Healthcare Marketing Research Paper Example | Topics and Well Written Essays - 2500 words

Healthcare Marketing - Research Paper Example The Affordable healthcare Act however does not just look at the issue of affordability, it looks on so many factors. The factors that the Affordable healthcare Act has addressed are so many that they could not have been implemented all at once without causing some disruption in the market. As a result, it is being implemented in steps, with the last bit expected to be implemented in 2022, over twenty years after the first bit was implemented in 2012. One of the biggest problem that have faced the American healthcare in the last few decades was not just the inability by millions of Americans to afford health insurance, but the fact that insurance companies have been seen to not be faithful to their promise after a patient who has been paying them premiums gets sick (Selker & Wasser, 2013). This has been a challenge and many Americans have suffered in the past because they would hope to be covered when they were sick only for the insurance company they had insured themselves through coming up with excuses as to why they cannot be compensated. The affordable care act is very useful in making sure that the insurance firms will have to be accountable in making sure that they cover the patients when they get sick (Zuniga, Marks, & Gostin, 2013). This is going to bring in a new paradigm in the healthcare market. Definitely, the fact that most people were losing hope with insurance firms meant that they were choosing to not buy health i nsurance. This meant that even those who could afford healthcare insurance were becoming suspicious and refusing to buy it, thus increasing the number of people who have not been covered. The other issue that the affordable healthcare act seeks to solve is the issue of insurance companies refusing to pay out when an applicant makes an honest mistake on their application. This is one issue that has stained the American healthcare insurance and needs to be addressed. The affordable

Education - One of the Most Powerful Social Institutions Assignment

Education - One of the Most Powerful Social Institutions - Assignment Example It equips an individual with skills and experience needed for the maintenance of the society through self-enhancement and upward social mobility. Conflict perspective suggests that education creates social barriers between individuals, which sustains social inequality. Instead of looking at things in a societal level, symbolic interaction perspective zeroes in on classroom and school dynamics, which influences the individual’s outlook in life. From a functionalist perspective, education is seen as the primary agent of shared values and norms. Education is not responsible for just teaching academic knowledge but it should also develop an individual’s identity that corresponds to what is accepted by the society. Functionalism studies social events and institutions by looking at its manifest and latent functions. With education, it’s manifest or obvious function is teaching academic knowledge, as well as, developing the social skills of the individual. As an agent of development and stability, it is responsible for the transmission of culture by instilling shared values and norms corresponding to that of the larger society. And lastly, equipping an individual with knowledge, values and social skills, it creates an opportunity for upward social mobility through employment. The educational institution is primarily responsible for developing individuals as contributing members of the society. Latent or hidden funct ions of the institution are to create a safe and practical place for parents to leave their children behind as they make a living and become contributing members of the society. Education also serves to control the entry of individuals in the labour force. Lastly, it creates and establishes social networks through friendships, partnerships and relationships between individuals essential as they grow and mature. Conflict perspective views education very differently from the functional perspective.     

Japanese Canadians During Wwii Essay Example for Free

Japanese Canadians During Wwii Essay Japanese people were blamed for everything from a bad crop to a flat tire† (Biase). Japanese Canadians claimed they were given many dirty and hateful looks, and overheard â€Å"people cursing at Japanese for their car troubles† (Biase). The Japanese Canadians were being punished for a crime they did not commit. Canada’s only defence for its actions was that, â€Å"Japanese people were not white and they ‘could’ be spies† (Biase). This meant people were suspicious and literally afraid of Japanese for being spies sent from Japan. As a result, Japanese Canadians had to deal with being blamed for things they did not deserve, thus resulting in being treated unjustly as a human being. This notice was distributed throughout British Columbia. If any Japanese were found in the prohibited areas listed, they would be incarcerated. Thirdly, the Japanese Canadians were sent to internment camps across Canada against their will. In Canada, there were 10 internment camps where, â€Å"3 were road camps, 2 were prisoner of war camps (POW) and 5 were self-supporting camps† (Robinson). Internment camps is a â€Å"large detention  center created for political opponents,  enemy aliens, people with  mental illness, members of specific ethnic or religious groups, civilian inhabitants of a critical war-zone, or other groups of people, usually during a war† (Dictionary). In this case, internment camps in Canada at the time were designed for only Japanese Canadians. Internment camps were labour/work camps, which required heavy-duty work for the 22,000 imprisoned Japanese Canadians to do. Since World War II caused a large shortage of farmers, especially sugar beet farmers, the Security Commission Council organized, â€Å"Sugar beet projects to combat the labour shortage. This gave Japanese males a choice. The choice was to work in road camps as slaves or go to the beet camps and be with their families. Working in the beet camp was the choice taken by the majority of Japanese married men† (Biase). Considering the Japanese Canadians had to live inside the camps, the living conditions inside the internment camps were poor. They were crowded and were primitive with no electricity or running water. A story from Hideo Kukubo tells what life was like during the war: â€Å"I was in that camp for four years. When it got cold the temperature went down to as much as 60 below. The buildings stood on flat land beside a lake. We lived in huts with no insulation. Even if we had the stove burning the inside of the windows would all be frosted up and white, really white. I had to lie in bed with everything on that I had at one time there were 720 people there, all men, and a lot of them were old men. This is just one of the many horrible stories the Japanese Canadians experienced. Therefore, the Japanese Canadians were treated unfairly when they were forced to work and live in internment camps. In conclusion, the Japanese Canadians suffered during the period 1929 to 1945. They had their property and rights taken from them, they were blamed for unnecessary things and forced into camps where labour was the only thing you did all day. Therefore, when Prime Minister Brian Mulroney announced a historic redress settlement for the Japanese Canadians on September 22, 1988, it truly was the best thing to do, even though it was long overdue.

Workplace Health and Safety

Workplace Health and Safety Safety Engineering TMA 1 At the start it is fair to surmise that health and safety was never at the forefront of any business or company. But over many years it can clearly be seen and noted that a company cannot flourish without it. This being said it was not until the early 1930’s that the first formal Health and safety text book was introduced by H.W. Heinrich which speaks volumes of how poor the health and safety situation was coming up to this time. Moving forward through the ages it can be seen that things where moving in the right direction from the emergence of more responsible and co-ordinated attitudes in the 50’s to the all powerful Health and Safety at Work Act in 1974 to our current day Acts that protect workers in every which way imaginable. Companies that work hard and invest in overall workplace health and safety should experience reductions in illnesses, injuries and fatalities. This will return financial savings in a number of the companies sectors, such as reducing employees compensation fees and medical costs, avoiding preset penalty fines, and reducing the amount of money used to train new/replacement staff and the cost of conducting accident investigations. Overall, employers commonly find that improvements to workplace health and safety can mean substantial improvements to their companies’ financial performance and productivity. By investing in health and safety a company can improve business and must see that complying with health and safety should not be looked at as a regulatory load that has been forced upon them as it offers significant opportunities. Benefits can include: Cut costs; Lower risks; Reduce employee sickness/absence and staff turnover; Less accidents; Smaller risk of lawful action; improved status with suppliers and partners; Greater reputation for business responsibility among investors, customers and communities; More productivity, because employees are happier, fitter, healthier and more motivated. HSE figures show the personal and economic cost of failing to meet health and safety standards each year: Masses of working days and hours are used up because of work-related illness and injury. Thousands deceased from occupational diseases/illness. Over a million employees have self-reported distress from a work induced illness. As much as one worker is fatally injured every working day. It is clear to see that without an adequate health and safety setup within a company no matter how big or small they may be that they cannot compete or even exist without Safety. From a purely financial business mind the risks are far too great to waver safety and from a humanist perspective the loss of life should never be something to be risked against. 2A. What caused the event By what route(s) or mechanism(s) did the deviation or hazardous event occur? What should be done to prevent its recurrence or, if it is not technically or economically possible to prevent repetition, how can its probability be reduced to an acceptable level? Can the knowledge gained be applied elsewhere? 2B. The quantitative approach to health and safety simply put can be defined as a set of equations used to determine levels of safety. Quantitative safety levels are data and numbers put forward in order to try and estimate achievable levels of safety and measure how well they perform in quantitative results. It should be made clear that if a quantitative safety performance level has been set, it must be able to be measured or estimated in quantitative terms. Quantitative data does give a very clear picture of a system and should be applied if possible. Setting up a reliable quantitative system for safety target levels helps and enables companies to measure and record all achieved levels of safety, and could help provide a sound basis for managers and directors to make decisions. The desired target safety outcome should be presented in either relative or absolute terms. Mathematical models are the common practice used to define quantitative safety target, for example to make an estimate of a target rate of safety occurrences of a stated severity. It is also very important to note that it is often impractical or even impossible to quantify all factors. 3A. What is a hazard? The meaning of a hazard is often very misleading and can be very confusing as many dictionaries do not give specific definition and at times combine the term â€Å"risk† causing great confusion between the two. Most describe a hazard as a danger or a risk which explains why many substitute one for the other. The way that I feel best describes a hazard is- any source of potential harm, damage or ill health effects on someone or something under normal working conditions. Realistically it is something that can cause harm or ill effects to either individuals (health effects) or organizations (property damage or equipment loss). For example any working system whether it is mechanical, electrical or chemical can reach its potential to destruct through use by any amount of means i.e.; fire, explosion, mechanical fault. It would not be good practise to measure a hazard confidently against size or severity. What is risk? Risk can be foreseen as the probability or the chance of ill effect that someone may experience an adverse health effect or even be caused harm by being exposed to a hazard. It can also very easily apply to a companies, property or equipment loss or damage. An example of risk could be: the risk of developing lung cancers from smoking could be shown as – â€Å"smokers are 10 times (for example) more likely to contract and die of cancer than non smokers†. An alternative way of reporting risk is by using a number or lettering system i.e. â€Å"a number X, of smokers per 100 smokers will have a chance of developing lung cancer† (dependent on age and the amount of years they had been smoking). This type of risk is expressed a likelihood or probability of a person developing a disease or incurring an injury. These differ to hazards because they refer to the likely or possible consequences (e.g., emphysema, lung cancer and heart disease from cigarette smoking.) 3B. Ordinary (industrial) Ordinary risks are a common in all industry related businesses and are caused predominantly by employee’s everyday work and activity whilst carrying out their jobs. Classic examples of these can range from; slipping and tripping hazards, objects falling on personal from heights, personal falling from heights, physical injuries caused from lifting, physical injuries causes from interference with industrial equipment. All of the above risks are only applicable to staff working in an industrial environment and not the general public Residual A danger or risk of an event or action irrespective of being in line with science and fact can be seen as a residual risk, residual risks can and will conceive dangers, even if all possible measures of safety are theoretically applied. An example could be of a water tank or pump failing and the residual risk being flooding. Process Process risk can be seen as the result of a risk differing from predicted estimates based on the pure random chance of an event. For example if a die is thrown 6 times. It could be estimated that it will land on the number 1 once every 6 throws if the nice is fair. Process risk can be explained that the number of one’s thrown could be more or less than once due to the randomness of chance in the dice throwing process Societal risks Societal risk, as its name suggest is the risk to the society or local group of people that may be subject or exposed to a major hazard. The risk is best surmised and worked out by area and location ranging from factors like blast radius, flood radius, predictable wind direction when measuring a gas release. An example where societal risk would need to be factored in would be when any company plans to build or produce something that could/would hold some kind potential societal hazard. This can be plotted and calculated using a FN curve to determine the full risk of the set up. 4. Classify the following situations in terms of type of risk and complete the risk table by assigning probabilities between 0 (not possible) and 1 (certain) with 0.1 – 0.3 (low), 0.4 – 0.6 (average), 0.7 – 0.9 (high) for injury and equipment damage for each hazard. State concisely the reasons for your choices and any qualifications you feel are required. Factors such as weather, location and population density should be considered and stated. (i) Object falling from scaffold. (ii) Tripping over a low level pipe in a petrochemical plant whilst on nightshift. (iii) Electric shock from overhead cable/line struck by lightning. (iv) Radioactive leak into a river from nuclear power station. (v) Electricity supply interruption in an equipment store with emergency lighting. (vi) Not replacing a walkway grating on an oil rig. (vii) Hydrogen sulphide release from pocket in the end of a blanked off pipe in a crude oil fractionation plant. (i). I have selected the object falling from a scaffold as an ordinary risk and scored the probability of risk as 0.5 as is the nature of the risk there will always be the risk of objects falling from a height when working at height, I have not scored it to high as safety measures are always in place when working at heights to prevent and limit this type of risk. I have scored the probability of damage higher as generally anything falling has the potential to cause damage and at 0.8 this highlights that fact. (ii) I have categorised the tripping situation as a ordinary risk as well as a process risk, ordinary because tripping situations are overly common and happen day to day in industry and a process risk because process risks can be seen as the result of a risk differing from predicted estimates based on the pure random chance of an event i.e. tripping over a low level pipe that you may or may not have passed over safely 100 times before. I have scored the probability as low because if it was a pipe that has always been there it should be clearly marked as a danger and known to employees working around it and scored the risk of damage as low to reflect the low risk of probability of falling over the pipe and causing injury or damage to equipment. (iii) I have selected residual risk, process risk and societal risk to cover this as all 3 risks or at least parts of them can be seen. Residual as all risks and dangers can be covered and measured but not account for a lightning strike, process risk as the chances of lighting striking are extremely low but the pure chance and randomness of the event prove the process risk element and societal risk as the local area may be affected be power cuts and disruptions to their everyday functions. I have scored the probability as low as the chances statistically of lightning striking are low but have scored the risk of damage as extremely high as damage to life and equipment could be irreversible. (iv) I have selected the radioactive leak as a societal risk as the potential ecological damage to the surrounding area would be detrimental, not only affecting local wildlife but also human life and in fact any other business or being that depended on the river. I have scored the probability as low as current nuclear Power stations operate under extremely strict safety laws and practises. This being said I have scored the probability of damage as 1 the highest possible as this sort of incident could not happen without massive amounts of damage. (v) I have scored this event very low on both damage and risk probability as the only risk present would be ordinary and since safety measures are in place i.e. emergency lighting I could not foresee a high risk or probability of danger. (vi) I have scored this risk as high as the risk is very high that damage or injury will occur. I have classed it as a ordinary industrial risk as it would be caused by employee’s everyday work and activity whilst carrying out their jobs or negligence thereof. (vii) A danger or risk of an event or action irrespective of being in line with science and fact can be seen as a residual risk, residual risks can and will conceive dangers, even if all possible measures of safety are theoretically applied. An example could be Hydrogen sulphide released from a pocket in the end of a blanked off pipe in a crude oil fractionation plant, and the societal risk would be placed on anyone in the direct area. 5. The incident in my opinion could very easily been avoided, to look at the reasons why I will discuss measures that I feel should have been in place and followed, and as a result of them not being followed the incident occurring. What where the operators training and skills? Was the operator fully trained to operate is this kind of hazardous environment? Could the operator have been trained but simply forget a crucial step by not replacing the man hole cover and put it down to human error. What was the HS culture like in the workplace? His own and the companies? Could this be to blame, was there a permit to work in operation? Safe system of work in operation? Had the operator read it and signed on. These are all vital steps that need to be taken into account when working in hazardous areas and are often over looked. These would have highlighted what he could do and how to complete the task, including replacing the manhole cover when not in use. Had the operator carried out this task before? If not should the operator been supervised by someone with experience of the job at hand? And should the operator been working alone at all? Should the vessel have been charged again with nitrogen before work began again to ensure/minimize low chance of ignition? As the manhole had been left open allowing air to fill the chamber. Could an intrinsically safe scraper rod have been used? One not causing a spark? Risk Assessment/COSHH assessments? Were any done? Had the user Followed â€Å"Safe working with flammable substances† regs and abided by the five principles of control; Ventilation Ignition sources Exchange of a flammable substance for a less flammable one Separation. Without knowing the answer to any of the questions above any of them could very easily caused the incident. In my personal opinion I would have put the incident down to not following safe working practise on the job, i.e. not replacing the manhole cover and not re-charging the vessel with nitrogen to minimise the chance of ignition.

A Review of University Days by James Thurber Essay examples -- James

In the essay, â€Å"University Days† James Thurber does a sensational job keeping the reader’s interest throughout the entire story. He explains his college experiences in a way that makes the reader both interested and amused at the same time. Thurber portrays the message that the all-star football player was not the brightest bulb on the tree, which is humorous because many people can relate to that because it’s the same at their school. The author uses a creative writing style to try and capture his audience’s attention throughout the entire essay. He uses descriptive wording, humor, and stories that relate to the reader to accomplish his goal of telling his college stories in an exciting and memorable way. The descriptive wording used in this essay contributes to the enjoyment of the story. Many authors just tell stories without going in-depth and it makes the reader’s mind wander. That’s why Thurber’s style is so effective; he explains every situation very clearly and also backs them up with examples. He recalled the story about his classmate, Bolenciecwcz who was seen as the star of the football team. He was reminiscing on a time in particular that their teacher asked the football player what form of transportation he took to get to school. Bolenciecwcz had a tough time comprehending the question and was beginning to feel some pressure from his classmates to answer the question correctly. He was having so much trouble searching for an answer that the author described the situation by saying, â€Å"At this time, Bolenciecwcz was staring at the floor, trying to think, his great brow furrowed, his huge hands rubbing together, his face red.†(346) His classmates burst out into laughter at this point; in order to help the speechless... ...rd work really does pay off. This is an example that if a person fails the first try, rather than quitting, they should work even harder to accomplish the task. All of these examples were extremely influential on Thurber’s life and changed him into a more responsible person. The author’s unique writing style which includes; descriptive wording, humorous quotes, and stories that relate to the reader contribute to making the essay very easy to follow along with and it also helps enhance the excitement of the story. Thurber’s style allows him to express his thoughts in a way that makes the reader laugh and want to continue reading on. This is a sensational short story that I recommend to anyone looking to read a well-written essay or even anyone just trying to get a laugh. It’s a quick and easy read, and his creative writing styles make the story well worth it!

Australia is at War Essay -- Prime Minister Robert Gordon Menzies

‘Australia is at War’ is a primary source from the year 1939 and is a speech by renowned Prime Minister Robert Gordon Menzies (1894 – 1978). This speech was delivered at the beginning of World War II declaring Australia’s participation and assistance to its â€Å"Mother Land†, Great Britain. World War II was developed and initiated by the infamous Adolf Hitler, a notorious German leader and the head of the Nazis. German’s invasion of Poland initiated Great Britain’s move towards force rather than their original approach of negotiations and peace, as stated in Prime Minister Menzies’ speech, â€Å"they [Great Britain] have kept the door of negotiations open; they have given no cause for provocation.† So the purpose of this source, Menzies speech, which was broadcasted on national radio, was to inform Australia of the drastic measures that were to be taken against Germany in the defence for their Mother Land. As Australia ha d only pronounced federation a mere thirty-eight years earlier, Great Britain was still referred to as the â€Å"Mother Land†, as it was still greatly depended upon it, concluding that when Great Britain had declared war upon Germany, as a result, Australia too was also at war. From Australia’s contribution to Great Britain began the rise of varies army reinforcement groups such as AIF (the Australian Imperial Force), RAAF (Royal Australian Air Force), RAN (Royal Australian Navy) and many more. Prime Minister Menzies announced this speech to the whole of Australia on a radio broadcast to enlighten the nation of the beginning of World War II, Australia’s involvement and the circumstances surrounding this catastrophe that affected the whole of the world. Robert Menzies was born on 20th of December 1894 in Victoria, Australia a... ...peech ‘Australia is at War’ spoken by Prime Minister Robert Menzies at the outbreak of World War II in 1939 is a trustworthy and accurate primary source. The national announcement broadcasted by Menzies himself was addressing Australia of their forces uniting and aiding Great Britain in their war against Hitler and Germany. Justifiable historians and authors such as Joan Beaumont, Allen Martin and Christopher Waters’ work corroborates with the contents and purpose of Robert Menzies speech to display its accurateness and reliability. Works Cited Beaumont, Joan. Australia's War 1939-45. Sydney: Southwood Press, 1996. Martin, Allen William. Robert Menzies: A Life. Melbourne: Melbourne University Press, 1993. Waters, Christopher. "The Menzies Government and the Grand Alliance During 1939." Australian Journal of Polotocs and History 56.4 (2012): 560-573.

Substance Abuse: Driving Under the Influence

According to the National Highway Traffic Safety Administration (NHTSA), 16,694 people died in 2004 in alcohol and drug related traffic collisions, representing 40% of all traffic related deaths in the United States. (â€Å"2004 Traffic Safety†¦Ã¢â‚¬  2005) In addition about half of the one million people injured in road accidents were also due to driving under the influence (DUI). These are startling statistics, which underscore the enormity of the problem posed by the vast number of people who drive while intoxicated. Another point of concern regarding drunk driving or DUI is that repeat or hardcore offenders are the cause of a large proportion of traffic accidents with one out of eight intoxicated drivers in fatal crashes having had a prior DUI/DWI conviction within the past three years. (Pena, 2005) As a result, a number of programs have sprung up around the country seeking to rehabilitate the repeat DUI offenders through education, counseling, and treatment. The laws against DUI and rehab programs have resulted in a gradual but steady decline in fatalities from drunk driving since the 1980s. In this essay, I shall focus on such programs that seek to address the problem of DUI, particularly programs for the chronic and repeat offenders. The laws and penalties against driving while intoxicated have been made stricter in the US since the 1970s. The drinking age has also been uniformly raised to 21 years, while it was 18 in several states prior to the 1980s.1 Currently, driving while intoxicated (DWI) or driving under the influence (DUI) is a criminal offense in most jurisdictions within the United States.2 The punishment for DUI includes jail terms, monetary fines, mandatory DUI programs, and confiscation of driver's license for repeated offenders. Some states even treat DUI as a felony under certain circumstances such as the presence of a very high blood alcohol content (BAC), the severity of the accident caused by the drunk driver, or in cases where the driver is a repeat offender. (â€Å"Drunk Driving-United States† 2005) In case of alcohol consumption, most states laws have designated the legal limit of blood alcohol content (BAC) for drunk driving at 0.08 (i.e., 80 mg of alcohol in 100 ml of blood). In cases of driving under the influence of prescription medication or illicit drugs there is no â€Å"per se† or legal limit. Instead, in cases of driving under the influence of drugs other than alcohol, the key factor is whether the driver's faculties were impaired by the substance that was consumed. Due to this reason, the detection and successful prosecution of drivers impaired by prescription medication or illegal drugs is difficult. Besides performing a chemical test (blood, urine, or breath analysis) in order to determine the BAC of the offender, a law enforcing officer may also administer a Field Sobriety Test (FST) on a suspect driver. There are certain standardized FSTs such as the â€Å"Walk and Turn† test, the â€Å"One-leg Stand† and â€Å"Horizontal Gaze Test,† which can reliably determine the level of impairment of an intoxicated driver. (Ibid.) The Transportation Equity Act (TEA-21) enacted in 1998 encourages States to enact Repeat Intoxicated Driver laws providing for minimum penalty for repeat offenders such as: a)Suspension of driver's license for not less than one year b)Impoundment, immobilization, or installation of ignition interlock system on vehicles c)An assessment of the individual's degree of abuse of alcohol and treatment as appropriate d)Not less than 30 days community service or 5 days of imprisonment for 2nd offense and not less than 60 days community service or 10 days of imprisonment for 3rd and subsequent offense. (â€Å"Minimum Penalties for Repeat offenders† n.d.) As mentioned in the introduction, there are a number of DUI programs in the United States that seek to control the menace of drunk driving through education, counseling and treatment of the offenders. Some of these programs are described below: California's Driving Under the Influence (DUI) Program: California was among the first states in the US (along with New York) to introduce laws pertaining to drunk driving. It has also introduced an effective DUI Program, which is governed by legislation enacted in 1978. The State has a system in place that determines the need for DUI program services, licenses DUI programs, establishes regulations, approves participant fees and fee schedules, and provides DUI information. A person convicted of a first DUI offense are required to complete a state-licensed three-month, 30-hour alcohol and drug education and counseling program. Drivers detected with a blood alcohol content of 0.20 or higher must complete a state-licensed sixmonth, 45-hour alcohol and drug education and counseling program. These programs are designed to enable participants to consider attitudes and behavior, support positive lifestyle changes, and reduce or eliminate the use of alcohol and/or drugs. (â€Å"An Overview of California's†¦Ã¢â‚¬  2004) Repeat DUI offenders (second and subsequent DUI convictions) must complete an 18-month multiple offender program. Such programs provide 52 hours of group counseling; 12 hours of alcohol and drug education; 6 hours of community reentry monitoring; and biweekly individual interviews during the first 12 months of the program. A county in California may elect to provide 30-month DUI programs for third and subsequent DUI offenders, which provide longer periods of counselling, education, and community service, i.e., 78 hours of group counseling; 12 hours of alcohol and drug education; 120-300 hours of community service; and close and regular individual interviews. Presently, such services are available in Los Angeles and San Francisco Counties. (â€Å"An Overview of California's†¦Ã¢â‚¬  2004) The California Association of Drinking Driver Treatment Programs (â€Å"CADDTP†) has been formed to help promote understanding of, and improve the role of the DUI programs in California. Most people agree that California's DUI program network is â€Å"the most inclusive, structured, and complex† and its entire programs are self-supporting through fees paid by participants. They have caused DUI arrests and alcohol-related fatalities to decline steadily in the last two decades when it was introduced. (â€Å"California Association of Drinking Driver Treatment Programs† n.d.) Drug Courts for DUI: An American Council on Alcoholism (ACA) Program: In collaboration with the National Association for Drug Court Professionals (NADCP) and the National Commission Against Drunk Driving (NCADD), the American Council on Alcoholism Program (ACAP) seeks to promote and establish courts that focus on alcoholism treatment for drunk driving offenders. This is because ACA believes that the root cause of the drunk driving problem is alcohol abuse and alcoholism and unless we address the root problem of alcoholism, we will not be able to solve the problem of drunk driving. The ACA also believes that traditional means of prevention have had little or no effect on â€Å"hard core† drunk drivers or repeat offenders; therefore it is working for the application of the highly successful drug courts model to cure hardcore drunk drivers of their alcoholism. Drug Court Programs have been found to be highly successful in rehabilitating repeat and hardcore DUI offenders. Recidivism rate in such programs is remarkably low (about 11% v 60% for most other programs). A unique feature of Drug Court is the direct involvement of the judge in the treatment process who remains in direct contact with the defendant and engages in frequent discussion of the progress. The frequent contact between the judge and the defendant creates a paternal-like relationship between them and the judge is able to give positive reinforcement, issue instant reprimands or order incarceration for up to 30 days as the situation demands. (Kavanaugh, 2003). An example of a successful DUI Drug Court Program is the Butte County Revia Project started in 1996 for repeat drinking drivers. The key to this model of treatment is the use of ReVia (generic name: naltrexone) for weaning the repeat DUI offenders from their alcohol dependence. (â€Å"Butt County Revia Project,† 2003) The Century Council3 created The National Hardcore Drunk Driver Project in 1997 in order to coordinate efforts directed towards deterrence of hardcore drunk drivers who habitually drive while highly intoxicated. The Council's main aim is to call attention to the serious nature of the crime of drunk driving and to provide the needed framework in order to close loopholes in existing laws and programs, enact needed legislation, and ensure that the responsible agencies and organizations work together effectively to address the problem. The Council stresses that successful DUI programs for repeat and hardcore offenders should be based on swift identification, certain punishment and effective treatment. It conducts research on DUI and has published a comprehensive source book on the topic, which provides up-to-date data to assist legislators, highway safety officials, law enforcement officers, judges, prosecutors, community activists, corrections personnel, and treatment professionals in developing programs to reduce hardcore drunk driving. (â€Å"National Hardcore Drunk Driver Project† 2003) There are a number of other organizations in the US as well as many other countries that are engaged in conducting programs for the treatment of chronic and repeat DUI offenders. These include the Alcoholics Anonymous (AA)-a support group of alcoholics that seeks to cure alcohol addicts from their addiction through a twelve-step process; the Al-Anon/ Al-Ateen Family Groups–a fellowship of relatives and friends of alcoholics who share their experience, strength, and hope, in order to solve their common problems.4 The Al-Anon programs are based on the belief that alcoholism is a family illness, and that changed attitudes can aid recovery. Convicted DUI offenders can be sent to jail and fined, particularly in case of repeat offenders. Other alternatives to jail sentence, apart from the DUI Programs for rehabilitation that were discussed in the preceding paragraphs are: Electronic Monitoring (wearing of an ankle bracelet that monitors the whereabouts of the wearer); Work Release-the convicted person works at a place determined by the Probation Department and goes home to sleep; Work Furlough-an arrangement in which the participant keeps his job but returns to a dormitory style facility at night; and City Jail-operated by the local police where the participants spend the night but are released during the day. (â€Å"Jail Alternatives† 2005) Most DUI laws are aimed at deterring driving under the influence of alcohol and drugs. One way of deterring DUI offenses is by making policies and laws that change the drivers' attitude towards DUI and by altering their perceptions of the likely consequences as a result of DUI behavior. (Greenburg et al, 2004). Such anti-DUI laws could be enacted and public information campaigns launched that enhance a driver's perception of â€Å"the certainty, swiftness and severity of prosecution† for drunk-driving offenses, or by increasing awareness of the physical dangers associated with driving while intoxicated (Ibid.) Some experts believe that the â€Å"moral component† of the laws is much more important than the â€Å"fear factor† of apprehension and punishment in the long-term control of drunk driving. This is mainly because the likelihood of detection for DUI offenders is very low or uncertain. According to a study quoted by Robin, â€Å"On any given outing, an intoxicated driver has less than a 1-in-1000 chance of being apprehended by the police.† (Robin 1991) Tough laws against drunken driving have a moral aspect that gradually develop a culture in a society that is intolerant of DUI regardless of the perceived legal risks to the driver involved. Hence, DUI laws are more likely to achieve their objective of controlling drunk driving if we emphasize the morality of the law rather than expect the hardcore violators to be deterred by the fear of getting caught. Despite a steady decline in the number of accidents and fatalities due to driving under the influence (DUI) in the US since the 1980s, the numbers are still unacceptably high. It is even more alarming that a large proportion of these accidents are caused by repeat offenders or hard core drinkers. As discussed in this paper, measures taken to control DUI range from stricter punishment to rehabilitation programs aimed at changing the behavior of chronic DUI offenders. Some of these programs have contributed significantly in reducing DUI offenses. However, a sustained, coordinated, and long-term effort is required for further reduction in DUI cases. Substance Abuse: Driving Under the Influence According to the National Highway Traffic Safety Administration (NHTSA), 16,694 people died in 2004 in alcohol and drug related traffic collisions, representing 40% of all traffic related deaths in the United States. (â€Å"2004 Traffic Safety†¦ † 2005) In addition about half of the one million people injured in road accidents were also due to driving under the influence (DUI). These are startling statistics, which underscore the enormity of the problem posed by the vast number of people who drive while intoxicated. Another point of concern regarding drunk driving or DUI is that repeat or hardcore offenders are the cause of a large proportion of traffic accidents with one out of eight intoxicated drivers in fatal crashes having had a prior DUI/DWI conviction within the past three years. (Pena, 2005) As a result, a number of programs have sprung up around the country seeking to rehabilitate the repeat DUI offenders through education, counseling, and treatment. The laws against DUI and rehab programs have resulted in a gradual but steady decline in fatalities from drunk driving since the 1980s. In this essay, I shall focus on such programs that seek to address the problem of DUI, particularly programs for the chronic and repeat offenders. The laws and penalties against driving while intoxicated have been made stricter in the US since the 1970s. The drinking age has also been uniformly raised to 21 years, while it was 18 in several states prior to the 1980s. 1 Currently, driving while intoxicated (DWI) or driving under the influence (DUI) is a criminal offense in most jurisdictions within the United States. The punishment for DUI includes jail terms, monetary fines, mandatory DUI programs, and confiscation of driver's license for repeated offenders. Some states even treat DUI as a felony under certain circumstances such as the presence of a very high blood alcohol content (BAC), the severity of the accident caused by the drunk driver, or in cases where the driver is a repeat offender. (â€Å"Drunk Driving-United States† 2005) In case of alcohol consumption, most states laws have designated the legal limit of blood alcohol content (BAC) for drunk driving at 0. 08 (i. e. , 80 mg of alcohol in 100 ml of blood). In cases of driving under the influence of prescription medication or illicit drugs there is no â€Å"per se† or legal limit. Instead, in cases of driving under the influence of drugs other than alcohol, the key factor is whether the driver's faculties were impaired by the substance that was consumed. Due to this reason, the detection and successful prosecution of drivers impaired by prescription medication or illegal drugs is difficult. Besides performing a chemical test (blood, urine, or breath analysis) in order to determine the BAC of the offender, a law enforcing officer may also administer a Field Sobriety Test (FST) on a suspect driver. There are certain standardized FSTs such as the â€Å"Walk and Turn† test, the â€Å"One-leg Stand† and â€Å"Horizontal Gaze Test,† which can reliably determine the level of impairment of an intoxicated driver. (Ibid. ) The Transportation Equity Act (TEA-21) enacted in 1998 encourages States to enact Repeat Intoxicated Driver laws providing for minimum penalty for repeat offenders such as: a)Suspension of driver's license for not less than one year b)Impoundment, immobilization, or installation of ignition interlock system on vehicles )An assessment of the individual's degree of abuse of alcohol and treatment as appropriate d)Not less than 30 days community service or 5 days of imprisonment for 2nd offense and not less than 60 days community service or 10 days of imprisonment for 3rd and subsequent offense. (â€Å"Minimum Penalties for Repeat offenders† n. d. ) As mentioned in the introduction, there are a number of DUI programs in the United States that seek to control the menace of drunk driving through education, counseling and treatment of the offenders. Some of these programs are described below: California's Driving Under the Influence (DUI) Program: California was among the first states in the US (along with New York) to introduce laws pertaining to drunk driving. It has also introduced an effective DUI Program, which is governed by legislation enacted in 1978. The State has a system in place that determines the need for DUI program services, licenses DUI programs, establishes regulations, approves participant fees and fee schedules, and provides DUI information. A person convicted of a first DUI offense are required to complete a state-licensed three-month, 30-hour alcohol and drug education and counseling program. Drivers detected with a blood alcohol content of 0. 20 or higher must complete a state-licensed sixmonth, 45-hour alcohol and drug education and counseling program. These programs are designed to enable participants to consider attitudes and behavior, support positive lifestyle changes, and reduce or eliminate the use of alcohol and/or drugs. (â€Å"An Overview of California's†¦ 2004) Repeat DUI offenders (second and subsequent DUI convictions) must complete an 18-month multiple offender program. Such programs provide 52 hours of group counseling; 12 hours of alcohol and drug education; 6 hours of community reentry monitoring; and biweekly individual interviews during the first 12 months of the program. A county in California may elect to provide 30-month DUI programs for third and subsequent DUI offenders, which provide longer periods of counselling, education, and community service, i. e. 78 hours of group counseling; 12 hours of alcohol and drug education; 120-300 hours of community service; and close and regular individual interviews. Presently, such services are available in Los Angeles and San Francisco Counties. (â€Å"An Overview of California's†¦ † 2004) The California Association of Drinking Driver Treatment Programs (â€Å"CADDTP†) has been formed to help promote understanding of, and improve the role of the DUI programs in California. Most people agree that California's DUI program network is â€Å"the most inclusive, structured, and complex† and its entire programs are self-supporting through fees paid by participants. They have caused DUI arrests and alcohol-related fatalities to decline steadily in the last two decades when it was introduced. (â€Å"California Association of Drinking Driver Treatment Programs† n. d. ) Drug Courts for DUI: An American Council on Alcoholism (ACA) Program: In collaboration with the National Association for Drug Court Professionals (NADCP) and the National Commission Against Drunk Driving (NCADD), the American Council on Alcoholism Program (ACAP) seeks to promote and establish courts that focus on alcoholism treatment for drunk driving offenders. This is because ACA believes that the root cause of the drunk driving problem is alcohol abuse and alcoholism and unless we address the root problem of alcoholism, we will not be able to solve the problem of drunk driving. The ACA also believes that traditional means of prevention have had little or no effect on â€Å"hard core† drunk drivers or repeat offenders; therefore it is working for the application of the highly successful drug courts model to cure hardcore drunk drivers of their alcoholism. Drug Court Programs have been found to be highly successful in rehabilitating repeat and hardcore DUI offenders. Recidivism rate in such programs is remarkably low (about 11% v 60% for most other programs). A unique feature of Drug Court is the direct involvement of the judge in the treatment process who remains in direct contact with the defendant and engages in frequent discussion of the progress. The frequent contact between the judge and the defendant creates a paternal-like relationship between them and the judge is able to give positive reinforcement, issue instant reprimands or order incarceration for up to 30 days as the situation demands. An example of a successful DUI Drug Court Program is the Butte County Revia Project started in 1996 for repeat drinking drivers. The key to this model of treatment is the use of ReVia (generic name: naltrexone) for weaning the repeat DUI offenders from their alcohol dependence. (â€Å"Butt County Revia Project,† 2003) The Century Council3 created The National Hardcore Drunk Driver Project in 1997 in order to coordinate efforts directed towards deterrence of hardcore drunk drivers who habitually drive while highly intoxicated. The Council's main aim is to call attention to the serious nature of the crime of drunk driving and to provide the needed framework in order to close loopholes in existing laws and programs, enact needed legislation, and ensure that the responsible agencies and organizations work together effectively to address the problem. The Council stresses that successful DUI programs for repeat and hardcore offenders should be based on swift identification, certain punishment and effective treatment. It conducts research on DUI and has published a comprehensive source book on the topic, which provides up-to-date data to assist legislators, highway safety officials, law enforcement officers, judges, prosecutors, community activists, corrections personnel, and treatment professionals in developing programs to reduce hardcore drunk driving. (â€Å"National Hardcore Drunk Driver Project† 2003) There are a number of other organizations in the US as well as many other countries that are engaged in conducting programs for the treatment of chronic and repeat DUI offenders. These include the Alcoholics Anonymous (AA)-a support group of alcoholics that seeks to cure alcohol addicts from their addiction through a twelve-step process; the Al-Anon/ Al-Ateen Family Groups–a fellowship of relatives and friends of alcoholics who share their experience, strength, and hope, in order to solve their common problems. 4 The Al-Anon programs are based on the belief that alcoholism is a family illness, and that changed attitudes can aid recovery. Convicted DUI offenders can be sent to jail and fined, particularly in case of repeat offenders. Other alternatives to jail sentence, apart from the DUI Programs for rehabilitation that were discussed in the preceding paragraphs are: Electronic Monitoring (wearing of an ankle bracelet that monitors the whereabouts of the wearer); Work Release-the convicted person works at a place determined by the Probation Department and goes home to sleep; Work Furlough-an arrangement in which the participant keeps his job but returns to a dormitory style facility at night; and City Jail-operated by the local police where the participants spend the night but are released during the day. (â€Å"Jail Alternatives† 2005) Most DUI laws are aimed at deterring driving under the influence of alcohol and drugs. One way of deterring DUI offenses is by making policies and laws that change the drivers' attitude towards DUI and by altering their perceptions of the likely consequences as a result of DUI behavior. (Greenburg et al, 2004). Such anti-DUI laws could be enacted and public information campaigns launched that enhance a driver's perception of â€Å"the certainty, swiftness and severity of prosecution† for drunk-driving offenses, or by increasing awareness of the physical dangers associated with driving while intoxicated (Ibid. Some experts believe that the â€Å"moral component† of the laws is much more important than the â€Å"fear factor† of apprehension and punishment in the long-term control of drunk driving. This is mainly because the likelihood of detection for DUI offenders is very low or uncertain. According to a study quoted by Robin, â€Å"On any given outing, an intoxicated driver has less than a 1-in-1000 chance of being apprehended by the police. (Robin 1991) Tough laws against drunken driving have a moral aspect that gradually develop a culture in a society that is intolerant of DUI regardless of the perceived legal risks to the driver involved. Hence, DUI laws are more likely to achieve their objective of controlling drunk driving if we emphasize the morality of the law rather than expect the hardcore violators to be deterred by the fear of getting caught. Despite a steady decline in the number of accidents and fatalities due to driving under the influence (DUI) in the US since the 1980s, the numbers are still unacceptably high. It is even more alarming that a large proportion of these accidents are caused by repeat offenders or hard core drinkers. As discussed in this paper, measures taken to control DUI range from stricter punishment to rehabilitation programs aimed at changing the behavior of chronic DUI offenders. Some of these programs have contributed significantly in reducing DUI offenses. However, a sustained, coordinated, and long-term effort is required for further reduction in DUI cases.