Helping People in Need a Supererogation or an Obligation

Helping people in need a supererogation or an obligation People in poor nations are starving to death when we are enjoying our delicious meal with our friends and family. There are various governmental aid-projects and privately run charities which are responsible for delivering donations from the relatively wealthy nations to the nations in need. I believe it is a morally right thing to help the people in need, but not every one of us would make donations regularly.Peter Singer uses the drowning child example to make people rethink about this current scenario. He believes that it is our obligation to help the people in poor developing countries. There are objections to his stance, but before considering and discussing from both sides, I am now going to describe and explain the Singer's drowning child example first. Imagine a child is drowning in a shallow pond and saving the child’s life means jumping into the pond and thereby getting one’s clothes wet and muddy. Would you still save the child?All of those having a rational mind will say yes. In spite of the bad consequence of fouling the clothes, saving the child’s life is morally what we ought to do as the importance of the child’s life so far outweighs the little cost of getting one’s clothes wet and muddy. It is within our power to prevent the child’s death without sacrificing something that is of even greater importance. Thus, this is what we ought to do and it is our obligation to prevent something this bad from happening (Singer, 1997).Even when there are other people near the pond who are equally qualified of saving the child but are doing nothing but simply passing by, would you still jump in and save the child? Similarly, all of those being asked said yes. It simply does not make any moral difference to the situation. Undoubtedly, not saving the child in this situation might make one feeling less guilty but everyone thinks that we ought to save the child. We agree that this is our moral obligation and it would be wrong not doing so (Singer, 1997). Then what if the child were being far away, maybe even in another country?Would people still hold the same stance? The answer is yes. Distance and nationality do not make not saving the child just. Whichever child or even adult, if saving his life is what we are able to do without having something of great significance to us being sacrifice, we ought to do that. This is morally what we ought to do without violating other things that are of similar or higher moral importance (Singer, 1972). The situation of the drowning child example is actually synonymous with those hungry children and adults suffering from famine or other disasters, both natural or man-made.If we agree that saving the child that are drowning in a pond is morally what we ought to do and not doing so is unjust, then why should we think otherwise when it comes to helping the people who are suffering in poor developing countries? Why does making regular donations to nations in need not our moral obligation whereas saving the child drowning in a pond is? We have agreed that distance and nationality does not matter in this moral stance. Moreover, the problem of being too far away from the sufferers and we might not be able to come to their aid in time has been overcome by the effort of charities.What is it that stop us from making regular donations? There are explanations to this bipolar situation, giving reasons to help better understanding the causes leading to this global scenario. First of all, saving the drowning child is helping out directly, while making a donation is not. The donation will be distributed to the people in need through the government or some privately run charities. Some of the donation will be used for administrative cost or get swallowed up in corruption.People will never know how much of their donation can really be given to those in need. As corruption is usually a prevalent problem in many of the developing countries, people sometimes have the worry that their donation might not serve to their right purposes but only be ended up in greedy hands. This worry is reasonable but actually most of the donations can get to serve their proper purposes (Giving What We Can, 2012). Although not all of the sum can be used for aid, the part of it that gets to its destination still can make the best of its worth.The aid organizations may not be one-hundred percent efficient, but they can help to solve the problem of distance, serving as an agent for delivery. There are many people around the world who are compassionate about the plight of the others. Charities and governmental organizations collect the aids and help distributing them to the areas in need. I think this is by far the most efficient way of giving out a helping hand. The cost for administration is inevitable and the part of donations spent on it could be seen as for supporting these organizations to keep runnin g.Furthermore, in my point of view, there are always ways to minimize corruption. We can donate money to aid projects that do not involve valuable goods or specifically make donations to programs which serves to tackle the corruption problem in where it is prevailing. The probability of wasting a proportion of the donations should not mean aiding being useless. Those that can get though may make a significant change that we could not imagine. The second explanation is about the psychological difference between the drowning child example and the reality.We feel more related to the sufferers when we could see them. The feeling of guilt for not helping is lesser when we could not see or witness the sufferings (Singer, 1972). Although it makes one feels less guilty without the sight of suffering presenting nearby, it does not make helping those further away a lower priority morally. As we have discussed that distance is not a considering factor in deciding whether it is our obligation t o help or not, both of those from our own country and from the other countries deserve our help.Moreover, in this age of the prosperous development of media technology, charities and governmental aid agencies can effectively show the current situation of the emaciated children to the public. Therefore, it does not sound very plausible to me saying that people not making donations is because of the lack of awareness of the issue. According to Peter Singer, a moral philosopher, if we are able to prevent something very bad from happening, without thereby sacrificing anything morally significant, we ought, morally, to do it (Singer, 1972).Some people object this position. I am going to summarize those objections. For one of the reasons is that this is simply too extreme as most people do not judge those who are ignorant of the others' suffering. People usually criticize those who violate some moral norms, for example: murdering, sex assault,etc. Some writers, including Sidgwick and Urms on, Stated that if the moral code that we set is too hard too uphold, there will be a general breakdown in the moral system (Singer, 1972).The moral code that we are currently using mainly includes not invading the others' privileges, for example: stealing, killing, etc and other things that could help keeping the society safe and sound. Helping the poor nations is not necessary for the wealthy nations. Thus, people usually do not see it as what they must do. This is regrettable but understandable. If making regular donations to those in need is being made to be an obligation and a moral code, it might be too hard for everyone to follow. Eventually, people might choose not to follow anything from the moral code (Singer, 1972).Singer argues that if the conduct is good, why should we categorize it into morally obligatory or morally optional? If morality means doing something good, then shouldn't a good conduct be in the moral code? Moreover, drawing a line to divide conducts into the aforementioned categories is by no means easy. It is hard to define the standard to be used for distinguishing conducts into two kinds. Helping the people in need in other countries is always be defined as a generous and selfless gesture. However, Singer thinks otherwise. He thinks that â€Å"our traditional moral categories are upset†.He objects the traditional distinction that is drawn between duty and charity by using the current standard. It is our moral obligation to prevent as much sufferings as possible in the meantime not sacrificing something else of comparable moral importance (Singer, 1972). How does a man act is actually influenced by the general societal values and the people around him. When a man making a donation or joining voluntary services to help those in need is being praised for his generosity, he would think that what he has done is a supererogation.Actually, coming to the others' aid to prevent suffering without sacrificing as much is an obligation tha t people usually overlook. This situation is for long being shaped by the general social atmosphere and this is what being upsetting. The moral attitude of people is shaped by each other and also the society. Admittedly, helping those is need is always greatly encouraged. However, this is by no means enough. Preventing as much sufferings as possible without causing sacrifices as significant is morally obligatory and not doing so should be seen as unjust (Singer, 1972).I agree with Singer that if it is within one's ability to help, saving other people from suffering seems to be just and morally right, while otherwise seems wrong. Although there might be concerns that what we have given might not be able to serve their greatest worth, I believe that the part of aids that get to the hands of those in need is able to make a significant change in their lives. There are worries that helping those poor developing countries might worsen the current situation. Firstly, those countries usuall y have a higher birth-rate.The aids that we give now would only support them to have a even greater population that the countries themselves are not able to feed (Giving What We Can, 2012). This might leads to a greater demand in foreign help and eventually turns into an ever-expanding cycle. This worry is understandable but there are always other alternatives to help in this kind of situation. For fear of the problem of overpopulation, donations could be made to organizations that help in promoting and enhancing birth-control in the developing countries.Moreover, the reason behind the scene of them having a high birth-rate is the high mortality rate of children. They need a large family size to ensure having enough manpower to take care of the family, to work and to earn. If their lives were not this hard, the birth-rate would presumably decline (Giving What We Can, 2012). The other worry is that the developing countries might become more and more dependent on the aids (Giving What We Can, 2012). This worry is again not necessary as there are many aid projects that are actually aiming at helping those developing nations to be self-supportive.People in some of the poor nations are taught to grow crops for supporting themselves and for selling to make money. Donations could be made to support this kind of projects. Moreover, helping those in need does not necessarily means lengthening their life expectancy but might be about improving their living quality (Giving What We Can, 2012). One example is performing a simple eye operation to cure their eye diseases so that they could see the world more clearly. It is our obligation to help the others in need when it is within our own power without sacrificing something of higher importance.Death and sufferings are things that should be prevented. This is what we ought to do. With the gap between the rich and the poor growing everyday, our moral attitude towards giving out aids should be revised. Helping should not be s een as a supererogation but an moral obligation. References: Giving What We Can. (2012). Myths About Aids, from http://www. givingwhatwecan. org/why-give/myths-about-aid Singer, Peter. (1972). Famine, Affluence, and Morality. Philosophy and Public Affairs, 1(1), 230-234. Singer, Peter. (1997). The Drowning Child and the Expanding Circle. News Internationalist, 1.

English Language Skills for Academic Study Essay

English Language Skills for Academic Study - Essay Example Conversely, the possibility of all the income going to one person denoted as having a Gini coefficient of 1 (Minton, 2012).Global inequality is demonstrated through income gaps that have been witnessed between individuals, where the gap between the rich and the poor has drawn closer. Therefore, income inequality has a negative effect on economic growth. Intensive Global Inequality Apparently, income equality as an extra ordinary economic development is not based on the United States of America only. Other countries in the world such as Britain, Canada, China, India, and even Sweden have experienced an increase in the national economic share to around 1 % (Cleaver, 2013). Similarly, one of the world’s famous magazines, Forbes has argued that in the United States of America, there are around 421 billionaires, Russia has 96, China has 95 and India has 48. In addition, Santiso & Blommestein, 2007 argues that the world richest man is a Mexican who is worth approximately $ 69 Billio n, the largest building belongs to an Indian among other economic income disparities. In a general sense, the concentration of wealth has become part of a wider disparity in the in income distribution. This is arguably true because some parts and groups of people do not receive the share of resources. This leads to negative economic growth. Consequently, the income gap has continually varied in most countries in the world for the last three decades. For instance, the Gini coefficient in the United States of America has gone up to almost 30% from 1980 with coefficient ranging at 0.39. In China, the coefficient has increased by 50% reading at about 0.42. In the same way, Sweden has increased by around 25% read at 0.24 Gini coefficient (Jubis, 2013). However, in contrast to this, Latin America has been named as the world unequal continent since it has experienced a down ward trend demonstrated through the sharp decline of the Gini coefficient (Dicken, 2010). In light of such deliberati ons, it is correct to argue that the income gap leads to negative economic growth. This assertion is true because people with low income would not be in a position accomplishing all their needs. Income Inequality as the ‘Delay Factor’ to Recession Recovery It is argued that income inequality has become a barrier or a slowing factor towards the recovery of the great recession. A recent debate economic contraction has given a vivid picture on the level of income inequality in the economic development. In light of this, two liberalist economists have given their contribution toward this debate (Stevenson & Duch, 2008). According to Stigliz, the economic inequality is preventing the recovery of the global recession due to numerous reasons. To begin with, the liberal economist argues that the middle class is not capable of giving support to consumer spending, which has driven the growth of the economy for the longest period (Stevenson & Duch, 2008). For this reason, most peo ple in the United States of America cannot manage to pay education for themselves and their children. Moreover, Stigliz articulates that the enormous lack of income from the middle class has led to the lack of tax payments a situation that is associated with frequent and more severe cycles of income inequality (Jubis, 2013). It is apparent that with low income, some people would not be able to revive any economic activities within

Diary Entries (About a Brit Lit Character) Essay

Diary Entries (About a Brit Lit Character) - Essay Example Fortunately, it does not work with me. It is very clear to me that there is something lurking beneath that casual hospitality. Well then, let me attend to other matters my friend. It has been hours since I went up here to my favorite room at the mezzanine. Yours, H. 23th April 635 My Dear Friend, It has been almost a month since I last shared my reflections with you. I am holding a cameo medallion that I gave to my Queen during our wedding. Oh and yes! The ring! That wonderful piece of intaglio jewelry that she loved very much. The stones were embedded beyond the gold’s surface. I cannot forget the look on her face when I gave the pieces to her. I wonder what’s happening between us now. She seems distant. Anyway, I need to go as it seems I lost track of time. I hear the morning sound of the campanile from the nearby chapel already Yours, H. 1st May 635 My Dear Friend, My dear Queen is very happy with my consent to invite my brother over. She is talking about having a pa lace ball, to coincide with our anniversary. She is thinking of ordering some fresco paintings for the rotunda, the palace hall where she intends to accept the majority of the guests. Also, she mentioned about using a new type of wares called majolica. She mentioned how colorful the earthenwares are, and she wants the guests to be served in a new fashion.

Canada's Dispute with the UAE Research Paper Example | Topics and Well Written Essays - 1500 words

Canada's Dispute with the UAE - Research Paper Example Furthermore, a study conducted by Etihad showed that in presence of more flights, the government would earn around 26 million Canadian dollars in taxes and would witness the creation of more than 1900 employees (Patrick & Lennox, 2008). Consequences Towards the end of fall 2010, the Canadian media got headlines when they aired the news that Canadian Defense Minister, Peter Mackay has been â€Å"thrown out† of the UAE. However, the reality was a bit different. Weeks before this incident happened, the lease, which allowed Canada to have a military camp in UAE for its soldiers in Afghanistan, expired. It meant that now if any military plane, which had to land in UAE, would have to take authorization from the UAE administration. However, Mackay did not have any such authorization and therefore, the UAE officials had no choice but to restrict the landing of Mackay in UAE (Abma, 2011). The consequences of this dispute have been adverse and if the parties fail to show any flexibility or if there is no intervention from any third party to solve the issues, then this pay the trailer of what is going to happen next. Recently, the Canadian Prime Minister Stephen Harper amazed the world by blaming the UAE government on being soft on terrorism. Furthermore, the Prime Minister also linked the introduction of visa restrictions and ending of lease arrangement for Canadian forces to fight in Afghanistan with blackmail to get the UAE’s subsidized airlines to suck money out of Canada. In fact, Prime Minister Harper has been really loud and angry on this issue and has gone on to raise doubts on the intentions of the UAE administration in helping Canada... Towards the end of fall 2010, the Canadian media got headlines when they aired the news that Canadian Defense Minister, Peter Mackay has been â€Å"thrown out† of the UAE. However, the reality was a bit different. Weeks before this incident happened, the lease, which allowed Canada to have a military camp in UAE for its soldiers in Afghanistan, expired. It meant that now if any military plane, which had to land in UAE, would have to take authorization from the UAE administration. However, Mackay did not have any such authorization and therefore, the UAE officials had no choice but to restrict the landing of Mackay in UAE (Abma, 2011). The consequences of this dispute have been adverse and if the parties fail to show any flexibility or if there is no intervention from any third party to solve the issues, then this pay the trailer of what is going to happen next. Recently, the Canadian Prime Minister Stephen Harper amazed the world by blaming the UAE government on being soft on terrorism. Furthermore, the Prime Minister also linked the introduction of visa restrictions and ending of lease arrangement for Canadian forces to fight in Afghanistan with blackmail to get the UAE’s subsidized airlines to suck money out of Canada. In fact, Prime Minister Harper has been really loud and angry on this issue and has gone on to raise doubts on the intentions of the UAE administration in helping Canada against the war on terror as part of the plan to ask for bigger favors (Kukucha & Bratt, 2011).

International Dimension for Business Essay Example | Topics and Well Written Essays - 3000 words

International Dimension for Business - Essay Example With the opening up of world economy, nearly all the business entities big or small, old or new are getting inspired in taking their business to the international level (Aswathappa, 2010, p.6). Companies are getting determined in their decision to operate across the globe. The shifting of organisations from a domestic viewpoint to a level of internationalization gives rise to a number of challenges for the firm (Turner & Johnson, 2009, p.2). The challenges may be in the form of setting up of infrastructure in the foreign market, purchasing the materials from overseas suppliers and the biggest challenge is to sell it to the foreign customers. One of the biggest trends of the recent times has been the lowering of international trade barriers. Different organisations such as World Trade Organisation, GATT and IMF are constantly working towards the intensification of globalised trade. In the recent past globalisation has been a catchphrase for the business organisations. Globalisation is a global phenomenon which can be defined as the movement of goods, services, resources, funds and labour around the world in a harmonized and synchronized way. In this process a global relation among the countries gets developed and ensures efficacy in using the scares resources of the world (Milward, 2003, p.10-16). The present study deals with the international dimension of business or in other words the other avenue to conduct business apart from the local listings. The study will reveal the international market entry strategies such as foreign direct investment, franchising, licensing and exporting. The study will also try to analyse the foreign market entry strategy of Volkswagen. The reason for choosing this organisation for conducting the study is because it is amongst prime multinational companies. A multinational company is described as the company which operates in its home country as well as in foreign market. The factors which contributed towards choosing this company a re its rich history, brand image and also considering the fact that it is the biggest car manufacturing & marketing company of the world. Company History The history of the company dates back to 1937, when the company was known as ‘Gesellschaft zur Vorbereitung des Deutschen Volkswagens mbH’. In the next year the company is renamed to ‘Volkswagenwerk GmbH’. The construction of the plant for manufacturing cars started on 1938 at Wolfsburg, Germany. During the period of 2nd world war the production of the company switched to weapons and arms. At around 20000 forced labours, prisoners were working at the plant. After the end of World War II the responsibility of Volkswagenwerk was placed on to the hands of British military government. During that era mass production of volkswagon beetle was started. During the 1950s the product line of the company was increased. In the meantime the production of Volkswagon bus was initialized. The bus is still popular even in this century for its multi-functionality and is popularly known as VB bully. As the wheels rolls on the company slowly touched the milestone of producing one million Volkswagon beetle cars. The employees and dealers from the country and overseas celebrated this memorable day in a special comportment. In 1972 the company has broken the all time record of car production with the figure touching mammoth 15,007,034 units. The company slowly moved towards the production of new age cars during 1973 with its model ‘passat’. With that initiation the company moved towards the production of varieties new age cars. That was the time when Golf was built inside the industrial units of the company. The

What is IR Theory Essay Example | Topics and Well Written Essays - 500 words

What is IR Theory - Essay Example International Relation theory raises fundamentally empirical issues which can only be settled by analyzing the facts. Professor Martin Wight, in the 1960 April issue of international Relations, published a paper titled â€Å"Why Is There No International Theory?† The Professor believes that the sovereign state has, since the Reformation, been the focal point of Western political thought and experience (Morgenthau 63). The international theory is true to diplomatic experience, and is augmented when belief in progress is prevalent. According to this school of thought, if things remain as they were in the past, man would become desperate. This theory he referred to as â€Å"the argument from desperation†. International relations is widely involves recurrence and repetition as international reality and international theory collide. International theory becomes a sort of philosophy of history as it involves the ultimate experience of national existence and national extinction. For national existence, every individual requires the protection of the state that represents them in the international community (Wight 38). This view considers a sovereign State to be the end of a political experience and activity. This juristic expression considers international politics to be an untidy extension of domestic politics. It is a systematic and continued balance of power between different players. International Relations is a transient subject with the modern society being in a state of transition. The past occurrences in one state relating with other states influences the future interactions that are likely to occur. Therefore, the theorizing of international relations is likened to a system of abstract propositions with a predictive function. In the view of this system, nations become stereotyped participators in stereotyped symmetric or asymmetric relations (Morgenthau 65). The modern society has emerged from a medieval society and is

The Affordable Care Act and Primary Care Essay Example for Free

The Affordable Care Act and Primary Care Essay The purpose of this paper is to discuss the importance of providing increased access to primary care and the expected impact of the 2010 Affordable Care Act on the delivery of primary care in the United States, extending current trends through the year 2023. Addressed topics will include a brief overview of the Affordable Care Act, current state of primary care and the impact of the Affordable Care Act upon primary care patients, providers and payers. The Affordable Care Act In March 2010, President Obama signed comprehensive health reform, the Patient Protection and Affordable Care Act (ACA) into law. This law makes preventive care, including primary care, family planning and other services more accessible and affordable for many Americans. According to the Center on Budget an Policy Priorities , the ACA would expand health care coverage to 32 million citizens who are currently uninsured. Expanded coverage of Medicaid and Medicare allows for increased inclusion of individuals who previously were not eligible for state and federal health insurance programs. The Medicaid expansion is 100% federally funded for the first three years (2014-2016) and at least 90% federally funded through 2022 and beyond (CBO, 2013). Included in the law is health insurance reform that makes illegal preexisting condition clauses in health insurance coverage and provides coverage for young adults under a family health insurance plan. Affordable Care Act and Primary Care 3 The uninsured and self employed would be able to purchase health insurance through state-based â€Å"exchanges†. Subsidies would be available to those who cannot afford to purchase insurance if they meet income requirements. Primary Care in the United States In the United States medical practice was not regulated until the 20th Century. Medical care was provided by a â€Å"doctor† who may or may not have been trained at a medical school. Many doctors received no formal training, learning as apprentices. These early practitioners provided a multitude of medical services to an entire family including delivering babies, setting fractures, surgeries, diagnosing and dispensing medications. Through organizations such as the American Medical Association the practice of medicine became regulated. These early pioneers were the early practitioners of primary care. Influenced by American ideals and desire for technology and wealth, the number of medical students choosing a path in primary care diminished in favor of specialty practice such as surgery, cardiology, radiology, etc. For several years there has been a decline in the United States primary care workforce. Primary care providers include general practitioners, general internal medicine practitioners, family physicians, physician assistants and nurse practitioners. The United States healthcare system has been facing a decline in its primary care Affordable Care Act and Primary Care 4 workforce, infrastructure and access to primary care services for several years. According to research (Petterson,2013) a number of factors, including poor reimbursements to primary care providers, low comparative income, and poor quality of work life due to high patient loads, have contributed to more providers choosing to train and practice in specialty medicine. This trend has led to a shortage of primary care providers across the country, likely contributing to fragmented care, inappropriate use of specialists, and less emphasis on prevention. Patients People who have access to a regular primary care physician are more likely  than those who do not, to receive recommended preventive services and timely care for medical condi ­tions before they become more serious and more costly to treat by visiting the emergency room instead of a primary care provider (Abrams, 2011). Patients are more likely to adhere to physician recommendations when seen by a primary care provider. Among low-income patients, access to primary care is associated with better preventive care, better management of chronic conditions, and reduced mortality. Preventing illness is as much a part of primary care as is the diagnosis and treatment of health conditions. The Affordable Care Act provides positive incentives to encourage people to obtain preventive primary care services. Through provisions in the act, applying to Medicare and Medicaid beneficiaries, as well as the privately insured, the law eliminates coinsurance, deductibles, and co payments for approved preventive services Affordable Care Act and Primary Care 5 and tests, such as blood-pressure and cancer screenings, mammograms and Pap tests, and immunizations. Studies have shown full coverage of preventive services with no patient cost, increases use of preventive screening services over time (Abrams, 2011). In a study of low-income patients, researchers found that even small incremental changes in co-payments had a substantial impact on the afford ­ability and utilization of care. Included in the ACA is the concept of a patient â€Å"medical home.† This is a pri ­mary care site that provides patients with timely access to care, including availability of appointments after regular office hours with patients to manage health conditions and prevent complications, coordinates all care, and engages in continuous quality improvement (Abrams, 2011). Primary care providers will be the coordinators of the medical home. These medical homes will also ensure greater coordina ­tion between the primary care site and local emergency departments. Primary Care Providers With the ACA the total number of primary care office visits is expected to increase from the 462 million visits in 2008, to 565 million in 2015. Also  expected is the need for an additional 52,000 primary care providers by 2025 due to insurance coverage expansion (Hofer, 2011). The ACA will entice primary care providers to accept more of the newly covered by increasing Medicare and Medicaid payments for primary care services. There are two Affordable Care Act and Primary Care 6 provisions in the ACA that augment payments to primary care providers, one provides a bonus to providers whom participate in Medicare, the second increases reimbursements for Medicaid participation. The goal of these financial incentives is to stabilize and expand the existing primary care workforce. The Affordable Care Act invests an estimated $3.5 billion in the primary care provider bonus program from 2011 to 2016. As a result, Medicaid primary care phy ­sicians are estimated to gain an additional $8.3 billion in reimbursement between 2013 and 2019 (Abrams, 2011). To address this growing shortage of primary care providers, the Affordable Care Act provides support of education and training for primary care providers and community health centers. The Affordable Care Act includes $1.5 billion authorized over 2011 to 2015 for the National Health Service Corps to provide scholarships and loan forgiveness for primary care physicians, nurse practitioners, and physician assistants practicing in health professional shortage areas (Abrams, 2011). Other provisions that offer financial support for training new primary care physicians include more favorable loan repayment require ­ments for the federally supported Primary Care Loan Program and a loan repayment pro ­gram for pediatric sub specialists and child or adoles ­cent mental or behavioral health providers working in underserved areas. The necessary midlevel primary care practi ­tioner is recognized through scholarships, loans, and loan repayment programs, as well as through the creation and expansion of training opportunities. Affordable Care Act and Primary Care 7 Payer The Affordable Care Act brings an unprecedented level of scrutiny and transparency to health insurance companies. The concept of an insurance exchange is a major component of the federal Affordable Care Act. An important component of the federal law is that individuals must have health insurance with federal subsidies to help them pay for it. To improve access and protect patient rights, ACA introduces new commercial insurance standards, such as the removal of medical underwriting, elimination of lifetime limits, prohibition of pre-existing condition exclusions, and removal of cost-sharing for preventive services. Insurance plans will be required to cover essential health benefits which are defined under the ACA (Rosenbaum, 2011). Insurance companies expect significant changes in enrollment, demographics, and plan types. Economic, behavioral, political, and strategic influences are expected to shape the changing insurance coverage landscape, according to a Department of Health and Human Services Report. Implications for insurance industry stakeholders are considerable, due to being regulated by state and federal government. Insurance companies and insurance trade publications are stating they will be forced to raise premiums due to ACA requirements, fess and taxes forced upon them ( DHHS,2013). The ACA imposes an annual fee or excise tax on most businesses that provide health insurance, starting in 2014. The fee will be raised proportionately each year among Affordable Care Act and Primary Care 8 insurance providers based on their share of the health insurance market (DHHS, 2013). Certain insurers are exempt from federal excise tax, including public charities and social welfare organizations. In addition, nonprofit insurers that receive more than 80 percent of their gross revenue from government programs that target low-income individuals, seniors, and people with disabilities (including Medicare, Medicaid, and the Children’s Health Insurance Program) are not subject to the tax. Supply and demand will determine how the excise tax is ultimately split between insurance companies and purchasers. Insurers have recently turned in strong financial results and thus are well positioned to bear some of the tax (DHHS, 2013). It is speculated they will pass a portion on to consumers. The Joint Committee on Taxation estimates that premiums subject to the fee will be 2 to 2 ½ percent higher than they would otherwise be. The Congressional Budget Office estimates that ACA will slightly reduce premiums for employer-sponsored health insurance in the near future. For employers with more than 50 workers, CBO estimates that the law will reduce average premiums by up to 3 percent in 2016. For small employers, the estimated change in premiums ranges from an increase of 1 percent to a reduction of 2 percent . It is important to note that the health insurance industry will gain millions of new enrollees in the next few years as a result of ACA. Insurance plans providing preventative health coverage will benefit financially by providing less expensive care for treatable Affordable Care Act and Primary Care 9 chronic conditions and early diagnosis on other medical conditions. Summary  With the oncoming implementation of the Affordable Care Act the benefits of the plan encourage the active role of the primary care provider. The uninsured patient now has access to health care that will afford him a better quality of life and address the financial implications of a poorly managed health care system in the United States. The ACA provides a means to entice more into the field of primary care. While it is in the early stages of scrutiny, the health insurance industry is a growing industry and is positioned to be profitable as a result of ACA, even with increased regulation. Conclusion With the implementation of the Affordable Care Act, the United States is positioned to provide a more sustainable and stronger health care system, due in part to the primary care provisions provided with the ACA. The health care system outlined would provide expanded service for patients, improve outcomes and quality and reduce future health care spending for the nation. References Abrams, M., Nuzum, R., Mika, S. and Lawlor, G. (2011, January). Realizing Health Reform’s Potential. The Commonwealth Fund. 1, 1-8. http://www.commonwealthfund.org/Publications/Issue-Briefs/2011/Jan/Strengthen-Primary-Care.aspx Center on Budget and Policy Priorities. (2013, July). Status of the ACA Medicaid Expansion After Supreme Court Ruling. Retrieved from http://www.cbpp.org Congressional Budget Office. (2013). CBO’s Estimate of the Net Budgetary Impact of the Affordable care Act’s Health Insurance Coverage Provisions Has Not Changed Much Over Time. (CBO Publication No. 144176). Washington, D.C. U.S. Government Printing Office. http://www.cbo.gov/publication/44176. Department of Health and Human Services. (2013, February). Health Insurance Premium Increases in the Individual Market Since the Passage of the Affordable Care Act. (DHHS. Research Brief). Washington, D.C. http://aspe.hhs.gov/health/reports/2013/RateIncreaseIndvMkt/rb.cfm Hofer, A., Abraham, J., Moscovice, I. (2011, March). Expansion of Coverage under the Patient Protection and Affordable Care Act and Primary Care Utilization. Milbank Quarterly. 89(1): 69-89. http://www.milbank.org/publications/the-milbank-quarterly Patient Protection and Affordable Care Act, 42 U.S.C.  § 18001 (2010). Petterson, S., Liaw, W., Phillips, R., Rabin, D., Meyers, D. and Bazemore, A. (2013). Projecting US Primary Care Physician Workforce Needs: 2010-2025. Annuals of Medicine. 6, 503-509. http://annfammed.org/content/10/6/503.full Rosenbaum, Sara. (2013, February). The Patient Protection and Affordable Care Act: Implications for Public Health Policy and Practice. Public Health Reports. 126, 130-135. http://www.publichealthreports.org/