Why Governments Regulate The Health Care Industry Economics Essay

Why Governments Regulate The Health Care Industry Economics Essay In the first part of the essay we define market failure and look at the model of perfect market, we then compare this with health care market and find out the causes or factors that results in failure in the health care market. In the second part we will look at the ways governments in four different countries have intervened to ensure that the causes of the market failure are corrected. Market failure can defined as a situation whereby there is a failure to achieve an efficient allocation of resources within the market economy. A fundamental problem with the concept of market failure, as economists occasionally recognize, is that it describes a situation that exists everywhere (Nelson, 1987; Dahlman, 1979). There are different kinds of market that exist in the society with the perfect market and monopoly at the extremes and the others in between this spectrum. Perfect Market The perfect market model also referred to as a perfect competition is the most important model because it serves a benchmark from which other kinds of market can be viewed. The main objective of any firm in the market is to maximise profit and the price of the goods and services are determined by market forces. The perfect market is based on the following assumptions; There is full information, The transactions are impersonal, There are no barriers to entry or exit, There are many buyer and sellers, and they cannot influence the market price, The products are homogenous which means that the buyers cannot differentiate between products. Finally the goods are private goods. Why is health care market different? The first reason for this is that health care is a public good which is different from a private good as seen in the perfect market model, public good has two features, non-rivalrous which means that the use of it by one person does not stop another from benefitting from it, and it is non-excludable this means it will difficult to prevent people from enjoying the benefits. With public good there is what is known as a free-rider problem people will not pay for them because others are willing to pay for them. The nature of public goods poses a problem for the market because the private sector will not make a profit from their provision since everyone can enjoy it whether they pay or not. Health care is also a public good and under provision of it also leads to market failure. Health care is also a merit good that society values and believes that people should have them because consumption is believed to generate positive externalities-this will be discussed in the next paragraph as we ll as other causes of market failure. Causes of market failure in health care 1. Externalities Externalities also referred to as third-party effects occur when others are affected by the transaction arising from the production and consumption of health care for which the costs or benefits are not taken into account.The core of the argument against market failure analysis is derived from the study of transactions. (Zerbe et al p7).Whenever there is a transaction externalities are known to occur which leads to transaction costs. This is defined as the resources necessary to transfer, establish and maintain property rights. The property rights was developed by R H Coase where he stated that individuals form firms to reduce transaction costs. Externalities may arise in different ways and they may be either positive (beneficial) or negative (harmful), and can be during production or consumption. Examples of negative externality is smoking which results in external costs on a third party passive smoking and also alcohol ingestion can lead to antisocial behaviour. Vaccination agains t infectious diseases is a form of positive externality where an individual is certain of protection by the consumption of another person. An example of external cost of production is via pollution from an industry and external benefits of production is the patent rights given to firm that discovered a new drug, stopping all other firms from copying the products. When there are externalities in health care this will not lead to a perfect market hence market failure will occur. The externalities discussed so far can be referred to as selfishly motivated. There is externality referred to as caring externality which occurs when individuals get personal satisfaction from knowing that a person is getting the health care they need. Externalities are around us every day but they are not taken into account whenever there is a transaction, this is because property rights are not well defined. Health care is not owned by anyone so therefore there is economic incentive to protect it and the on ly way the property rights can be well defined and protected will be through government regulation e.g. by banning smoking in public places and also making vaccinations compulsory. Even with government legislation it is difficult to achieve this. (Zerbe,1976,1980;Medema and Zerbe,1999a),in a world in which property rights are fully specified and in which transaction costs are zero, the allocation of resources will be efficient. This kind of world does not exist, this is an indication that market failure will always occur. 2. Imperfect information Economics is concerned with the efficient use of limited productive resources for the purpose of attaining the maximum satisfaction of our material wants (Jackson and McConnell, 1985, p3), this involves transacting parties utilising these resources to meet and satisfy their wants. This is based on the assumption that the parties have full information about the goods and services being bought or sold and also about each other. These assumptions describe a market where there is perfect information (Stiglitz, 1993).In the health care there is imperfect information and/or information asymmetry. Information asymmetry can be defined (using the acquisition of health insurance as a classical example) as situation whereby client that wants to get a health insurance has more detailed information about himself than the insurance company. Imperfect information is the case of a physician who has more knowledge than patients. The uncertainty of illness and the cost of it when it arises is one the principal reasons for taking health insurance. Two problems arise whenever there is insurance cover; these are adverse selection and moral hazard. Information asymmetry and adverse selection was first described by George Akerlof in his article, The market for lemons: Quality, Uncertainty and the Market Mechanism. Adverse selection is often referred to as a hidden information problem in a market, where for example sellers may know more about a product than a customer. (Estrin and Laidler). During the 1980s, when HIV/AIDS was first discovered insurance companies suffered from adverse selection as a lot on individuals with this disease took increased insurance cover without disclosing their status. This led to the suggestion that genetic testing should be used for individuals who may wish to acquire health insurance.The concept moral hazard was first defined by the French economist Dreze in 1961 (Mooney 1994, p 135), but it is often described as a hidden action because it results in be havioural changes in patients once their expected losses are covered by health insurance. Ehrlich and Becker (1972) distinguished between ex ante and ex post moral hazard. The former occur in a healthy state when individuals can engage in preventive care such as regular exercises and good eating habits and the latter when the individual is ill, but since the health be it taxation or other forms of health insurance which allows a subsidise price or free at the point of use, there is a greater demand by the patient than it will be if the patient was to pay all the costs. Donaldson and Gerard (1993, p 31), comments,thus, the market fails to transmit efficient price signals to consumers. Donaldson and Gerrard (1993) identified two types of provider moral hazard. They identify moral hazard by doctors who are identifiable actors in the health care system and also moral hazard by hospitals. Doctors are known to act on behalf of the patients both as the demander and supplier of services and do not account for the cost. First on the supply side they are the provider of health care and on the demand side there is information asymmetry. There are different reimbursement which affects doctors attitudes and two that affects the patients attitudes ( charges to patients, private practice).Provider moral hazard occurs most commonly with the fee-for-service (FFS) reimbursement doctors are paid on the quantity of services; more services will result in a higher income. Therefore there is a financial incentive for physicians to provide care in excess of what the patients may require if they had full information. There is not much literature on hospital moral hazard so this can be a n area for future development. 3. Imperfect competition The perfect market provide the best means of making sure that the economy is efficient by encouraging firms to compete and also creating choice. These conditions for efficiency serve as a benchmark to help identify sources of allocative inefficiency referred to as market failures. But in the real world the perfect market does not exist as Hausman argued, when taken literally, the notion of market failure is of little relevance, because perfectly competitive equilibrium, the benchmark against which market fail, does not obtain. Despite this the competitive market have been used on the assumptions on which it was formed, as Amelia Fletcher, Director of Markets and Policies Initiatives commented, Competition is a rivalrous process, in which firms compete effectively to give the consumers a better deal. The question is that is this obtainable in health care with the uncertainty that surrounds ill health? The first problem here is the limited information has about the outcomes and benefit s of various medical treatments. Individuals rarely have the same illness over time so there is little opportunity to acquire information and even on those with long standing chronic illness like diabetes who may have information. The changing world of advanced technologies means that there will be information disparities. Oligopoly is the dominant market model in health care and McPake and Normand (2008, p 141) noted, the key feature of an oligopoly is that the decision made by one firm depends on the decision made by other firms, i.e. there is a high degree of interdependence between firms. Thus there may be incentives for hospitals to collude which results in adverse outcomes for the society. It is generally accepted that competition works best when there is excess capacity, but in health care there is excess demand. 4. Inequality and poverty An individual ability to purchase health care depends upon his income to a large extent. In standard economic theory its the ability and willingness to pay that determines how resources are maximally utilised but this does not happen in the real world as we have noted from previous sections in this essay. Goodwin (2005) commented that, hospitals make demand and other raw materials from suppliers with the expectation that the final products will be bought by consumers-the demand by consumers are those backed by the consumers ability to pay. So what is important in a perfect market is effective demand i.e., there is distribution of resources to meet the basic human needs. Therefore if for example few wealthy people desire a particular commodity and many poor people lack money to purchase basic health needs then the market will be stimulated to create those commodities for the rich, hence the market will fail. Government intervention and regulation of health care market From our discussion it can be seen that intervention is necessary to counteract the causes of market failure as well as the consequences such as adverse selection and moral hazard. Boadway and Wildasin (1984, p 61) suggest that, while typically the remedy for market failure due to public goods is for the public sector to provide the good, the remedy for externalities is often to provide incentives to the private sector to produce the correct amount. We will examined detailed evidence from four countries: the United Kingdom (UK), the United States of America (USA),France and Finland to ascertain how they intervene and regulate their health care systems. Methods of government intervention 1. State provision One of the main ways of solving market failure is through public funding of the health service. In the UK, France and Finland hospitals are funded through taxes but in UK it is through general taxation while France and Finland use a social insurance system. This system ensures universal coverage for the population, prevents exploitation of patients by monopoly of providers. The main problem is the issue moral hazard which is more common in publicly tax funded system in UK than the social insurance system of Finland and France. In the UK the issue of moral hazard is controlled by using gatekeepers, waiting lists, waiting times. In France and Finland price mechanism is used to deter moral hazard. Compared to the USA where it is more of private insurance, co-payments, deductibles and medical savings account schemes have been used as ways of reducing moral hazard. Donaldson and Gerard (1993, p 72) argued that, even the US health care system recognises the shortcomings of a total reliance upon market forces. The main form of government regulation there is in the form of insurance schemes for elderly people (Medicare) and indigent people (Medicaid). But in the USA, adverse selection is very common and it also occurs in UK but to a lesser extent, but this is almost non-existent in the social insurance system (France and Finland). 2. Taxation and subsidies Imperfections in the market lead to inefficient allocation of resources and this leads to negative or positive externalities. Taxation is used to discourage certain behaviours like monopolising and overpricing and subsidies can help to reduce the cost of paying for merit goods like health care. Governments in all four countries for example in order to reduce the negative externalities caused by smoking introduced taxes for the purchase for cigarettes and also legislate that companies should advertise the dangers of smoking on the pack of cigarettes sold.Antirust legislation are passed in all four countries e.g. law prohibiting the formation of monopolies and preventing imperfect competition. 3. Regulation Dolan and Olsen (2002), commented that there is constant pressure for more spending in most health services around the world, therefore policy makers have to impose regulatory measures on the providers of services to achieve efficient allocation of the resources. Regulation can be through price control, quality control e.t.c. Regulation of pharmaceuticals is one area where most of government intervention occur, for example in the UK, the National Institute of Clinical Excellence(NICE) issues guidelines on which drugs are approved and can also be used. Also sets a ceiling on how much the cost should be but one main disadvantage is that it can exclude the use of new and effective treatment because of the costs. In USA there is the Food and Drug Administration (FDA) which also a regulatory body. In France there is the Agence Francaise de Securite Sanitaire des Produits de Sante (AFSSAPS), and in Finland the National Agency for Medicines. 4. Cost benefit analysis Government intervention must take into account the cost benefit analysis, if the benefits are more than the costs. Then the government should collect taxes and provide the good. Government failure Government failure can occur when mechanisms put in place to improve the market failure worsens the situation and lead to inefficiency and inequity in the health care and also create distortion. The following can result in government failure; 1. Inefficiency of State provision In all four countries political self interest can lead to inefficiency and worsen the market failure already present because politicians can design policies to retain power rather than maximise efficiency. In France and Finland the taxation is usually higher and results in more expenditure and in the UK the citizens do not know how much is been used for health care and other sectors of the economy. 2. Changes in government policies In the USA insurance firms can find it difficult to plan without knowledge of taxes, subsidies e.t.c and this will lead to inefficiency. 3.Free markets usually leads to more efficient provision of health care(USA as an example) which allows the law of demand and supply to determine how the market works 4. Lack of incentives Undesirable incentives usually create inefficiencies, for example in France where doctors are paid by salary in some hospitals this will lead to inefficiency. 5. Lack of information Government can lack information just as much as the market because most times the government do not know what kind of health care the consumer really needs and provides this based on the information they have and may not even know the full costs/benefits of the policy. 6. Bureaucracy Most times procedures of the government are usually cumbersome and this cuts across all the four countries. Governments respond more slowly to changes and also the time it takes from planning to implementation may cause policies to be ineffective. Conclusion Market failure is known to exist in all market economy and the health market is not an exception. It has been shown that there reasons why health care market may not work efficiently, thereby necessitating government intervention. Health care is a public good and coupled with the externalities and information gaps are causes of market failure which requires correction but a sufficient justification for government intervention. Intervention is known to be costly, so therefore for it to be effective a cost-benefit analysis to suggest it is worthwhile needs to undertaken to avoid government failure which lead to market failure in itself.

The Return: Nightfall Chapter 1

Damon Salvatore was lounging in midair, nominally supported by one branch of a†¦who knew the names of trees anyway? Who gave a damn? It was tall, it allowed him to peep into Caroline Forbes's third-story bedroom, and it made a comfy backrest. He lay back in the convenient tree fork, hands clasped together behind his head, one neatly booted leg dangling over thirty feet of empty space. He was comfortable as a cat, eyes half-closed as he watched. He was waiting for the magic moment of 4:44A.M . to arrive, when Caroline would perform her bizarre ritual. He'd already seen it twice and he was enthralled. Then he got a mosquito bite. Which was ridiculous because mosquitoes didn't prey on vampires. Their blood wasn't nutritious like human blood. But it certainly felt like a tiny mosquito bite on the back of his neck. He swiveled to see behind him, feeling the balmy summer night all around him – and saw nothing. The needles of some conifer. Nothing flying about. Nothing crawling on them. All right then. It must have been a conifer needle. But it certainly did hurt. And the pain got worse with time, not better. A suicidal bee? Damon felt the back of his neck carefully. No venom sack, no stinger. Just a tiny squishy lump that hurt. A moment later his attention was called back to the window. He wasn't sure exactly what was going on but he could feel the sudden buzzing of Power around the sleeping Caroline, like a high-tension wire. Several days ago, it had drawn him to this place, but once he'd arrived he couldn't seem to find the source. The clock ticked 4:40 and beeped an alarm. Caroline woke and swatted it across the room. Lucky girl, Damon thought, with wicked appreciation. If I were a rogue human instead of a vampire, then your virtue – presuming you've any left – might be in danger. Fortunately for you, I had to give up all that sort of thing nearly half a millennium ago. Damon flashed a smile at nothing in particular, held it for a twentieth of a second, and then turned it off, his black eyes going cold. He looked back into the open window. Yes†¦he'd always felt that his idiot younger brother Stefan didn't appreciate Caroline Forbes enough. There was no doubt that the girl was worth looking at: long, golden-brown limbs, a shapely body, and bronze-colored hair that fell around her face in waves. And then there was her mind. Naturally skewed, vengeful, spiteful. Delicious. For instance, if he wasn't mistaken, she was working with little voodoo dolls on her desk in there. Terrific. Damon liked to see the creative arts at work. The alien Power still buzzed, and still he couldn't get a fix on it. Was it inside – in thegirl ? Surely not. Caroline was hastily grabbing for what looked like a handful of silken green cobwebs. She stripped her T-shirt off and – almost too fast for the vampire eye to see – had herself dressed in lingerie that made her look like a jungle princess. She stared intently at her own reflection in a stand-alone full-length mirror. Now, whatcan you be waiting for, little girl? Damon wondered. Well – he might as well keep a low profile. There was a dark flutter, one ebony feather fell to the ground, and then there was nothing but an exceptionally large crow sitting in the tree. Damon watched intently from one bright bird-eye as Caroline moved forward suddenly as if she'd gotten an electric jolt, lips parted, her gaze on what seemed to be her own reflection. Then she smiled at it in greeting. Damon could pinpoint the source of Power now. It was inside the mirror. Not in the samedimension as the mirror, certainly, but contained inside it. Caroline was behaving – oddly. She tossed back her long bronze hair so that it fell in magnificent disarray down her back; she wet her lips and smiled as if at a lover. When she spoke, Damon could hear her quite clearly. â€Å"Thank you. But you're late today.† There was still no one but her in the bedroom, and Damon could hear no answer. But the lips of the Caroline in the mirror were not moving in synch with the real girl's lips. Bravo! he thought, always willing to appreciate a new trick on humans. Well done, whoever you are! Lip-reading the mirror girl's words, he caught something aboutsorry . Andlovely . Damon cocked his head. Caroline's reflection was saying, â€Å"†¦you don'thave to†¦after today.† The real Caroline answered huskily. â€Å"But what if I can't fool them?† And the reflection: â€Å"†¦have help. Don't worry, rest easy†¦Ã¢â‚¬  â€Å"Okay. And nobody will get, like,fatally hurt, right? I mean, we're not talking about death – forhumans .† The reflection: â€Å"Why should we†¦?† Damon smiled inwardly. How many times had he heard exchanges likethat before? As a spider himself, he knew: First you got your fly into the parlor; then you reassured her; and before she knew it, you could have anything from her, until you didn'tneed her any longer. And then – his black eyes glittered – it was time for a new fly. Now Caroline's hands were writhing in her lap. â€Å"Just as long as you really – you know. What you promised. You really mean it about loving me?† â€Å"†¦trust me. I'll take care of you – and your enemies, too. I've already begun†¦Ã¢â‚¬  Suddenly Caroline stretched, and it was a stretch that boys at Robert E. Lee High School would have paid to watch. â€Å"That's what I want to see,† she said. â€Å"I'm justso sick of hearing about Elena this, Stefan that†¦and now it's going to start all over.† Caroline broke off abruptly, as if someone had hung up on her on the phone and she'd only just realized it. For a moment her eyes narrowed and her lips thinned. Then, slowly, she relaxed. Her eyes remained on the mirror, and one hand lifted until it was resting lightly on her stomach. She stared at it and slowly her features seemed to soften, to melt into an expression of apprehension and anxiety. But Damon hadn't taken his eyes off the mirror for an instant. Normal mirror, normal mirror, normal mirror – l era! Just at the last moment, as Caroline turned away, a flash of red. Flames? Now, whatcould be going on? he thought lazily, fluttering as he transformed from a sleek crow back into a drop-dead gorgeous young man lounging in a high branch of the tree. Certainly the mirror-creature wasn't from around Fell's Church. But it sounded as if it meant to make trouble for his brother, and a fragile, beautiful smile touched Damon's lips for a second. There was nothing he loved more than to watch self-righteous, sanctimonious, I'm-better-than-you-cos-I-don't-drink-human-blood Stefan get in trouble. The teenagers of Fell's Church – and some of the adults – regarded the tale of Stefan Salvatore and their local beauty Elena Gilbert as a modern Romeo-and-Juliet story. She had given her life to save his when they'd both been captured by a maniac, and afterward he had died of a broken heart. There were even whispers that Stefan had been notquite human†¦but something else. A demon lover that Elena had died to redeem. Damon knew the truth. Stefan was dead all right – but he had been dead for hundreds of years. And it was true that he was a vampire, but calling him a demon was like calling Tinkerbell armed and dangerous. Meanwhile Caroline couldn't seem to stop talking to an empty room. â€Å"Just you wait,† she whispered, walking over to the piles of untidy papers and books that littered her desk. She rummaged through the papers until she found a miniature video camera that had a green light shining at her like a single unblinking eye. Delicately, she connected the camera to her computer and began typing a password. Damon's eyesight was much better than a human's, and he could clearly see the tanned fingers with the long shining bronze nails:CFRULES . Caroline Forbes rules, he thought. Pitiful. Then she turned around, and Damon saw tears well up in her eyes. The next moment, unexpectedly, she was sobbing. She sat heavily on the bed, weeping and rocking herself back and forth, occasionally striking the mattress with a clenched fist. But mainly she just sobbed and sobbed. Damon was startled. But then custom took over and he murmured, â€Å"Caroline? Caroline, may I come in?† â€Å"What? Who?† She looked around frantically. â€Å"It's Damon. May I come in?† he asked, his voice dripping with mock sympathy, simultaneously using mind control on her. All vampires had such powers of control over mortals. How great the Power was depended on many things: the vampire's diet (human blood was by far the most potent), the strength of the victim's will, the relationship between the vampire and the victim, the fluctuation of day and night – and so many other things that even Damon didn't begin to understand. He only knew when he felt his own Power quicken, as it was quickening now. And Caroline was waiting. â€Å"I can come in?† he said in his most musical, most beguiling voice, at the same time crushing Caroline's strong will under one much stronger. â€Å"Yes,† she answered, wiping her eyes quickly, apparently seeing nothing unusual in his entrance by a third-story window. Their eyes locked. â€Å"Come in, Damon.† She had issued the necessary invitation for a vampire. With one graceful motion he swung himself over the sill. The interior of her room smelled like perfumes – and not subtle ones. He felt really quite savage now – it was surprising the way the bloodfever had come on so suddenly, so irresistibly. His upper canines had extended to about half again their size, and their edges were razor-sharp. This was no time for conversation, for loitering around as he usually did. For a gourmet, half the pleasure was in the anticipation, sure, but right now he was inneed . He drew strongly on his Power to control the human brain and gave Caroline a dazzling smile. That was all it took. Caroline had been moving toward him; now she stopped. Her lips, partly open to ask a question, remained parted; and her pupils suddenly widened as if she were in a dark room, and then contracted and remained contracted. â€Å"I†¦I†¦Ã¢â‚¬  she managed. â€Å"Ohhh†¦Ã¢â‚¬  There. She was his. And so easily, too. His fangs were throbbing with a kind of pleasurable pain, a tender soreness beckoning him to strike as quickly as the lunge of a cobra, to sink his teeth to the hilt in an artery. He was hungry – no,starving – and his whole body was burning with the urge to drink as deeply as he liked. After all, there were others to choose from if he drained this vessel dry. Carefully, never taking his eyes from hers, he lifted Caroline's head to expose her throat, with the sweet pulse throbbing in its hollow. It filled all his senses: the beating of her heart, the smell of the exotic blood just under the surface, dense and ripe and sweet. His head was spinning. He'd never been so excited, so eager – So eager that it gave him pause. After all, one girl was as good as another, right? What was different about this time? What waswrong with him? And then he knew. I'll have my own mind back, thank you. Suddenly Damon's intellect was icy cold; the sensual aura in which he'd been trapped frozen over instantly. He dropped Caroline's chin and stood very still. Hehad almost fallen under the influence of the thing that was using Caroline. It had been trying to snare him into breaking his word to Elena. And again, he could just barely sense a whisk of red in the mirror. It was one of those creatures drawn to the nova of Power that Fell's Church had become – he knew that. It had been using him, spurring him on, trying to get him to drain Caroline dry. To take all her blood, to kill a human, something he hadn't done since meeting Elena. Why? Coldly furious, he centered himself, and then probed in all directions with his mind to find the parasite. It should still be here; the mirror was only a portal for it to travel small distances. And it had been controlling him – him, Damon Salvatore – so it had to be very close indeed. Still, he could find nothing. That made him even angrier than before. Absently fingering the back of his neck, he sent a dark message: I will warn you once, and once only. Stay away from ME! He sent the thought out with a blast of Power that flashed like sheet lightning in his own senses. It ought to have knocked something dead nearby – from the roof, from the air, from a branch†¦maybe even from next door. Fromsomewhere , a creature should have plummeted to the ground, and he should have been able to sense it. But although Damon could feel clouds darkening above him in response to his mood, and the wind rubbing branches together outside, there was no falling body, no attempt at dying retaliation. He could find nothing close enough to have entered his thoughts, and nothing at a distance could be that strong. Damon might amuse himself sometimes by pretending to be vain, but underneath he had a cool and logical ability to analyze himself. He was strong. He knew that. As long as he kept himself well nourished and free of weakening sentiment, there were few creatures that could stand against him – at least in this plane. Two were right here in Fell's Church,a little mocking counterpoint in his mind said, but Damon shrugged that off disdainfully. Surely there could be no other vampire Elders nearby, or he would sense them. Ordinary vampires, yes, they were already flocking. But they were all too weak to enterhis mind. He was equally certain there was no creature within range that could challenge him. He would have sensed it as he sensed the blazing ley lines of uncanny magical power that formed a nexus under Fell's Church. He looked at Caroline again, still held motionless by the trance he'd put on her. She would come out of it gradually, none the worse for the experience – for whathe'd done to her, at least. He turned and, as gracefully as a panther, swung out of the window, onto the tree – and then dropped easily thirty feet to the ground.

Extreme Motivation Essay

What do employees want and why do they want it? In today’s business world, companies are employing a plethora of motivational techniques, in order to increase their profits. Human resources departments use a merit based motivational program, an approach that focuses on the esteem of the employee, or a combination of both. The merit based, pay-for-performance program, employed by Jack Welch, uses money to motivate high performance, whereas the other approach focuses more on helping an employee feel better about his or her self, which will lead to higher performance. Neither method is right nor wrong, it depends on the organization. The organization needs to make sure it is meeting the needs of its employees. Maslow’s hierarchy of needs suggests people must satisfy five groups of needs in order-physiological, security, belongingness, esteem, and self-actualization. Concerning Maslow’s theory in terms of pay-for-performance, it can be analyzed under each of these five areas. The physiological need is the lowest in the hierarchy, and is generally the easiest to fulfill. This physiological level is the necessities and is usually entry level of pay, which is adequate to motivate a worker to pursue the desired position. Once a person attains the physiological level, security is the next need in line. Security is having the feeling of job security. Pay raises and pension plans are money motivators, thus keeping the employee motivated in achieving company quotas and goals in the long term. Social processes describe belongingness needs in Maslow’s hierarchy. A company that provides an indirect monetary reward through a social gathering satisfies this need. A social gathering helps co-workers develop personal and business relationships with each other. Esteem can be divided into two subcategories, self-respect and respect gained from peers. Monetary forms of company provided benefits such as larger offices, job titles and raises could suit this category. The most difficult level of the hierarchy to reach is self-actualization. According to â€Å"Management with Exercises in Management, â€Å"[†¦] it can be argued these needs must be met entirely from within the individual† (Griffin, 2008, p. 439). Even though self-actualization rests with the individual, a manager can promote an environment where one can realize his or her own potential. With the pay-for-performance incentive plan, one can achieve self-actualization by reaching their goals and receiving a direct reward for the performance in the form of money. Money is not the only motivating factor, as displayed by a company named Seagate (Griffin, 2008, p. 463). With respect to Seagate’s motivational strategies, one must satisfy five groups of needs in order, physiological, security, belongingness, esteem, and self-actualization. The company decided their circumstance was dire enough for drastic measures. Seagate sent 200 managers to a weeklong adventure race in New Zealand. Providing food, water, and air at the adventure retreat, fulfills the managers’ physiological needs. In the racing tasks, the employees learn how to depend and trust each other, thus gaining each other’s security and fulfilling the security need. Belongingness is an important aspect in a career. An individual spends more than forty hours a week with their work family. It is very important that one have a good rapport with their co-workers, in order to achieve self-actualization. In the adventure retreat, the ending task is the race itself. For each leg of the adventure race, you must rely on your teammates and co-workers to complete the race together. The participation of all the employees fulfills the esteem area. Everyone is equal, honest, and encourages building the esteem of all participants. Self-actualization is the final level and most challenging to achieve. At the end of the retreat, participants leave with a new self-awareness and feel they were able to open up to their colleagues. This retreat gives everyone an important role on a team and creates dependence upon each other in order to complete tasks. This team building experience gives individuals the potential for growth and creates an open environment. Every organization has different ideas concerning motivation; Jack Welch is more of a pay-for-performance man (Griffin, 2008, p. 463). When it comes to motivational theory, Jack Welsh, former CEO of General Electric, thinks that financial rewards are the most important. Jack Welch said it best, when he said, â€Å"No company, large or small, can succeed over the long run without energized employees who believe in the mission and understand how to achieve it† (Gallo, 2008). Mr.  Welch firmly believes money is the most important factor in motivating employees in reaching their goals. Two different motivational theories discussed in â€Å"Management with Exercises in Management† correlate the incentive process of the workplace (Griffin, 2008). The expectancy theory is the first theory that relates to Welch’s money incentives. The expectancy theory â€Å"depends on two things—how much we want something and how likely we think we are to get it† (Griffin, 2008, p. 442). The expectancy theory states that if an incentive is there for an employee, the employee must also feel they have a chance to earn it. For instance, if a company offers a monthly bonus of $1000. 00 to an employee to reach a certain goal, the employee must feel they have a chance to reach that goal as well. If the employee does not feel they can reach the goal, even though the bonus is monetary, they will not attempt to reach the goal. Jack Welch also utilizes the reinforcement theory in his approach. The reinforcement theory contends, when positive behaviors are rewarded, they are more likely to be repeated (Griffin, 2008, p. 448). Mr. Welch has a reputation of rewarding his employees with cold, hard cash. By rewarding high performing employees with money, Welch demonstrates he rewards behavior benefitting the company. These monetary rewards are going to motivate the other employees to perform at a high level as well. Motivation seems to have pros and cons when it comes to an organization or firm. Seagate, a Silicon Valley firm, explains why retreats are motivating to workers. Seagate’s tactics are a combination of a human relations and a human resource approach to motivation. The human relations approach emphasizes the importance of social processes in the workplace. Employees want to feel useful and important, have strong social needs, and these needs are more important than money when it comes to motivation (Griffin, 2008, p. 436). Managers give workers the feeling of importance by allowing them some power and control over their daily operations. For example, a manager will allow a team or an individual to provide input on a decision, although the manager already knew the result. This method satisfies basic social needs, therefore, results in higher motivation, which helps individuals reach self-actualization. Another motivational approach one may use would be a human resource approach. The human resource approach takes the concepts of needs and motivation to another level. The human relationists believe the illusion of contribution and participation enhances motivation. The human resource view adds that the contributions themselves are valuable to both individuals and organizations (Griffin, 2008, p. 437). People are able and want to contribute. Management needs to make full use of the available human resources by promoting participation and team building. Carla Cavanagh (2010) believes a human resources approach is a great way to train middle managers, and one could even argue it could extend to the rest of the employees. Cavanagh believes there should be a mutual trust between employees, they should be appreciated, conversed with, involved with decisions and their growth stimulated. When this much attention is shown to an employee, they become empowered and motivated to perform at a high level (Cavanagh, 2010). Seagate’s employees are motivated because, each year, selected managers participate in a weeklong retreat in New Zealand. During the event, they learn important characteristics of a strong culture that endorses trust, accountability, and healthy competition. In addition, they work on skills for adventure racing. When they return to work, the managers apply what they learned to their division (Griffin 2008, pp. 463-464). This environment places individuals in a position that they must ask teammates for help in order to complete tasks. The ability to ask for help eliminates major roadblocks within a team or organization. When an employee can ask for help, they open up to other employees. They begin to fill a social need and therefore, a level of trust. The employees also allow themselves to receive input from another team member or management. When members of teams or work groups give and accept ideas, they can collaborate and solve many issues. This in turn gives the employees a feeling of contribution and provides the organization with resolutions to problems. Everyday companies are looking for new ways to motivate their employees to perform at higher levels more efficiently. There are so many different theories and approaches to motivation, which forces companies to research several different avenues before finally arriving with a solution. Jack Welch and his pay-for-performance method can work in one environment, but a human resource method may work best in a different environment. The success of a motivational strategy essentially depends on the organizations culture, and its leaders. As long as an organization can work off Maslow’s hierarchy as a template, they are on the right path to motivating employees, improving performance, and increasing profits.

The German Infinitive Verb Form

Just like in English, the German infinitive is the basic form of a verb (schlafen/to sleep). However, it is less frequently found than in English to be accompanied by the preposition zu/to. The following is an overview of specifics pertaining to the German infinitive. The Ending of German Infinitives Most German infinitives end with -en (springen/to jump), but there are also some verbs that end in the infinitive with -ern, -eln, -n (wandern/to wander, hike, sammeln/to collect, sein/to be). Tenses and Moods The German infinitive is used in the following tenses and moods: The future: Er will morgen arbeiten./He wants to work tomorrow.Conjunctive II: Mein Vater mà ¶chte gerne nach Kà ¶ln reisen./My father would like to travel to Cologne.In the passive: Die Tà ¼r sollte verriegelt sein./The door should be locked.In the passive perfect: Das Kind scheint zu spà ¤t angekommen zu sein./The child seems to have arrived too late.With modal verbs:  Der Junge soll die Banana essen, aber er will nicht./The boy should eat the banana, but he does not want to. Infinitives as Nouns Infinitives can become nouns. No changes are necessary. Only you must remember to precede the infinitive noun with the article das and to always capitalize it. For example: das Liegen/the lying-down, das Essen- the food, das Fahren/the driving. Infinitives as Subject Some German infinitives can stand in as the subject of a sentence. Some of these are: anfangen, aufhà ¶ren, beginnen, andenken, glauben, hoffen, meinen, vergessen, versuchen. For example: Sie meint, sie hat immer recht./Sie meint, immer recht zu haben: She thinks she is always right. Note: If you say: Sie meint, er hat immer recht you cant replace er with the infinitive since the original subject of the sentence isnt restated. Ich freue mich, dass ich ihn bald wiedersehe./I am happy that I will be able to see him again.Ich freue mich ihn bald wiederzusehen./Im happy to see him again. Conjugated Verb Infinitive Only a handful of verbs can pair up with an infinitive in a German sentence. These verbs are: bleiben, gehen, fahren, lernen, hà ¶ren, sehen, lassen. (Ich bleibe hier sitzen/I will stay sitting here.) Conjunction Infinitive   Phrases with the following conjunctions will always carry a German infinitive, whether it a short or longer phrase: anstatt, ohne, um. For example:   Er versucht ohne seinen Stock zu gehen./He tries to walk without his cane.Sie geht in die Schule, um zu lernen./She goes to school to learn. Noun Infinitive   Sentences with der Spaß and die Lust will carry a German infinitive: Sie hat Lust, heute einkaufen zu gehen./She feels like going shopping today. Sentences with the following nouns will also carry a German infinitive: die Absicht, die Angst, die Freude, die Gelegenheit, der Grund, die Mà ¶glichkeit, die Mà ¼he, das Problem, die Schwierigkeiten, die Zeit. For example: Ich habe Angst dieses alte Auto zu fahren./I am scared to drive this old car.Sie sollte diese Gelegenheit nicht verpassen./She should not miss this opportunity. Exceptions: There will not be an infinitive  if there is a conjunction in the sentence: Es gibt ihr viel Freude, dass er mitgekommen ist./It gives her great joy that he came along.