized Europe and Japan. †¢ Jubilee 2000 Drop the Debt Campaign started slow but ended up with large amount of national debt being cancelled in the poorest of countries. †¢ The Emergency Plan for HIV is providing $15 billion to fight this pandemic. The bottom line of this chapter is, â€Å"OK, USA and other rich countries, you are saying good things, now step-up to the plate and do what you have agreed to do.† Chapter Eighteen–Our Generation’s Challenge Our generation is heir to two and a half centuries of economic progress. We can realistically envision a world without extreme poverty by the year 2025 because of technological progress which enables us to meet basic needs on a global scale. We can also achieve a margin above basic needs unprecedented in history. Until the Industrial Revolution, humanity had known only unending struggles against famine, pandemic disease, and extreme poverty–all compounded by cycles of war, and political despotism. At the same time, Enlightenment thinkers began to envision the possibility of sustained social progress in which science and technology could be harnessed to achieve sustained improvements in the organization of social, political, and economic life. He proposes four thinkers which led this movement: †¢ Thomas Jefferson and other founders of the American Republic led the thought that political institutions could be fashioned consciously to meet the needs of society through a human-made political system. †¢ Adam Smith believed that the economic system could similarly be shaped to meet human need and his economic design runs parallel to Jefferson’s political designs. †¢ Immanuel Kant called for an appropriate global system of governance to end the age-old scourge of war. †¢ Science and technology, fueled by human reason can be a sustained force for social improvement and human betterment led by Francis Bacon and Marie-Jean-Antoine Condorcet. Condorcet put much emphasis on public education to accomplish the goals. One of the most abiding commitments of the Enlightenment was the idea that social progress should be universal and not restricted to a corner of Western Europe. He said now it is our generation’s turn to help foster the following: †¢ Political systems that promote human well-being †¢ Economic systems that spread the benefits of science, technology, and division of labor to all parts of the world. †¢ International cooperation in order to secure a perpetual peace. †¢ Science and technology, grounded in human rationality, to fuel the continued prospects for improving the human condition. He then spends three or four pages discussing the good and bad points of the Anti-globalization Movement which is taking place. He also spends time discussing three movements which made these kind of changes in the world in their time: †¢ The end of Slavery †¢ The end of Colonization †¢ The Civil Rights and Anti-Apartheid Movement He closes with discussing the next steps which are: †¢ Commit to ending poverty †¢ Adopt a plan of action built around the Millennium Development Goals †¢ Raise the voice of the poor †¢ Redeem the role of the United States in the world †¢ Rescue the IMF and World Bank †¢ Strengthen the United Nations †¢ Harness global science †¢ Promote sustainable development †¢ Make a personal commitment to become involved Summary This is an interesting book with new perspectives for me, and which is beginning to be taken seriously by the world. I believe, as stated earlier, that MAI’s role is on-the-ground solutions for ending poverty through CHE which is spelled out in Chapter 12. But, as also noted, we can do it at a far lower cost than he estimates because of our commitment to empowering people to do things on their own and primarily with their own funds.