Langston Hughes And I Hear America Singing By Walt Whitman

In contrasting or comparing literary works it is crucial that the reader analyze the authors voice to gain a better understanding of the theme they are implying. In the contrast between the poems â€Å"I, too, sing America† by Langston Hughes, and â€Å"I hear America singing† by Walt Whitman it is clear that the two poets have very different point of views regarding American patriotism. Walt Whitman’s views on America’s joy and peace in his poems are very straightforward, while Langston Hughes poem--a response to Whitman’s--wants the reader to acknowledge what America should be like for everyone, including people of color such as himself. The authors of these poems prove to have conflicting judgements on matters in America including a theme of†¦show more content†¦Not only do their tones signify why the poems are so distinctive but they make it obvious to the speaker what they are both trying to say. Langston Hughes at first talks about ho w they send him to eat in the kitchen and towards the end of the poem he says, â€Å". . . Nobody’ll dare Say to me, â€Å"Eat in the kitchen,† Then . . .† (ll. 11-14). He is defying what people like Whitman have to say and in the process showing that their actions are wrong and that he will not stand for it. Moreover, he confronts Whitman’s idea of America’s perfectness. Unlike Hughes, Whitman’s tone is a lot more clear. He mentions the words, â€Å". . . young fellows, robust, friendly . . .† (ll. 17-18) . Whitman also mentions the line, â€Å". . . Singing with their mouths their strong melodious songs.† (l. 18) . His tone is clearly happy and joyful, and while it is quite obvious that his voice is merry, it’s also laced with ignorance toward the real situation of everyone struggling with their work, old and young, man or woman. His own utopia causes him to see America for what it isn’t, while Hughes understands the struggle of everyday Americans, even not being considered one himself. Furthermore, it allows him to think about what can change in America in the future. The futuristic visions the poets hold say a great deal about them and their patriotism. Walt Whitman shows omission to the subject and doesn’t mention any type of future for America in his poem. He says, â€Å"I hearShow MoreRelatedThe Difference Between Langston Hughes And I Hear America Singing998 Words   |  4 PagesIn this essay I will be talking about the differences between Walt Whitmans poem â€Å" I Hear America Singing† and Langston Hughes poem â€Å" I, Too, Sing America†. I will also be giving my opinion on whether or not Langston Hughes is responding to Walt Whitmans poem. Langston Hughes was an American poet, social activist, novelist, playwright, and a columnist from Joplin, Missouri. Walt Whitman was an American poet, essayist, and a journalist from West Hills, New York. This is all just background informationRead MoreSimilarities And Similarities Between Langston Hughes And I Hear America Singing835 Words   |  4 Pagesthis paper I will be ta lking about the similarities and differences in the two different poems. The two poems were written by two incredible poets and were probably one of the best in their lifetimes. The first poem is written by Walt Whitman and is called â€Å" I Hear America Singing†. The other poem is by Langston Hughes and is called â€Å"I, Too, Sing America† .Many people believe that Langston Hughes wrote his poem â€Å"I, Too, Sing America† in response to Walt Whitmans poem â€Å" I Hear America Singing†. SomeRead MoreWalt Whitman And Langston Hughes Analysis796 Words   |  4 PagesWalt Whitman and Langston Hughes. Two highly renowed poets. One of Whitmans most known poems, I Hear America Singing, is about living the American life; he explains multiple types of people in his piece of work and how they are all a part of America. Similar to this, Langston Hughes wrote the poem I, Too, Sing America, and in this, he includes African Americans, suggesting that Whitman left some people out. Also saying, that blacks are proud and just as big of a part of America as anyone elseRead MoreWalt Whitman, Langston Hughes, And Tupac Shakur1088 Words   |  5 PagesWalt Whitman, Langston Hughes, and Tupac Shakur have a major role in English Literature, Even though they live during the different time periods from different backgrounds, and they all have written many poems about the American dream. When it comes to the American dream, people have different points of view on the topic. Many people believe that American dream is about all American citizens having equal rights and opportunities to achieve the success through hard work. On the other hand, many peopleRead MoreI Too Sing America Analysis852 Words   |  4 PagesSinging America Langston Hughes has cited Walt Whitman as one of his greatest influences he has had, and some believe that Hughes wrote I, Too, Sing America in response to Whitmans I Hear America Singing. Hughes builds on to Whitmans poem by writing his poem along the same lines and basics as Whitmans. Both poems talk about the way people work hard, how they sing America, and the way they are so content and never complain. All the characters work all day and they sing America, meaning theyRead MoreCompare And Contrast Langston Hughes And I Hear America Singing753 Words   |  4 PagesAmerica Singing Slavery was a time of despair and great pain for many African Americans. Americans today hold a much different view on slavery than all of their ancestors. Slavery is not only suggested but it is illegal completely and very immoral. Back then, blacks and some whites fought to end slavery. The 246 years of black enslavement finally came to an end on December 6, 1865. Many people used art, writing, and music as a way to express themselves during this hard time. Walt Whitman, an AmericanRead MoreAn Analytical Comparison of I Hear America Singing and I, Too:708 Words   |  3 PagesAn Analytical Comparison of â€Å"I Hear America Singing† and â€Å"I, Too† Born ten years after the death of Walt Whitman, there was no possible way for Langston Hughes to ever meet or communication with Whitman, but that did not mean Hughes could not establish a connection to him, or at least his work. In 1925, Hughes wrote a poem titled â€Å"I, Too† was inspired by and directed in response to the poem â€Å"I Hear America Singing†, which was composed by Whitman much earlier. Whitman’s poem consisted of a varietyRead MoreAnalysis Of Walt Whitman s Works And Pieces1452 Words   |  6 Pagestreated equally and they must remove the barriers that are preventing freedom. As America develops its culture, these unintimidated activists have similar dreams including Walt Whitman, Langston Hughes, Charlotte Gilman, Malala Yousafzi, Alice Paul, and Martin Luther King Jr. influence their views of society to promote equality and social change. Walt Whitman’s works and pieces illuminates on the potential of America. Whitman is a very outspoken and an optimistic poet and feels that when he was visitingRead MoreI Hear America Singing By Langston Hughes991 Words   |  4 Pages Langston Hughes spoke and captivated the general struggles of an African American’s life during the 1900s through his poem, â€Å"I, Too.† Hughes’ points out the injustice of bigotry or one’s beliefs in America, and his overall message is saying that an African American’s hard work is just as noteworthy as any other American. In contrast, Walt Whitman, author of â€Å"I Hear America Singing,† speaks about the employed citizens of America. He gives honor to those who are living their lives and working to makeRead MoreAnalysis Of The Poem I Hear America Singing 994 Words   |  4 Pages Hughes versus Whitman Langston Hughes spoke and captivated the general struggles of an African American’s life during the 1900s through his poem, â€Å"I, Too.† Hughes’ points out the injustice of bigotry or one’s beliefs in America, and his overall message is saying that an African American’s hard work is just as noteworthy as any other American. In contrast, Walt Whitman, author of â€Å"I Hear America Singing,† speaks about the employed citizens of America. He gives honor to those who are living their

Arthur Miller s The Crucible Essay - 1194 Words

In Arthur Miller’s The Crucible, the normal criteria that a central character fits, is not met by the apparent protagonist, John Proctor. Common traits one might expect to find in a traditional hero are humility, patience and caring. John Proctor, while he is the principal, has many qualities that could instead assume him the role of the antagonist and land him in the adversary box. His background and slight character flaws cause him to take on the personalities of both a protagonist and antagonist. Proctor, because he exhibits qualities of both types of characters, is what is known as a tragic hero. Tragic heroes are characters within stories that due to a judgment error, is the cause of his/her own demise. In Proctor’s case, his error was made when he refuses to give up the names of other alleged witches, and refuses to allow the court to hang his confession in the center of town. John Proctor embodies three major signs of tragic heroism. Proctor, even through the res t of the village perceives him as great, knows deep down inside that because of past sins, he will never be able to live up to his reputation. As well, John Proctor is a tragic hero because he had the power to stop his own execution, therefore his downfall was no one s’ fault but his own. This reluctance to forfeit the names of other â€Å"witches† could be seen as a character flaw. The final criteria that Proctor meets for a tragic hero is that the punishment received is way too severe for the â€Å"crime† committed.Show MoreRelatedArthur Miller s The Crucible2214 Words   |  9 PagesJohn Proctor: A tragic hero A man s reputation in many forms is his, life’s work. To have your reputation dismantled is like taking away one s accomplishments and life’s work. Arthur Miller s The Crucible is a play about justice and injustice, and how our justice system can be easily corrupted. The story revolves around a man named John Proctor, the tragic hero of this story. John Protector is a symbolic character created by Arthur Miller, because he faced the justice system head on. Proctor’sRead MoreArthur Miller s The Crucible1191 Words   |  5 PagesIn Arthur Miller’s The Crucible, the normal criteria that a central character fits, is not met by the protagonist, John Proctor. Common traits one might expect to find in a traditional hero are humility, patience and caring. John Proctor, while he is the principal, has many qualities that could instead assume him the role of the antagonist and land him in the adversary box. His background and slight character flaws cause him to t ake on the the personalities of both a protagonist and antagonist. ProctorRead MoreArthur Miller s The Crucible833 Words   |  4 PagesThere are an array of Aristotelian tragic heroes throughout American literature. One of which includes John Proctor, main character farmer in mid-30s, from Arthur Miller s play, The Crucible. Yet, in order for him to obtain such a title he must possess specific characteristics. Five of which include possession of hubris, a flaw or decision leading to desire for revenge, a reversal of good fortune brought forth by the error of judgement, acceptance of poor fortune brought forth by their actions,Read MoreAnalysis Of Arthur Miller s The Crucible 1457 Words   |  6 PagesSteven Huang Ms. Folkrod English 3, Period 7 26 October 2014 Proctor’s Pride and Downfall A tragic hero is a hero in a story whose natural flaws or wrong judgments, associates with bad fate, causes his downfall or death. In Arthur Miller’s The Crucible, there are tragic heroes. In the late 1600s, there are a series of witch trials happens at Salem, MA. John Proctor, a farmer who lives in a farm with his wife Elizabeth Proctor, is the protagonist during the Salem witch trial. John is a candid, frankRead MoreAnalysis Of Arthur Miller s The Crucible 961 Words   |  4 Pages Movie paper analysis of The crucible The circumstance brought upon a person can change them greatly. The Crucible edited and rewritten by Arthur Miller, is a movie which takes place in Salem, Massachusetts in 1692. The leading actors are Daniel Day-Lewis as Proctor, Winona Ryder as Abigail, Paul Scofield as Judge Danforth, Joan Allen as Elizabeth, Bruce Davison as Parris, and Rob Campbell as Hale. It was directed by Nicholas Hytner and was Based on the witch hunt which surrounded MassachusettsRead MoreAnalysis Of Arthur Miller s The Crucible 1732 Words   |  7 Pagesin the world. II. Biographical Arthur Miller was a controversial playwright during the 1950’s and 60’s, note because of the material that he choose to write about, but because of the events that took place surrounding one of his best works: The Crucible. One of his friends and a fellow playwright Elia Kazan was accused of being a Communist by the house Un-American Activities Committee. Elia, who had admitted to being previously a Communist during the 1930’s (long before the cold war) was askedRead MoreAnalysis Of Arthur Miller s The Crucible 1052 Words   |  5 PagesArthur Miller was one of the leading American playwrights in the 20th century. Arthur Miller was born on October 17, 1915 in Harlem New York City to Isidore and Augusta Miller (GradeSaver). After graduating from high school, Miller worked a variety of odd jobs including hosting a radio program; this was before the University of Michigan accepted him. At school, he studied journalism, became the night editor of the Michigan Daily, and began experimenting with theater and writing plays. He lived throughRead MoreAnalysis Of Arthur Miller s The Crucible 908 Words   |  4 PagesDel Giudice Mrs. Schmiedeler English 2F 21 October 2015 Crucible Essay â€Å"It takes many good deeds to build a good reputation, and only one bad one to lose it.† This is a quote by Benjamin Franklin and it explains how the puritan society in The Crucible work. this quote shows how fragile a reputation can be, you can spend your whole life increasing your reputation, but one wrong move and it’s completely wrong. In The Crucible, many of Arthur Miller’s characters are very concerned with their reputationRead MoreAnalysis Of Arthur Miller s The Crucible 2138 Words   |  9 Pages Crucible Character Essay - John Proctor #6 In Arthur Miller’s â€Å"The Crucible† the protagonist is a man by the name of John Proctor. Proctor is a very complex character because he doesn t have the cleanest history. He is a man in about his forties who had committed the sin of cheating on his wife with a young girl. This act of his gives a bad first impression to the reader. Proctor however does try to become a better man and do the right thing to save his wife s life, which changes feelingsRead MoreThe Scarlet Letter And Arthur Miller s The Crucible1050 Words   |  5 PagesNathaniel Hawthorne’s The Scarlet Letter and Arthur Miller’s The Crucible, the repercussions of committing adultery are exhibited through characters in two different puritanical societies. Arthur Dimmesdale, Hester Prynne, John Proctor, and Abigail Williams are all victims to this. Despite living in sincere societies, these characters behave hypocritically in order to hide a concealed truth, resulting in internal ignomi ny, until they ultimately confess. Arthur Dimmesdale shows his guilt and hypocritical

The Uk Diabetes Problem Health And Social Care Essay Free Essays

I have done the nursing occupation in my back place state Nepal and now I am making the attention helper for aged people in attention place. Most of the occupants are enduring from different diseases, such as diabetes, dementedness.In my unit most of occupant are suffered from diabetes. We will write a custom essay sample on The Uk Diabetes Problem Health And Social Care Essay or any similar topic only for you Order Now In my state Nepal I have seen many patients of diabetes, from where I got the more cognition about the diabetes. Not merely UK people but besides whole universe people is enduring from the diabetes. Many research are conducted on this instance, diabetes affects six per centum of the universe ‘s population and its prevalence is duplicating every coevals.There are presently over two and half million people diabetes in UK and there are more than half a million people with diabetes who have the status and do n’t cognize it. Harmonizing to diabetes UK statistics show that over 80 % of people diagnosed with type2 diabetes and corpulence. Diabetes patient spend an norm of A ; lb ; 4500 yearly on costs for handling their diseases in the universe. The cost of diabetes to the national wellness service stands at about amp ; lb ; 1 million per hr and is increasing quickly a new study indicates ( www.diabetes.co.uk ) .Diabetes 29/04/2011 ) histories for about a ten percent of NHS budget each twelvemonth a entire exceeding A ; lb ; 9 billion. The complications of diabetes are legion and deathly and include amputation, bosom disease kidney failure and sightlessness, the study highlights the facts that eight out of 10 people with diabetes dices of bosom disease and stroke.Goverment is passing tonss of money and has committed to guaranting there is greater focal point on speed uping the gait of betterment in diabetes attention. Increasing the diabetes patients evidently affect the system and economic system position of the state because alternatively of utilizing money in productive work, concern and building authorities is paying for diabetes which is straight influences the state. HEALTH Wellbeing AND QUALITY OF LIFE It is really complicated and difficult to specify wellness, there are 100s of positions from different writer and different organisations.As we know all of the accept the definition of universe wellness organisation, wellness is a complete, physical mental and societal well- being and non simply the absence of disease and frailty which means wellness is in relationship with different factors like single, physical, societal physiological, emotional, environmental and cultural it means wellness is non merely absence of disease. Person may go ailment with his mental and societal position and his milieus. Health is really of import factor in human life as we know the stating wellness is wealth. Same like wellness wellbeing is besides the of import factor of healthy and affluent life. Actually well-being is being healthy felicity, free from emphasis, mentally, physically, socially and emotionally. Health and wellbeing are the most of import constituents of healthy life. These are the constituent which determines the quality of life. Along with wellness and well-being quality of life is really of import which play large function in life of single. Quality of life denotes how the person is? His day-to-day life activities, his or her wellbeing. This is the term which determines populating status, installations, possibilities, security, satisfaction, income, employment, nutrient, instruction, quality wellness services, hygiene, public assistance and support. It is different from everyone. The chief thing determine quality of life is our ability to bask all that life has to offer for cases, the ability to walk, talk and experience all contributes to our all quality of life. ( journal.diabetes.org volume 30/04/2011 ) Diabetess During our life clip we know is likely to diabetes mellitus, better known as diabetes.Diabetes is found when the sugar in our blood is excessively high. It happens when something goes incorrect with the manner our organic structure uses the nutrient we eat. Our organic structure breaks down nutrient into sugar, fat, and protein. Our organic structure uses sugar for energy. A endocrine called insulin helps our organic structure turn sugar into energy. Insulin is made in the pancreas, which is located near our tummy. When we eat, our pancreas supposed to do the right sum of insulin to travel the sugar from our blood into our organic structure ‘s cells. When we have diabetes, we have no insulin or non adequate insulin, or our organic structure does non react to the insulin it makes. The sugar stays in our blood. When excessively much sugar builds up in our blood and reaches a certain degree we have DIABETES. Diabetes is serious, womb-to-tomb unwellness. It can do bosom and blood v as diseases, sightlessness, kidney failure, nervus harm, dentition and gum jobs, and toe, pes or leg amputations. ( www.handsonhealth-sc.org Idaho 1119 ) . If we can non command diabetes can perplex gestation, and birth defects are more common in babes born to adult females who have it. Understanding digestion and insulin Most of the nutrient we eat is broke down into glucose, it is the signifier of the sugar in the blood.it is the chief fuel for the organic structure. After digestion procedure, glucose base on ballss into the blood stream, where it is used by cells for growing and energy. For glucose to acquire into the cells insulin must be present. Insulin is a endocrine produced by the pancreas, pancreas is the big secretory organ behind tummy, people with diabetes do non do insulin, or they can non utilize insulin decently, or both. This causes glucose to construct up in the blood alternatively of traveling into the cells. As a consequence people with the status frequently feel ; thirsty, hungry tired. How to cite The Uk Diabetes Problem Health And Social Care Essay, Essay examples

Health Services In United States Essay Research free essay sample

Health Services In United States Essay, Research Paper Health Services in United StatesThe historic payment system for reimbursing infirmaries both by insurance companies and by Medicare has been Retrospective Cost Based Reimbursement ( RCBR ) . This system of reimbursement encourages infirmaries to over charge in order to cover the costs of the uninsured who utilize the infirmary. Charges have continued to lift twelvemonth after twelvemonth finally seting the employers at a point where they could no longer afford the payments. For physician reimbursements, both insurance companies and Medicare employed the Usual and Customary ( U+C ) attack to reimbursement. This pattern, which averaged the charges for a process in a part, besides encourages physicians to over-charge in order to raise the mean sum paid to them for a process. These two systems, RCBR and U+C finally started to suck excessively much money out of the insurance companies, employers, and the Medicare/Social Security trust fund so that intercessions were deemed necessary. Possibly the biggest intercession adopted by the private sector to cut down medical service costs was the tendency toward concerns self-insuring. By making so, they avoided state-mandated benefits that were required if they hired a third-party insurance company. In add-on, the money was now paid to claims as they arose instead than prospectively so income could be earned on this capital as it sat in the bank. Other intercession to cut down medical service costs chiefly involved private insurance companies as it was hard for little concerns to self-insure because of low-capitol. Underwriting was a typical pattern of insurance companies ; that is, excepting some employees from coverage if they have preexisting conditions or if they are employed in |high-riskX countries. Payment caps are were besides employed by insurance companies as a manner to salvage medical costs. This pattern meant puting bounds for the entire sum paid for selected diagnosings. These intercessions finally led to cleavage in the insurance market. A displacement occurred in the manner that insurance companies calculated premium charges. Community evaluation used to be the norm. It involves puting all donees into a big group and projecting their claims. Premiums were so spread across the full group as were hazards. However, as a consequence of the historical infirmary and physician payments strategies, insurance companies shifted to see evaluation. That is, a evaluation that bases a group+s premiums on its experient cost. Therefore, by merely including low-risk, low-priced persons under coverage, premiums for those persons may be minimized. This consequence leaves little groups behind, paying much more in premiums. These intercessions mentioned every bit good as increased experience-rating adopted by insurance companies and the subsequent phenomena of market cleavage have had effects on many degrees of the wellness attention system: Premiums for little employers have skyrocketed for two ground s. First, administrative costs for little employers are proportionately higher than those for larger houses ( Congressional Research Service ) and secondly, larger houses have more market clout and are so able to seal the contracts that provide lower premiums to their employees. Larger houses are besides able to distribute the hazards of their insured employees across a larger beneficiary base with tonss of capitol to absorb any abnormalcy in claims from one twelvemonth to the following. Small houses don+t have this luxury and as a consequence their premiums have increased. As wellness attention costs grew, many larger concerns opted to self-insure and take the hazards of their employees instead than paying an insurance company to execute this function. These employers besides avoided the province mandated benefits and could utilize capital non prospectively paid to gain involvement. It was in the 1980 s, when employers were going progressively concerned about surging wellness atten tion costs, commercial insurance companies were concerned about the hereafter of traditional wellness insurance, and doctors were progressively fall ining wellness programs to vouch a steady flow of clients, that managed attention truly spread out dramatically. As diagram 1 shows ( see fond regards ) , the figure of people enrolled in HMO s in 1976 was 6 million and by 1991 had reached 38.6 million. The higher costs of medical attention forced different groups into HMO s for different grounds. Doctors enrolled in HMO s gave up some liberty but were guaranteed a steady flow of patients. The patients enrolled were guaranteed attention for a fixed monthly premium at the disbursal of sing lone suppliers covered in their program. The draining of the Social Security trust fund by traditional infirmary RCBR method and doctors by U+C for Medicare was tackled by alternate payment mechanisms. The traditional U+C payment to physicians was replaced with the Resource Based Relative Value Scale ( RBRVS ) 1n 1992. This system of payment assigned a numerical value to every process performed in order to try to exteriorize what goes into a physician s service. In this manner, the payments to doctors could be regulated and controlled. Hospitals, which were traditionally reimbursed under RCBR were paid by the Prospective Payment System ( PPS ) get downing in 1983. Under this system, each episode of unwellness was associated with a fixed payment regardless of resources consumed, clip spent, or disbursals incurred. All unwellnesss were grouped into Diagnostic Related Groups ( DRG ) efficaciously cataloguing hospitalized patients harmonizing to fee payment. The ever-increasing costs associated with wellness attention brought along many cost-saving intercessions which have been mentioned. These intercessions had effects at all degrees of the wellness attention industry but particularly so in infirmaries as they represent 38 % of our state s wellness outgo. Hospital admittances declin ed aggressively as the new payment strategies for infirmaries were introduced in 1983. Since infirmaries were being paid by a PPS system, the inducement was to acquire the patients out every bit shortly as possible. Admiting patients is associated with high costs and infirmaries opted for more outpatient attention instead than admittances. This PPS payment construction besides influenced the mean length of stay. Hospitals were now encouraged financially to let go of patients every bit shortly as possible since they were reimbursed the same sum regardless of the continuance of the stay. Efficiency was now of paramount concern as a individual sitting in a bed represented a cost that could be contained if the patient was released earlier than subsequently. It is no surprise so that tenancy R Ates for infirmaries have besides declined since 1980. This combination of decreased admittances and shorter length of stay per visit resulted in few people in infirmaries at any given clip. These tendencies present particular jobs for smaller, rural infirmaries which have more trouble assemblage resources, remaining technologically current, and keeping fiscal strength. As a consequence, more and more smaller infirmaries are shuting, particularly in these rural countries. The high degree of unemployment in the early 1980 s along with stricter eligibility demands for Medicaid led to a rise in the figure of uninsured persons in the U.S. ( see diagram 2 ) . Market cleavage get downing in the early 80 s besides contributed to the figure of uninsured as those with preexistent conditions or high-risk occupations were denied coverage. Because of the extremely competitory infirmary market created by payment alterations, the inducement to handle the uninsured is lost and these people are progressively marginalized. No longer may hospitals subsidi se the intervention of the uninsured by over-charging employers or insurance companies. Many cuts have proposed by the Republicans in Congress that aim to pare down the cost of wellness attention. Medicare is at the root of many of these proposed policy alterations. Among them are additions in co-payments made by donees, caps on payments to donees, a decrease in the sum paid to donees per episode of unwellness, a retention of the rates of addition for infirmaries and physicians so that if services addition, payments lessening, and allowing the market of course travel people into HMOs. These proposed policy alterations are likely to consequence infirmaries in many ways, some of which are already being seen. It is likely that hospital admittances will go on to worsen as infirmaries have no inducement to acknowledge. Payments are the same to hospitals whether the dainty outpatient or they admit the patient, so to salvage money the natural inclination is to handle with ambulatory or out patient attention. Even more incentive is present for infirmaries non to acknowledge a patient as the sum paid to them will diminish as they increase services. Incentive to non treat+ is what it may be called. For those that are admitted to infirmaries, we will go on to see a decrease in the figure of yearss each patient stays in the infirmary. The motive for the infirmary to let go of the patient persists because of the payment strategies in topographic point. For the patient who is paying a higher co-payment, the inducement is besides to go forth the infirmary every bit shortly as they feel good plenty # 8230 ; and sometimes earlier! What we are likely to see are increasing Numberss of rural infirmary closings as they are unable to last the bead in hospital visits and corsets. Empty beds mean administrative costs for the infirmary that need to be defrayed by handling people. If there is cipher to handle, the infirmary must necessarily close down. As people continue to travel into HMO s to have some kind of coverage, infirmaries will possibly see an addition in the figure of visitants at infirmaries but they will be required to have anterior blessing for most processs and the sum paid to the infirmaries will stay the same regardless of the figure of processs so the inducement to handle more is lost. As Medicare cuts continue to predominate, it is likely that more and more donees of Medicare will be drawn into HMO s. Just as this has led to increased market cleavage in the private-insurance community so would it take to the same moral force in the Medicare community. Those infirmaries or doctors that sign contracts with HMO s will be procuring their patient-base while the HMO will be cornering more of the hospital/physician market. For those who are non enrolled in HMO s, their costs will non be controlled. Higher fees will be the likely consequence. Since the Medicare reform proposals pay less per episode of unwellness, the patient will be responsible for mo re of this increased sum. The sum of Medigap payments for Medicare donees is besides likely to travel up as a consequence of the current Medicare reform proposals. Medicare will pay less per episode of unwellness. If we assume that the charge per episode of unwellness will non come down, so the sum that must come out of the pocket of the beneficiary must increase. This addition will be a direct consequence of the cuts to the Medicare plan. Long-term attention in the United States has received much attending in recent old ages as the baby-boomers shortly will be the population necessitating this type of attention. For those seeking long-run attention there are several options available with different payments beginnings for each. They are briefly outlined here: Nursing Homes: nursing place attention may be provided in different scenes with differing payment options for each. They are consumer payment-this type of attention may include anything measure uping as day-to-day attention fo r an aged or mentally-ill patient necessitating long-run attention. There is by and large a day-to-day charge rate for the tutelary attention. Mediacaid covers tutelary and general attention one time personal financess are depleted. Medicare covers skilled nursing and skilled therapies following hospitalization This coverage is limited to 100 yearss maximal per episode. Home/Community-Based Care: this type of attention consists of skilled nursing attention and therapies, homemaker/home wellness assistance attention, high engineering place therapy, and lasting medical equipment. Consumer bought attention may include personal attention, including the aforesaid place wellness AIDSs and housewifes and job services. Besides, any RN clip spent beyond that authorized would be covered by the patient. Medicaid covers personal attention and aid for eligible frail aged or handicapped persons. Medicare covers skilled nursing, physical or speech therapy. Housing/Retirement Community: this is an enhanced service bundle and frequently includes more supportive or tutelary attention. A combination of both Medicare and Medicaid may be used to pay for this type of service. One organized method to make merely this is the Program of All-Inclusive Care for the Elderly ( PACE ) . The thought is that for qualified persons, PACE merges Medicaid and Medicare funding into an incorporate system that enables a care-manager to apportion resources by demand. Pace must be seen for what it is, attention for ague and chronic conditions within a long-run attention bundle. Diagram 1 Diagram 2Source: U.S. Bureau of the Census, Unpublished Current Population Survey Data, Health Insurance Coverage Status by State, Table Hi-4.