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Tag: Threat

  • Repricing on Health Insurance Claims

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    We have all heard the stories of the emergency room claim that cost $10,000 for a broken thumb, or the person who had to file bankruptcy from the huge bill while using a network outside of their HMO. These stories have been the fuel for arguments on what should be done with our Nation’s healthcare system. The truth is these stories occur more than most people realize, and many have misconceptions on how this happens. This is why it is crucial to have the right billing network to take advantage of most favorable, predetermined pricing available.

    Lets take a look at a couple of scenarios where one person is stuck with a high medical bill and the other is protected. Suppose that two people walk into an emergency room for the same injury, one having adequate health insurance and the other having none. The emergency room is going to immediately know that each patient will be billed differently. The person with the right network billing plan will be able to take advantage of a nationwide network, allowing predetermined pricing for most any medical condition you can name. The other will be at the mercy of what the emergency room decides to charge. Depending on the medical condition, the difference of what is paid out could be upwards of tens of thousands of dollars. The catch is, in order to receive this predetermined billing you must have access to the participating billing network.

    When you take a closer look at how these billing networks work it becomes clear where you may be exposed, especially on smaller networks. No one knows this better than the self employed and those who do not get insurance offered through work. When an individual purchases health insurance on the exchange (Healthcare.gov), the only network options available in Texas are HMO, or restricted networks. These networks are formed for the insurance company and the medical institution to share losses, while hoping to bring in excess volume of patients to offset the claims. Even these smaller type of HMO networks can have big holes in their billing networks. For example, if an individual has a surgery within their HMO network they may still have an unpleasant surprise when the final bill comes. Although their surgeon is likely covered, both the anesthesiologist and the surgical tools rented for the surgery might fall out of the billing HMO network, causing thousands of dollars to be paid by the patient. You guessed it, not a word of warning, just a bill that the health insurance will not cover well after the surgery.

    The only way to avoid a small HMO network pricing trap is to take advantage of much larger billing networks, allowing you to avoid the uncovered pitfalls. These larger networks, or providers, can have hundreds of thousands of doctors and medical institutions participating coast to coast. Many of these nationwide networks make it mandatory for their preferred discount to be the primary, or front runner, method of billing, protecting the patient’s financial interests from any threat of overpricing. In fact, these predetermined pricing modules are so accurate some insurance companies form their coverage to mirror the preferred billing, therefore limiting the out of pocket expense by thousands of dollars. Those who utilize this service can rest easy knowing that their interests will be protected moving forward from the right billing network with unrestricted networks nationwide.

    Although these billing network giants are elusive in today’s ACA health insurance environment, they do exist across the nation, Texas included. In fact, I have helped dozens and dozens of clients take advantage of these unrestricted networks over the last few months alone, at much more reasonable premiums than ACA policies. It is important to consider the network billing plans when choosing the right heath insurance plan for your family, especially for those who do not qualify for a subsidy (Federal income credit given to those with limited financial means). It is extremely important to speak to a health insurance professional who has access to these unrestricted billing networks, in order to protect your financial interests.

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    Source by Cal J Burgess

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  • MLM – In Unashamed Defense of Multi-Level and Network Marketing

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    One of the things that tells you are being successful in your online marketing efforts is an increasing number of emails from nay sayers, spoilers and people who are just down right rude.

    I recently received one from an IT expert who was independently well off thanks to stock options and profit sharing. He mocked MLM people as “bottom feeders” and said, “I mock MLM as a business model.” Probably very easy to do when you’re loaded thanks to stock options, etc – just hope his company doesn’t go the way of Enron!

    To be honest I mock most other business models as an inefficient and sometimes down right unethical way to do business. Example one:- Small family in china produces components for a larger company for a tiny margin, large company then sells products to a wholesaler, wholesale then sells it to a foreign wholesaler who then sells it to a retailer who sells it to the consumer. Now this is a basic model – sometimes the middle men can be much more numerous. Either way the original producer gets screwed and the consumer gets screwed thanks to the number of middle man. This is even worse in the agricultural industry. Go to a farmer and ask him how much he/she gets for a liter of milk, a ton of potatoes, etc – it will shock you! They get a pittance of the final shelf price. For farmers to continue to rely on the big multinationals to do the right thing by them is the seriously flawed business model as they continue to be driven to the wall. I MOCK TRADITIONAL BUSINESS MODELS.

    The worlds biggest MLM is the international illegal drug market – although they trade in evil and death they are a huge network of people from poppy fields in Afghanistan to street sellers in western cities – the high estimate is that the world wide industry is $500 billion. The a lot of money for what is an MLM. Should MLM still be mocked as a business model?!

    Multi-level marketing and network marketing is found throughout the business world. Real Estate agents, Dealerships, and many other ‘traditional’ business often have levels of reward depending on number of sales, sales people below you, etc. The internet abound with affiliate programs that are multi-leveled to reward affiliates not only for product sales, but also if they bring in new affiliates.

    Why is MLM so hated by the traditionalists? One it represents a threat. It means a load more competitors. It puts products profits into the hands of the consumers. It means less sales bonuses for them and less margins for the middle men. It means the wealthy can lose control of markets that they previously dominated. Who would you be more scared of – another multi-national with a sales team of 100 people, or a MLM with 100,000 non-professional sales people? Genuine people power has always frightened those in control of both the power and the purse strings. Why would you give the profits to the consumer instead of the share holders? Of course it rattles their cage – it threatens their very existence. Instead of a CEO earning millions for doing nothing, he/she would actually have to get out there and prove that they could sell a product to be successful. Hugely frightened for someone relying on their degrees and old tie network to get ahead.

    Multi-level marketing and network marketing is also hated by the traditionalist because it frees people from slavery to a forty hour working week. They love people to be in credit card debt. They love people to HAVE to go to work to survive. They love people having big mortgages. They love people being CONSUMERS. They don’t want consumers to turn into producers. It spoils there party. They don’t want people to be free to from the “traditional” working (slavery) model.

    At the end of the day it doesn’t matter what the naysayers say about MLM, the only thing that matters is can you succeed at MLM.

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    Source by Alastair Harris

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  • Risks in International Business

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    Just as there are reasons to get into global markets, and benefits from global markets, there are also risks involved in locating companies in certain countries. Each country may have its potentials; it also has its woes that are associated with doing business with major companies. Some of the rogue countries may have all the natural minerals but the risks involved in doing business in those countries exceed the benefits. Some of the risks in international business are:

    (1) Strategic Risk

    (2) Operational Risk

    (3) Political Risk

    (4) Country Risk

    (5) Technological Risk

    (6) Environmental Risk

    (7) Economic Risk

    (8) Financial Risk

    (9) Terrorism Risk

    Strategic Risk: The ability of a firm to make a strategic decision in order to respond to the forces that are a source of risk. These forces also impact the competitiveness of a firm. Porter defines them as: threat of new entrants in the industry, threat of substitute goods and services, intensity of competition within the industry, bargaining power of suppliers, and bargaining power of consumers.

    Operational Risk: This is caused by the assets and financial capital that aid in the day-to-day business operations. The breakdown of machineries, supply and demand of the resources and products, shortfall of the goods and services, lack of perfect logistic and inventory will lead to inefficiency of production. By controlling costs, unnecessary waste will be reduced, and the process improvement may enhance the lead-time, reduce variance and contribute to efficiency in globalization.

    Political Risk: The political actions and instability may make it difficult for companies to operate efficiently in these countries due to negative publicity and impact created by individuals in the top government. A firm cannot effectively operate to its full capacity in order to maximize profit in such an unstable country’s political turbulence. A new and hostile government may replace the friendly one, and hence expropriate foreign assets.

    Country Risk: The culture or the instability of a country may create risks that may make it difficult for multinational companies to operate safely, effectively, and efficiently. Some of the country risks come from the governments’ policies, economic conditions, security factors, and political conditions. Solving one of these problems without all of the problems (aggregate) together will not be enough in mitigating the country risk.

    Technological Risk: Lack of security in electronic transactions, the cost of developing new technology, and the fact that these new technology may fail, and when all of these are coupled with the outdated existing technology, the result may create a dangerous effect in doing business in the international arena.

    Environmental Risk: Air, water, and environmental pollution may affect the health of the citizens, and lead to public outcry of the citizens. These problems may also lead to damaging the reputation of the companies that do business in that area.

    Economic Risk: This comes from the inability of a country to meet its financial obligations. The changing of foreign-investment or/and domestic fiscal or monetary policies. The effect of exchange-rate and interest rate make it difficult to conduct international business.

    Financial Risk: This area is affected by the currency exchange rate, government flexibility in allowing the firms to repatriate profits or funds outside the country. The devaluation and inflation will also impact the firm’s ability to operate at an efficient capacity and still be stable. Most countries make it difficult for foreign firms to repatriate funds thus forcing these firms to invest its funds at a less optimal level. Sometimes, firms’ assets are confiscated and that contributes to financial losses.

    Terrorism Risk: These are attacks that may stem from lack of hope; confidence; differences in culture and religious philosophy, and/or merely hate of companies by citizens of host countries. It leads to potential hostile attitudes, sabotage of foreign companies and/or kidnapping of the employers and employees. Such frustrating situations make it difficult to operate in these countries.

    Although the benefits in international business exceed the risks, firms should take a risk assessment of each country and to also include intellectual property, red tape and corruption, human resource restrictions, and ownership restrictions in the analysis, in order to consider all risks involved before venturing into any of the countries.

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    Source by Sidney Okolo

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  • Fugazi – 5 Dollar Shows, 10 Dollar Albums And 1,000,000 Dollar Passion

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    Few bands in recent years have enjoyed the critical acclaim that this influential rock band has received. Formed in 1987 by the remnants of crucial hardcore bands Embrace and Rites of Spring, this band has reached the title of underground legends. This reputation is not the result of their evolution of hardcore punk and their experimentation with several other musical genres but of their ethics and ideals. This essay’s purpose is to expose one of the best bands of the American underground. Fugazi is composed of vocalist and guitarist Ian Mackaye, vocalist and guitarist Guy Picciotto, bassist Joe Lally, and drummer Brendan Canty.

    To start to chronicle Fugazi’s history, one must first look at their hardcore roots. Ian Mackaye was the vocalist of the iconic and often called “definitive” hardcore punk band Minor Threat formed in 1980. Minor Threat has a legendary status in the punk scene because of their music, their ideas and their approach. After Minor Threat disbanded in 1983, Mackaye went to form Embrace in 1985. Meanwhile, Guy Picciotto was part of Rites of Spring, often called the “first and definitive emocore band,” formed in 1984. These two influential bands were part of the movement known as “Revolution Summer,” an attempt to change the punk scene to more melodic music and introspective lyrics; several hardcore bands from the 80’s had attracted a lot of violence and intolerance because of their aggressive music and raging lyrics. The two bands were short-lived, and their members joined other groups. Ian Mackaye then formed a trio with Joe Lally and Colin Sears, who left and was replaced by Brendan Canty. Fugazi is a Vietnam acronym for bad combat scenarios that stands for F*cked Up, Got Ambushed, Zipped In. After a few shows they decided to add Picciotto into the mix and continued playing for several years.

    Fugazi are very difficult to classify and labeling them into a single genre is nearly impossible and, in some ways, insulting. Their music integrates elements of punk, hardcore, noise rock, and even soul, with innovative rhythms influenced by funk, jazz, reggae and dub. In fact, they have been categorized as post punk and post hardcore by many critics because their music is an evolution, progression and reaction to hardcore punk. This band is also notable because of the interlocking guitars of Picciotto and Mackaye, which stay in a balance as equals, unlike most bands that have a leading guitar and a rhythm guitar. Also, the contrast in both guitarists singing styles is fascinating. Mackaye’s hardcore roots make his singing be way more straightforward and anthem-like while Picciotto prefers a more abstract way of singing. Their experimental sounds have influenced many bands, like At the Drive-In and are regarded as one of the best bands of the last twenty years.

    Just as famous as their groundbreaking music are their ethics and ideals. They’re one of those hard-to-find bands that, while keeping their DIY punk ethics, still achieved mainstream success. They normally charged form $5 to $10 per show and insisted that their shows be open for everybody, age notwithstanding. They don’t sell merchandise like posters, pins, patches or t-shirts because they thought that having a person managing merchandise involved more costs and they wanted to keep the prices of their albums and shows at a minimum. At their shows, Fugazi encouraged the underage fans to wear black exes on their hands to stop them from consuming alcohol, particularly, a tradition created by Mackaye during his days at Teen Idles, a band older than Minor Threat. Much of Fugazi’s reputation comes from word of mouth. They had the reputation of powerful, cathartic shows and an eagerness to play anywhere. Another famous characteristic of Fugazi is that they, unlike most bands from their time, discouraged slam dancing, fist fights, and moshpits during their shows and are ready to stop playing and ask the problematic people to step out with their money back so they can continue their show.

    Fugazi have proved to be one of the most revered bands in the American Indie and Punk scenes because of their contribution to music. Just the fact that they never sold out when they had a myriad chances proves how valuable their music was for them, an admirable quality. In this conformist and corporative world where sounds are synthesized and copied to manipulate the masses, those underdogs that rebel against the mainstream and seek to achieve musical pleasure are the ones that are worth listening to. Many bands have taken Fugazi’s example but no band will ever compare to the greatness that was Fugazi, the band that could.

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    Source by Juan Diego Alvarado

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  • Irrational Use of Medicines – A Threat to Patient Community

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    More than 50% all medicines worldwide are prescribed,dispensed or sold inappropriately. 50% of patients

    fail to take them correctly. Conversely, about one-third of the world population lacks access to essential medicines. Treatment with medicines is one of the most cost-effective medical interventions known and the proportion of national health budget spent on medicines ranges between 10% and 20% in developed countries and between 20 and 40% in developing countries. Thus, it is extremely serious that so much medicine is being used in an inappropriate and irrational way.

    Irrational use

    Common types of irrational use of medicine are:

    1. The use of too many medicines per patient

    2. Inappropriate use of antibiotics, often in inadequate dosage, for viral infections

    3. Over-use of injections when oral formulations would be more appropriate;

    4. Failure to prescribe in accordance with clinical guidelines;

    5. Inappropriate self-medication, often of prescription-only medicines.

    Poor communication between professionals and consumers

    Communication between professionals and consumers is fundamental to the improvement of rational use of medicines by consumers. Professionals should provide the following information to the consumers: the name of the medicine, the purpose for which the medicine is being taken, dose, frequency of use, and duration of use. The prescribed and dispensed medicines should also be properly labeled indicating the above information. The shortage of qualified health personnel in public health facilities has resulted in inadequate labeling of medications , and in insufficient time spent by them to inform the consumers on how to take the medicine. Also important are the possible drug and food interactions that might occur after taking the medicines. In cases of medicines for chronic diseases such as anti cancer drugs, the adverse effects such as memory loss, depression and many others should be explained to the consumer.

    All this communication requires adequate time between the professionals and consumers which is not always available due to the enormous workload of the health professionals in the developing countries. The situations has been made worse by the increase in the spread of HIV/AIDS and the attendant treatment issues which have placed further burden on both the health professionals and consumers.

    The influence of the company towards prescribing its product specially when new product introduced into the market. A study conducted by German Government on new medicines showed that 300000 doctors were prescribing a new type of insulin (analogue insulin) which has no added advantage over existing insulin. As a result of this finding the German Ministry of health decided to exclude new drugs form the list of medications paid for the national health insurance system as long as they are more expensive than existing approved drugs. This is an important step into the right direction but many of such types of steps taken in future to protect patients from this serious and widespread public health problem

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    Source by Imran Asif

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