Reimbursement and Pay-for-Performance Essay

Introduction There is a growing trend in the United States called pay-for-performance. Pay-for-performance is a system that is used where providers are compensated by payers for meeting certain pre-established measures for quality and efficiency (What is Pay-for-Performance, n.a.). We are going to be discussing what pay-for-performance is. There are different aspects of pay-for-performance which include; the effects of reimbursement by this approach, the impact cost reductions has on quality and efficiency of health care, the affects to the providers and patients, and the effects on the future of health care. Pay-for-Performance Pay-for-performance (P4P) and value-based purchasing are terms that can be heard within the health care industry which, describes payment systems that reward physicians, hospitals, and other health care providers for their quality and efficiency. The objective of pay-for-performance (P4P) initiatives is to link reimbursement to quality of health care as well as reduce systemwide costs (Shi & Singh, 2012). Government agencies as well as private health plans are in the process of establishing programs in hopes to encourage hospitals, doctors, and other providers so that they will start to meet the quality of standards and achieve the ideal outcome for patients. The overall goal for pay-for-performance is to increase the quality of health care, while reducing the medical costs by implementing programs that will focus on things such as preventative care which would include services such as annual exams and vaccinations. Measurements and Incentives When it comes to quality of care measurements there are different categories one of which being structure. The structure measures patients access to health care, the use of electronic systems and the patients experience of the care that they received. Incentives can be either financial incentives or non-financial incentives. Pay-for-performance has quite a few pros  because it helps increase the motivation of the physician or health care facility which in return will how the company that the individual care for their job and wants to be rewarded based on their good behavior and quality of care that they provide the patient with. There can be a con when it comes to pay-for-performance which would be that if the physician or staff does not have the proper knowledge, training, and experience then they might not be able to reach or exceed the goals that have been set. When the proper knowledge, training, and experience is an issue than this can cause the company to have to invest money into getting that individual the training and resources that they need to obtain the set goals. How Reimbursement is Affected When it comes to the pay-for-performance programs they have been introduced to the health care system to offer incentives to physicians, hospitals, and other medical facilities however the underlying structure of the payment system already generates a lot of incentives on its own. Currently in the United States a majority of physicians are paid on a fee-for-service basis, which in returns encourages a high volume of services, without regard to the value of the service to the patient. In the health care industry there are services that after they are performed the reimbursement is more generous on the payout than others. The pay-for-performance can alter the current incentives that physicians, hospitals, and other medical providers already receive. Reimbursement has affected the pay-for-performance in a positive way because health care providers are able to financially gain from it for providing their patients with quality health care services. Reimbursements are reinventing the way that health care is going to be delivered because health care providers are going to be able to amplify their profit through improving their quality of care, instead of it being the fee-for-service quantity. Pros of Pay-for-Performance for Patients When patients see physicians who are part of the pay-for-performance program this can be beneficial for them. The reason that patients see benefits is because the physician will work with the patients individually to get better health care results for the patient. If a patient has high blood pressure then the physician will focus on that issue and will work with the patient  to get it back to normal which in return the physician will see an incentive for this and the patient wins as well because they are getting the treatment that they need and their overall health is going to increase as a result of the services provided. System Cost Reductions The system costs reductions will have a positive impact on the quality and efficiency of health care. A lot of analyst have worried that the Affordable Care Act will weaken the quality and efficiency in health care because there will be way more patients and not enough quality health care providers. According to Agency for Healthcare Research and Quality (n.d.): In 2000, health care spending rose to $1.3 trillion dollars, or an average of $4,637 per person. As a percentage of the Gross Domestic Product (GDP), it grew from 13.1 percent in 1999 to 13.2 percent in 2000. National health expenditures are expected to reach $2.8 trillion in 2011, with an average annual growth rate of 7.3 percent from 2001 to 2011. By growing 2.5 percent faster that then the GPD, expenditures will consume approximately 17 percent of the GDP in 2011(para. 6). Affects on providers and Customers Pay-for-performance affects health care providers and their customers in a positive aspect because it improves the quality of health care that they receive from their physician which in return increases value. The pay-for-performance program will take health care from basic health care delivery to high-quality health care delivery. The way that this is going to affect the patient â€Å"customer† is because they are going to have an overall better experience with more attention to their overall health. The patient will also see benefits because there are incentives for patients when they live a healthy lifestyle. One of the incentives that the patient will see is in cost savings in the immediate future. Pay-for-performance is positive for all stakeholders involved within the program because it delivers on the main goal which is to increase the quality of care to patients while reducing the costs. The pay-for-performance will also help health care providers to establish more rapport and generate a good feedback within the community because when their patient receives quality health care services then the patient is going to go back and tell their family and friends about their positive experience and recommend that health care provider to their loved  ones. Effects on Future Health Care Pay-for-performance programs are expected to expand across the United States health care in the near future, especially with the implementation of the Affordable Care Act. The pay-for-performance is going to continue to increase the quality of health care that the patient receives from their health care provider. Pay-for-performance is eventually going to be all across the United States and more medical professionals are going to be participating within this incentive program which is going to start making health care affordable for many Americans who cannot afford health care coverage and or services. In the future we are going to start seeing healthier Americans because they are going to get health care services that are tailored solely on their health care needs. Doctors are going to start working to provide quality care in order to get their patients healthier whether it be getting their weight under control, blood pressure, and various other illnesses. Conclusion Pay-for-performance and reimbursement is changing the health care delivery system into a more cost efficient health care system that before. This is going to improve the quality of care that one receives because it steers away from the fee-for-service and gives physicians motivation to provide their patients with a better quality of car because of the incentives that they will receive. There are going to be many baby boomers that are going to start requiring more health care services and with this pay-for-performance implementation it is going to give them a better quality of care than in previous years. With the pay-for-performance incentives this is going to motivate doctors to get their patients in overall better health which in the future we will probably start seeing a decrease in chronic illnesses as patients will be working towards a better and healthier lifestyle. References Agency for Healthcare Research and Quality (n.d.) http://www.ahrq.gov/research/findings/factsheets/costs/costria/index.html Rosenthal, M.B. (2006). How Will Paying for Performance Affect Patient Care?. Retrieved from http://virtualmentor.ama-assn.org/2006/03/pfor1-0603.html Shi, L., & Singh, D. A. (2012). Delivering health care in America: Health Policy (5th ed.). Boston, MA: Jones and Bartlett. Retrieved from The University of Phoenix eBook Collection database.

Impact of Technology Essay

Abstract The information technology investments have increased significantly with time and advancement in technology. In this study, an attempt is made to highlight how the information technology influences the organization productivity. The correlation between the information technology (IT) and productivity was very argumentative. Many studies were conducted to identify the impact of IT on productivity conclude different results. It is impossible to estimate the productivity growth due to the availability of so many advanced computer technologies, as it’s tough to consider all parameters involved while calculating productivity growth. Several researches and studies were documented stating positive effects of IT on productivity growth. But still there were few against this statement. Introduction The advancement in the information technology made both consumers and business enterprises to use it. Computers, laptops, wireless communications etc. are all part of IT and incorporated in every industry. Enterprises invest in these technologies because it was assumed technologies will enhance productivity. Companies aim to generate more business and high turnovers through less investment. In a race to gain more efficiency, the enterprises are adapting new technologies. Huge investments are made on new technologies to survive in industry. The major challenge is to produce high quality goods and services at low prices. Some enterprises understood the  value and importance of information technology and used it to deliver more products in less time and more reliable and convenient services at lower cost. This will also help to gain competitive advantage over rivals. It was illustrated in a study to generate high productivity growths from information technology; enterprises should cha nge the existing infrastructure as well as business practices (Brynjolfsson & Brown, 2005). Many enterprises changed the organizational structure to exploit the full potential of information technology and its applications. Brynjolfsson and Hitt (1998) linked productivity with living standards to understand it better. They mentioned that value of productivity can be easily understood when related with our living standards. They highlighted the significance of productivity by comparing it with our living standards and mentioned that, â€Å"productivity growth determines our living standards and the wealth of nations.† This reflects the customers’ behavior to consume more in less money. They also point out that the concept of productivity is simple and vast but tough to measure with accuracy. Information Technology and Productivity Productivity was described as the amount of output generated for a certain amount of input (Brynjolfsson, 2003; Hitt & Brynjolfsson, 1995). Productivity can also be defined as the measure of the quantity of outputs in goods and services per unit of input (Muriwai, 2006). Productivity can be measured either by keeping the output static or input. Productivity can be increased with increase in output keeping input constant or by decreasing the input keeping the output static. The term information technology was defined narrowly as the expenditures made on the computing hardware (Brynjolfsson, 2003 and Hitt & Brynjolfsson, 2005). It was elaborated a little more as. All the computer software and hardware, tools and services used in the business processes and operations are a part of information technology. The investments in information technology were defined as the expenses on the computer hardware and software and all other devices related with IT (Morrison, 1997). The main purpose of these investments is developing a modern infrastructure within the organization to boost productivity of both organization and employees (Dehning, Dow, & Stratopoulus, 2003). It was documented by Mahmood and Mann (2005) that  investment in IT was not sufficient enough to increase productivity. Strategic decisions had to be made whether investment in IT would help to accomplish objectives and goals set. A harmony must occur between IT investments and changes in business process to have high productivity growth, even greater than investment in information technology. Keller (2004) also stated that when IT is utilized appropriately at workplace that also helps a lot in productivity growth. Just investing in information technology is not sufficient to gain growth in productivity; but organization can visualize changes brought by information technology (Brynjolfsson & Hitt, 1998; Dedrick, Gurbaxani & Kraemer, 2003). A significant relation between IT investments per employee and overall productivity of company was found by Brynjolfsson (2003). The enterprises gained high productivity growth who invested huge sum in information technology effectively. But pattern of productivity growth across the enterprises varied no doubt the return from IT investment were positive (Brynjolfsson & Hitt, 1998). It takes time to realize productivity gains from investments in information technology. It was supported by Mahmood and Mann (1988) that productivity growth and performance of the organization improves in time period of two or three years after investing in information technology. Dedrick et al. (2003) also believed that productivity gains are realized after a long time period. It was highlighted in their research that information technology payoffs are high when firms’ effectively apply information technology in long run. It’s easy to measure productivity when tangible products and goods are produced as in the manufacturing sector. An input alteration in the manufacturing process can bring substantial changes in productivity. For instance, the use of automation technology and robotics produce outputs of good quality (Kao & Liu, 2005). On the contrary, it’s tough to measure and improve productivity in service sector. It’s next to impossible to evaluate the productivity of an employee. A method was proposed by Tallon and Kraemer (2006) to measure precisely the impact of information technology on productivity. A method of perceptual measures was recommended by them. Perceptual measures would bring new scope to study impact of technology on productivity. They described it as â€Å"perceptual measures, if structured around information technology impacts at the process-level, can yield richer insights than objective criteria alone†. Authors’ Agree and Disagree: The research was done by many to study the impact of IT on productivity (Brynjolfsson & Brown, 2005; Brynjolfsson & Hitt, 1998; Melville, Kraemer & Gurbaxani, 2004 and Kudyba, 2004). The expectation that productivity will certainly increase by utilizing the IT were not always true. But researches ended up with different conclusions, some stated positive impacts of IT on productivity and others negative. Information technology had negative impact on productivity. Mahmood and Mann (2005) mentioned in their study that there is no adequate evidence available in past researches showing the positive effects of IT on productivity. It was also supported by Dedrick et al. (2003) stating, â€Å"Studies have failed to identify a relationship between information technology investment and firm profitability.† The term productivity paradox was introduced by Robert Solow in 1987 explaining the inability of the information technology contributing towards firm productivity (Solow. 1987). He made a statement that growth in productivity was not accompanied by the information technology. He also discussed that the companies didn’t had expected results in productivity after investing in Information technology. He quoted, â€Å"You can see the computer age everywhere but in the productivity statistics†. In my opinion and during my research I realized that impact of IT on productivity had mixed reviews from different authors, researchers and economists. Researchers used new approach to reveal the hidden positive effects of IT on productivity. Brynjolfsson and Hitt (1998) illustrated that â€Å"Information technology has a positive and significant impact on firm output, contradicting the claims of a productivity paradox (p52).† This was also supported by Brynjolfsson (2003) and Dedrick et al. (2003) that productivity including the output per worker annually had increased significantly with use of information technology. It was mentioned by Kudyba (2004) that the output can be upraised with increased information technology skills. The new information technology and techniques effectively when used by the companies, those companies are productive than who don’t use it (Brynjolfsson & Brown, 2005). When the technologies and techniques were used perfectly and timely, yield high level of productivity. The three ways were  discussed by Brynjolfsson (2003), Keller (2004) and Brynjolfsson & Hitt (1998) to recognize productivity growth from IT: by decreasing the cost on Information technology and keeping the benefits from business stagnant; increase the benefits from business and keeping the investment in Information technology constant; or reduce the cost of information technology and benefits increase from business. The information technology is important and valuable for organization (Melville et al., 2004). They also stated that effective and efficient use of information technology can yield potential benefits, like cost reduction, improving quality and at last productivity. The companies, who used information technology effectively, had also observed an increase in price of their market share more than others. It had been reported by Mahmood and Mann (2005) that both IT labour and computer resources contribute towards return on investments. They also mentioned in their report that effective enterprises have developed and improved their infrastructures and investing highly in information technology. Information technology is a medium through which the information can be distributed easily within organizations. The highly advanced IT infrastructures create an atmosphere within organization that encourages decentralized process of decision making (Brynjolfsson & Brown, 2005). When modification of the business processes is done within organizations, it becomes necessary to integrate information technologies. The productivity can be enhanced by integrating information technology investments with decentralize process of decision making (Melville et al., 2004). The integration of information technology investments and other investments within business also proves to be beneficial (Brynjolfsson & Hitt, 1998). The operations and business processes within the organization must be evaluated and ensure that existing business enviro nment can adapt the new technology, before future information technology investments made (Zhou & Chen, 2003). The predictable and estimated outcomes can be realized from IT investments through integration of technologies and current business processes (Kudyba, 2004). It becomes important to restructure the business processes with the changing business environments when new information systems are set up (Zhou & Chen, 2003). McNamara and Watson (2005) also reported that the integration of the existing technology systems with new technologies within organizations yields the expected productivity growth.  They also discussed how the existing technologies can be employed in various business operations, it equally productive as investing in new information technologies. Brynjolfsson and Hitt (1998) found that â€Å"The greatest benefits of computers appear to be realized when computer investment is coupled with other complementary investments; new strategies, new business processes and new organizations all appear to be important in realizing the maximum benefit of information technology†. The companies must integrate all daily activities, decentralize decision process, flow of information from high to low level, this will enhance productivity growth and all these attributes directly or indirectly contribute to information technology (Brynjolfsson, 2003). The organizations use various methods and measures like product quality, profitability, and value of market shares to measure productivity (Dedrick et al., 2003). There is a possibility that productivity can also be gained through effective management. It was observed that productivity can be increased by information technology and make worth for consumers (Hitt & Brynjolfsson, 1995). Devaraj and Kohli (2003) proposed a method which requires elevation of the IT usage at the employees’ level individually and then finally investigating its effect on organizational performance. Employees’ of modern organization may call it push or pull of IT investments. This phenomenon of push or pull in IT investments may inspire employees’ for using new technologies and this may lead to productivity improvements. Kudyba (2004) mentioned that competitive advantage can be gained by hiring skilled and experienced employees. In my view, the employees must be trained to use new technologies or companies should hire skilled and experienced employees. It also depends how the new technologies are being utilized by the enterprises to enhance their productivity. Only those companies will maximize their productivity that will use the technology perfectly and timely. I have also learned during my research that productivity doesn’t depend on one factor, there are number of parameters that affect the overall productivity of the organizations. The accurate methods are required for calculating the productivity, to recognize the growth of productivity. Rather than focusing on productivity only, enterprises should develop new strategies to integrate t echnologies with new opportunities. The barriers to entry can be easily terminated by raising the firm’s efficiency and gaining competitive advantage. Benefit to Manager There is a big challenge ahead for all the mangers and decision makers how to consume the information technologies at best and have maximum benefits. It’s not compulsory that the companies will have same levels of productivity if provided with same information technology, it depends how the technology is utilized to have high growth in productivity (Brynjolfsson, 2003). To maintain competitive advantage in the industry, the managers had to find new ways in which they can exploit the full potential of technologies differently from their rivals. Melville et al. (2004) mentioned the competitive advantage gained through human resource and technical synergies cannot be maintained for long. A strategy or mechanism had to develop to gain competitive edge for long periods and which is not easy to imitate. The competitive advantage can be maintained until others don’t follow what you are doing, once others start following your techniques it’s tough to sustain competitive advantage (Brynjolfsson, 2003). I believe that managers should examine future values of all IT investments when productivity results were not up to the level of expectations. The organizational leaders are not ready to invest more on technologies, when results from previous IT investments are not beneficial enough (Devaraj & Kohli, 2003). A big challenge for the leaders to justify future investments in technologies when there is no significant evidence of productivity improvement from previously investments in information technologies (Dehning, Dow, & Stratopoulus, 2003). Managers should focus on other aspects of business process also rather than on productivity alone. Hitt and Brynjolfsson (1995) discussed that managers should concentrate more on how information technology can be used to improve product quality and customer service. Information technology has the potential to reduce the expenses on such services and change the mode of production and delivery of the goods and services so can’t be easily imitated by competitors (Hitt & Brynjolfsson, 1995). The uniqueness in utilizing the information technologies in business operations and processes is the key to stay ahead of the competitors in the market. This not only provides competitive advantage but also increases the overall growth in productivity. Conclusion The conclusion can be drawn that investing in information technology doesn’t  have any positive impact on productivity growth until utilized properly and effectively. The impact of investing in technologies can be realized how organizations utilize technologies effectively depending on the current situations of organizations and derive expected productivity results. The invention of telecommunication, computer software and hardware had totally changed operations within the organizations. The use of these forms of technology was extensively popular and in-demand among the various industrial sectors. The enterprises had changed their existing infrastructures to adapt these new technologies. The meaning both consumption and productivity have changed with innovation of information technology. Organizations across the globe are implementing new technologies to enhance the daily business activities with the purpose to survive and compete in this new global world of information tec hnology. References Brynjolfsson, E. (2003). ROI valuation :The IT productivity gap. (21). Retrieved from http://ebusiness.mit.edu/erik/Optimize/pr_roi.html. Brynjolfsson, E., & Brown, P. (2005). VII pillars of IT productivity. Optimize Manhasset.4(5), 26-35.Retrived from http://www.georgeschussel.com/wpcontent/uploads/articles/NY6420050502_erik.pdf. Brynjolfsson, E., & Hitt, L. M. (1998). Beyond the productivity paradox. Communications Of The ACM, 41(8), 49 – 55. Retrived from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.195.1657&rep=rep1&type=pdf Dedrick, J., Gurbaxani, V., & Kraemer K.L. (2003). Information Technology and Economic Performance: A Critical Review of the Empirical Evidence. ACM Computing Surveys ,35(1),1-28.Retrived from Business Source Complete. Dehning, B., Dow, K. E., & Stratopoulos, T. C. 2003. The info-tech â€Å"Productivity Paradox†dissected and tested. Management Accounting Quarterly,5(1),31-39. Retrieved from Business Source Complete. Devaraj, S., & Ko hli, R.(2003). Performance impacts of information technology: Is actual usage the missing link?. Management Science, 49(3),273-289. Retrieved from Business Source Complete. Hitt, L. & Brynjolfsson, E. (1995). Productivity, profit and consumer welfare: Three different measures of information technology’s value. MIS Quarterly, 20(2), 121 -143. Keller, E. (2004). What Is Your IT Productivity. MSI 22(2), 33 – 34. Kudyba, S. (2004). The productivity pay-off from effective allocation of IT and non- IT labour.

How did Lenin add to Marxism up to 1905, and with what consequences? Essay

Karl Marx was a German philosopher who wrote the Communist Manifesto, which encouraged workers to unite and seize power by revolution. His views became known as Marxism and influenced the thinking of socialists throughout Europe in the late nineteenth and twentieth centuries. Marx believed that history was evolving in a series of stages towards a perfect state – Communism. These stages started with Feudalism – with the aristocrats controlling politics. Next would come Capitalism – with the bourgeoisie in control of politics. Finally the â€Å"perfect state† would arrive Communism – with the proletariat in control of politics. Marx believed that a Communist state would come about in countries such as Russia that were still feudal or did not have fully developed capitalist societies. He urged the proletariat to join the capitalists in revolting against the aristocrats and complete a capitalist revolution and then continue until the proletarian revolution occurred leading to a communist state. Vladimir Ilyich Ulyanov, also known as Lenin, was born in 1870 in Simvrisk, Russia. Lenin had a turbulent start to his life. At the age of 17 Lenin had to deal with the fact that his brother Alexander Ulyanov was hung for plotting to assassinate Tsar Alexander III. He then studied at the University of Kazan, where he converted to Marxism, but was expelled for revolutionary activities. Then in 1895 Lenin was exiled to Siberia for distributing revolutionary pamphlets. During his exile, the Russian Social Democratic Workers Party (RSDWP) was formed in Minsk in 1898. After Lenin’s return from exile in 1900, he founded a newspaper, Iskra, with Julius Tsederbaum, also known as Martov. The idea of the paper was to establish it as the leading underground revolutionary paper that would push forward the revolutionary movement. In 1902 he published a pamphlet called † What is to be done?† This pamphlet contained his radical ideas towards the nature of a revolutionary party. In this pamphlet, there were three main points that Lenin made in relation to the role of a revolutionary party. â€Å"An organisation of revolutionaries must contain primarily and chiefly people whose occupation is revolutionary activity†¦ This organisation must necessarily be not very broad, and as secret as possible.† This idea was stating that he wanted the party to consist of activists. He wanted people to go out and do something for the party rather than sit around and do nothing to help the cause of the party. This idea was later to contribute towards the split of the RSDWP. Lenin also stated; â€Å"The one serious organisational principle for workers in our movement must be the strictest secrecy, strictest choice of members, training of professional revolutionaries.† Lenin wanted the party to be professional and didn’t want the country to know that there was a revolutionary party being constructed that was to revolt against the current government. The third major point that Lenin made in his pamphlet was; â€Å"We must break completely with the tradition of a purely workers or trade union type of social democratic organisation down to factory groups inclusive. The factory groups or committee †¦Ã¢â‚¬ ¦ must consist of a very small number of revolutionaries, receiving direct from the committee, orders and powers to conduct the whole social democratic party work in the factory.† This statement showed that Lenin wanted to create a dictatorial party that was to take orders from the top and no one else. He wanted to control the party and maintain it as a fully organised and prepared revolutionary organisation. In these three statements Lenin has already added to Marxism. Marx did not state what the role of the communist party would be. But here Lenin has said what he wants the party to do and how he wants it to be controlled. Marx also did not comment on how the party would operate and how it would gain power. Here in his pamphlet Lenin has shown that he wants a dictatorial party that will be run from the top and that they will take power with a highly organised and secret movement. Karl Marx never stated how and when revolution would take place. Lenin though did mention this. He made three changes to Marx’s theory. 1. Revolution would be accomplished by a small group of highly professional dedicated revolutionaries. They were needed to develop the revolutionary consciousness of workers and focus their attentions. 2. Lenin believed that the revolution would occur during a period of conflict between capitalist powers. He accepted Trotsky’s idea that a revolution would start in an underdeveloped country just like Russia where the struggle and conflict between proletariat and bourgeoisie was very great. This was known as the â€Å"weakest link† theory. 3. He did not think that the middle classes of Russia were strong enough to carry out a revolution. He believed that the working class could develop a revolutionary government of its own alliance with poor peasants who had a history of mass action in Russia. These changes show how Lenin believed in Marxism but added parts that Marx failed to mention in his theory. And so extended Marxism with his own ideas, Leninism. In 1903 the RSDWP held it’s second congress eventually in London, after the initial location Brussels was changed due to fear of persecution. In this congress four main issues were discussed. The first was the adoption of Iskra, Lenin and Martov’s revolutionary newspaper, as the party organ. The second issue discussed was probably the most important of the congress. The issue was that of membership. Lenin’s proposal was: â€Å"A member of the party is one who accepts its programmes and supports it, both materially and by personal participation in one of its organisations.† Lenin wanted party members that were active and actually went out and personally participated in events that would benefit the party. Whereas Martov believed that members should be: â€Å"A member of the RSDWP is one who accepts its programme and supports it both materially and by regular co-operation under the leadership of one of its organisations† Martov believed that party members should be passive and of large quantities similar to that of governments of nowadays. He wanted members to just accept the party’s programme and support in what they do. He didn’t state that he wanted active members like Lenin. George Plekhanov was the chairman of the congress as was the only main figure to agree with Lenin, all of the others on the Iskra editorial board came down on the side of Martov, as did Trotsky. Lenin’s proposal was rejected 28 to 23 and Martov’s proposal was accepted 28 to 22. The third issue of the Congress that was discussed was that of overseas organisations. It was decided that only the League of Revolutionary Social Democracy should be recognised and therefore the Union of Russian Social Democrats Abroad was disfranchised. This action caused the resignation of seven members of congress, all of them being Martov supporters, and sop now allowing supporters of Lenin to be in the majority. The fourth and final major point of the congress was that of Lenin’s proposal to reduce the members of the Iskra editorial board from six to three, and that the new party central committee have only three members. This was accepted and Lenin, Martov and Plekhanov were elected. But it became clear that Martov was in a minority and so rejected the offer and his supporters had nothing more to do with the elections. At this split Lenin’s supporters were dubbed the Bolshevik’s, majority, and Martov’s the Menshevik’s, minority. This congress shows how Lenin was adding to Marxism as he was trying to give the RSDWP some identity and an insight has to how he wanted it to be run. This was an addition to Marx, as he never mentioned how the party would be run and what the role of it would be. But these actions taken by Lenin have large consequences. His ideas clashed with that of Martov and so caused the split of the RSDWP. Another major consequence of Lenin’s abrasive personality and wish to have the RSDWP run his way was that this split of the party was non reconcilable. Plekhanov tried to create reconciliation between the Bolsheviks and Mensheviks and co-opted Mensheviks onto the now Bolshevik run Iskra board. But Lenin was having none of this. He resigned leaving Iskra to become a Menshevik organ and organised the Bolsheviks as a separate faction. Trotsky who was part of Martov’s Mensheviks wrote â€Å"Our political tasks† in 1904. â€Å"The party is replaced by the organisation of the party, the organisation by the control committee, and finally the control committee by the dictator.† Trotsky is commenting on the consequence of Lenin’s organisation of the party. He believes that Lenin’s concept of a revolutionary party would inevitably lead to dictatorship. In conclusion Lenin’s main addition to Marxism was to give the details about the role of the party, the membership of the party and the ultimate aim of the party, that Marx did not give when he began his theory of Marxism. But Lenin’s additions did not come without significant consequences that would affect the future of Russian politics.

Strategic Audit of Caterpillar Corporation Research Paper

Strategic Audit of Caterpillar Corporation - Research Paper Example The long term strategic goals of the company are along there different dimensions of Superior results, best team and global leadership. The company aims to achieve superior result which results in the fact that the company is regarded as a solid long term investment venture which gives shareholder return of the top 25% of the companies listed in S&P 500. The company also has a goal of having the best team. The team should be comprised of people who enjoy a work place characterized by features such as safe and inclusive. The company also wants to ensure that the customers of the company should be more successful with the company than with their competitors.   PoliciesThe values of the company are put to action through different activities. The company ensures integrity by delivering what they promise, being trust worthy and fair, and not influencing or getting influenced by others. In order to achieve excellence the company has in place the Caterpillar production system and 6 sigma.    In order to be sustainable the company gives products and services which are sustainable, and devote time and resources to sustainability. The company also focuses on team work and commitment in order to achieve the long term vision of the company.   Opportunities and Threats on External Environment 1. Natural physical EnvironmentCaterpillar Corporation Inc. is an American company that manufactures, designs, sells and markets different product segments including financial products, machinery, insurance and engines to customers.

Persuasive paper on global warming Term Example | Topics and Well Written Essays - 1000 words

Persuasive on global warming - Term Paper Example Thesis Statement: The purpose of this paper is to persuade the reader that global warming is a serious issue. It is a man-made phenomenon, with adverse impacts on the earth’s ecological system, and consequently on human, plant and animal life. The leading theory on global warming is that human industrial activity over the last century is the root cause of global warming, since it has been causing carbon dioxide emission into the atmosphere. Similarly, modes of transportation such as cars and buses increase the emission levels. Further, the burning of fossil fuels and clearing of forests result in production of carbon dioxide and other heat-trapping gases, which remain in the atmosphere for several decades and even centuries (Behreandt: 10). The accumulated gas prevents heat in the atmosphere from escaping into space, and the retained gas causes rise in the environmental temperature, termed as the greenhouse effect. This causes greater retention of heat by the earth, because carbon dioxide absorbs the earth’s heat radiation and acts like a blanket over the earth’s surface (Houghton: 9). The increased atmospheric warming results in activating natural processes that cause greater release of greenhouse gases. Michaels (p.50) states that â€Å"planetary near surface temperature has increased by approximately 1.5 degrees centigrade over the past century, and will continue at a higher rate for the next century†. The United Nation’s Intergovernmental Panel on Climate Change (IPCC), the American Meteorological Society, the American Geophysical Union, and the American Association for the Advancement of Science agree that â€Å"greenhouse gases accumulating in the earth’s atmosphere as a result of human activities, cause surface air temperatures and subsurface ocean temperatures to rise† (Behreandt: 10). The melting of ice from high altitudes and glaciers

Augmentative and Alternative Communication Essay

Augmentative and Alternative Communication - Essay Example k, a lot of research needs to be done in the field of developmental disabilities which have multifaceted and multilateral aspects that are not only complex by nature but they also need socio-psychological interventions, stretched over a period of time, involving extensive inter-personal communication. Of the various developmental disabilities, cerebral palsy is significantly different and encompasses a wide set of communication problem. Cerebral palsy is a disability where despite having a relatively high intelligence quotient, the person has almost no control over his locomotor parts including his speech, thus making communication extremely difficult. Though it affects muscle movements and synchronized coordination of body parts, it is not actually a muscular or neurological problem but abnormality in part of the brain that controls body coordination. It is, therefore, very important to address the need for an augmentative and alternative communication for the persons suffering from cerebral palsy. While there have been many studies that focused on improving linguistic, technical, and strategic competence, there is a scarcity of research on socio-relational competence. In order to enhance the participation of the persons affected with cerebral palsy in the development of the community, it is imperative that their socio-relational competencies be developed to the extent that they may start contributing to the socio-economic development of the society. Prior research indicated that providing access to Augmentative and Alternative Communication (AAC) devices to communicate would not guarantee the development of communicative competence in disabled individuals. According to Light â€Å"for AAC users to reach communicative competence, four critical skills must be mastered namely linguistic competence; technical competence; socio-relational competence and strategic competence† (Light, Binger, Agate, & Ramsay, 1999). According to Mirenda (2003) â€Å"the behavioral

Final report Essay Example | Topics and Well Written Essays - 1000 words

Final report - Essay Example In my capacity, I was entitled to: evaluate the effectiveness of the payment methods provided by the Al-Rahal Auto & Finance, Inc.; Set solutions to lack of payments by customers as scheduled; and to Simplify techniques of sending and/ or receiving clients’ insurance information. # A description of key projects or assignments completed All the above assignments actually formed the basic functions of the organization. This means therefore that the organization had to ensure their completion through ensuring simplicity of the systems to be used but keeping them very secure to deter possible hacking; sensitizing the organization on the need to set up a customer care unit to offer assistance to the clients in case of any problems; and using both e-mail and physical addresses for the attainment of both soft and hard copies of the same information. # How the work completed relates to the domain of International Business By carrying out all the mandates and plans of the organization, as set to meet the needs of the local and international clients efficiently and with ease recommended, the international business domain will obviously be achieved. Besides, the services of this organization are never restricted to any particular region/ country but for everyone interested. # Lessons in relation to the domain of international business The domain of international business requires operations within clients’ expectations and the internationally stipulated guidelines. To keep by this, the organization generates multilevel frameworks of its specific aims for the international business, leading to proposition, which in return broadens the focus and compares this firm to related disciplines. This strategy provides pathways that maintain the organization’s international business richly relevant for a high number of communities affected by the international business. It is therefore true that this experience has exposed me to the modern practices of business in a global context. # New skills/knowledge acquired As an international intern I was able to gain a sound investment portfolio that is broadly diversified and consistent with the main investment objectives of growth, income, or a combination of both, for the purpose of ensuring business and economic growth for the organization and its local and international customers. In this respect therefore, I was at a position where there were effective strategies for learning organization’s values, analyze globe’s current financial situation, and successfully understand my feeling about managing financial resources – the Dream-Plan-Track approach to financial planning (Sheldon, K.M. and Kasser, T., 1998). # What strengths and weaknesses have you discovered The international organization, Al-Rahal Auto & Finance, Inc., has a mission of being a strategic dealer partner that has the intense intension of specializing in providing personalized finance department for customers with less than perfect credit, through helping them to establish either from a position of no credit or subprime credit to a prime or near prime credit rating in a period of 36 months or less. Al-Rahal Auto & Finance, Inc. experienced team of managers which focuses largely on educating their customers about credit and thereafter providing adequate financing for an automobile with everything

Widget Wonders Essay Example | Topics and Well Written Essays - 250 words

Widget Wonders - Essay Example Microsoft Word 2013 would as well be vital for the purposes of processing manufacturing and distribution information documents. Apart from use of Microsoft Excel software mostly used by various organizations for the purpose of preparing and analyzing spreadsheets, I would also recommend installation of Kingsoft Spreadsheets 2013 as alternate software for analyzing spreadsheets. Kingsoft Spreadsheets 2013 is fast, cheaper, dependable spreadsheet software and capable of reading and even editing XLS and XLSX file formats. At times, the processed information is presented to the management or the different stakeholders this is why I would recommend installation of emaze online presentation software. This software is capable of doing the slideshows and video presentations in a 3D presentation. This will be incorporated in the direct 3D Modeling Express 6.0 software that I will also emphasize for this particular Information system. The files and documents in any information system are vital since in them is the company’s data that is vulnerable to different impending threats including viruses and hackers (Maram et.al, 2012). For security and safety measures of such documents and files therefore, first, I would recommend the use of Norton AntiVirus 2014 for it has established superiority as one of the best AntiVirus software for its capabilities of running comparisons which are cloud-based on a file against an infected edition of the same file. Second, I would recommend the installation of Intelex Document control software. Third, I would also recommend the use of Box cloud storage service to enhance the control and privacy of the files and lastly the installation of Zone Alarm software so as to keep off hackers from interfering with the company’s

Offer & Acceptance Article Example | Topics and Well Written Essays - 1750 words

Offer & Acceptance - Article Example McKendrick E. (2007) defines offer as offer is an expression of willingness to enter in to contract on certain terms. It must be made with the intention that it will become binding upon acceptance. There must be no further negotiations or discussions required [Storer v Manchester City Council,1 Gibson v Manchester City Council2]. In Storer the Court of Appeal establish that there was a binding contract. Here the fact that the ABC noticed in newsletter that will pay '500 to anyone who runs in and complete at least five races sponsored by the British Distance Running Association. According to Partridge v Crittenden3 normally advertisement is an invitation to treat for a bilateral contract but here ABC put notice in its newsletter. However, in Carlill v Carbolic Smock Ball Company4 decided that advertisement was a unilateral offer. It also held that advertisement was not an invitation to treat but was an offer to the whole world and that a contract was made with those persons who perfor med the condition 'on the faith of the advertisement'. In Bowerman v ABTA5 it is likely that a court would find that the advertisement was an offer. So it can be assumed that ABC made a valid offer. Now it needs to consider whether the offer has been accepted or not by Fast Fred, Swift Sally and Heavy Harry. McKendrick E. (2007) defines acceptance that an acceptance is an unqualified expression of assent to the terms proposed by the offeror. An offer is effective when it is communicated to the offeree. Proof of an offer to enter in to legal relations upon definite terms must be followed by the production of evidence from which the courts may infer an intention by the offeree to accept that offer. The acceptance can be made by words or by conduct. However, the communication of the acceptance is important. The general rule is that an acceptance must be communicated to the offeror. This is strict requirement. It must actually be brought to the notice of the offeror. It is for the offeree to ensure that communication has been made Powell v Lee. The general rule is that acceptance is not effective until it is communicated to the offeror and the acceptance cannot be made through sile nce. In Felthouse v Bindley6 the offeror cannot waive communication if that would be to the detriment of the offeree. In Brogden v Metropolitan Railway Company7, where the offeree accepted the offer by performance. Acceptance occurs when the offeree's words or conduct give rise to objective inference that the offeree assents to the offeree's terms. It is a vital question whether Emilio's initiatives has been treated as specific performance. The first involves Fast Fred who had run in four BDRA races. Acceptance required to complete at least five races. He voted against the Fat Slob party and he immediately cancelled his entry in the remaining BDRA races for the year. So no contract has been formed between the ABC and Fast Fred. McKendrick E. (2005) said that to be a valid acceptance two things must be considered these are the facts of acceptance and Communication of acceptance. However, if courts consider Brogden v Metropolitan Railway Company then performance is enough to form a contract. Swift Sally wanted to comply the condition and had run in the three BDRA races. Here she accepted the off

Australia Essay Example | Topics and Well Written Essays - 1250 words

Australia - Essay Example They were thought to have arrived here from the South East Asia during the last ice age. The belief is that the aboriginals numbered at least one million and scatter across 300 clans with at least 250 languages and 700 dialects between them. Due to the relatively dry environment of the country, the aboriginals were forced to become nomadic tribes traveling on a quest of trade, finding water, and food. Australia was founded in unforgiving territory. Stemming from the outback desserts, tropical rain forests, and snow capped mountains, the early aboriginals believe in the myth that the totemic spirits ancestors are all connected to nature, the past, present, and future (â€Å"Australias History†). This was the state of Australia before the British colonized the land for their own means. It was Captain James Cook who in the 17th century chartered the east coast in the name of Britain. When he first landed on Australian soil, the continent was recognized by most sailors as New Holland. Britain was more than happy to claim the land because its location made it perfect to use as a penal colony. As a new outpost, the penal colony came into being on January 26 1788 with the first British inhabitants alighting in Australia. A fleet of 11 ships carried 1.500 people with more than half of them being convicts. By 1868 it is believed that at least 160,000 men and women had settled in Australia as convicts being punished or banished by Britain. Of course life was different for the free settlers who came in during the 1790s. The convicts were constant under threat of losing their lives in the harsh conditions and even harsher treatment from the officers of the colony. Suffering alongside the convicts were the aboriginals who were displaced, their lands, stolen, and their tradit ional lifestyle and practices no longer fitting into the new world of Australia as

Outsourcing or Exporting America Essay Example | Topics and Well Written Essays - 750 words

Outsourcing or Exporting America - Essay Example The continued heated debate on outsourcing’s pros and cons have affected one of the pillars of American journalism, a CNN host and anchor, Lou Dobbs, on his strong contention that America has been embarking on selling jobs to other countries at the detriment of the American people. In an article written by Dobbs entitled â€Å"Exporting America: false choices† published in the CNNMoney on the 10th of March 2004, he openly countered the criticisms allegedly directed at him by his colleagues in the media industry. Several known and prominent journalists and media men were revealed to attack Dobbs’ views on exporting American jobs: â€Å"Gerard Baker of the Financial Times, An editorial in the Economist magazine, Daniel Henninger of the Wall Street Journal, and Washington Post columnist James Glassman† (Dobbs pars. 1-4). The detractors argued that Dobbs views that â€Å"outsourcing American jobs is neither sound, smart, humane nor in the national interestâ⠂¬  were preposterous, absurd, extremely protectionist and highly sensationalist. In support of Dobbs arguments, the most viable and credible contentions were the information that acknowledged the continued reflection of trade deficits in the country for more than three decades, actually, starting in 1980 (Crooks). This fact, in conjunction with information provided by Torrance who reviewed the ill-effects of outsourcing, to wit: â€Å"income levels are frozen and cannot compete with inflation. Workers lose leverage to negotiate fair wage increases or promotion. Foreign employment policies, such as minimum wage, and working conditions differ. Businesses who are outsourcing can set a minimum wage in developing countries that would never be accepted as a minimum wage in America† (Torrance par. 6). At the same token, Davidson, a guest columnist for FinalCall.com News, wrote in an article entitled â€Å"The outsourcing of America’s jobs†, one year before Dobbs†™ article was published, that the controversial nature of outsourcing jobs has been eminent and his citing another written discourse revealed that: â€Å"In an article that appeared in the August 1, 2003 edition of the Kansas City Star, Shashank Bengali suggested that the goal of a growing number of American companies is to outsource customer-service work to India, as a result of India’s low wages, thriving high-tech sector and annual output of two million English-speaking college graduates. A study by Forrester Research, a technology consulting group, estimates that 3.3 million white-collar service jobs will be outsourced to places like China, Russia and the Philippines—but more than half will go to India† (Davidson par. 7). The U.S. Census Bureau has divulged statistics that reveal continued greater imports of the U.S. of Indian goods, as compared to exports of American goods, which could be traced consistently with the outsourcing data abovementioned (U.S. Census Bureau). More alarming are the statistics cited by Otterman in her discourse that indicates the following facts: â€Å"Boston-based consultancy Forrester estimates that 400,000 service jobs have been lost to offshoring since 2000, with jobs leaving at a rate of 12,000 to 15,000 per month†¦By 2015, Forrester predicts, roughly 3.3 million service jobs will have moved offshore, including 1.7 million "back office" jobs such as payroll processing and accounting, and 473,000 jobs in

The Chesapeake and New England regions Essay Example for Free

The Chesapeake and New England regions Essay By the 1700s the English came to the New World and settled in The Chesapeake and New England regions. The lives of the people settled in these regions were centered on two dissimilar lifestyles. Distinctive differences between these regions were in expectations, beliefs, and social cultures. The differences created a clear cut between North and South. The wide gap between the development of The Chesapeake and New England regions was mainly because of the way their lives were centered. The Chesapeakes were geared around monetary profits and striking it rich, while New Englands focal point was about family and religious freedom. The Chesapeake region was settled in part to get rich quick, like what Captain John Smith said there was no talkbut dig gold, wash gold, refine gold, load gold (Doc F). Life expectancy was low because people only cared about gold. They barely took time to eat and take care of themselves. Diseases took its toll on the people of this region; few people lived to the age of 50. Because of that many people grew up never knowing their grandparents, which led to no family values being taught. Women were scarce; men outnumbered women six to one. In the Ships List of Emigrants Bound for Virginia there was about fifty single men and sixteen single women aboard. (Doc C) Governor Berkeley and His Council reported on their inability to defend Virginia against a Dutch attack because one third of the freemen available for defense are single freemen whose labor will hardly maintain them. (Doc G) Many woman wound up pregnant before marriage and many ended up widows having to raise a family as a singl e mother. The Chesapeake regions soil and weather was perfect for tobacco cultivation. They profited quickly with tobacco, but tobacco ruined the soil so they constantly had to expand for more land to grow more tobacco. With the scarcity of people, the need for laborers was high. In the beginning indentured servants were given passage and sometimes a small plot of land to come to the colony to work. Once they were freemen most of them never received their land, which led to the Bacons Rebellion. To justify the rebellion, in Bacons Manifesto, he stated that the government and land owners were at fault for the rebellion for withholding the land and money they fully deserved and were promised. (Doc H) Then black slaves became the  labor source of the Chesapeakes. They were less rebellious and easily controlled according to the landowners. Racial discrimination developed with the thinking that the blacks were made to serve. The social gap began to appear and widen causing much controversy in the area. On the other hand there was the New England region, where the people had a completely different view on life. The priority of this region was a family focus. In New England it was much cleaner, nicer, and cooler so there was little disease and death. This increased the life expectancy by ten to twenty years, which helped create a better stable family life. People grew up knowing their grandparents, and widowhood was less common. In the Ships List of Emigrants Bound for New England nearly all of the emigrants were families of more then four. (Doc B) New Englanders tended to stay together as a family. Women married in their twenties and gave birth every two or so years. New England men had much power over the women because widowhood was less likely many women didnt have the same rights as they did in the south. Towns were centered on the community so they intended that the towns be composed of at least forty familiesrich and poor, and that everyone should have a share of meadow and a house lot. (Doc D) In every town there was a meetinghouse surrounded by house and a village green. A meetinghouse was used for community gatherings and a place of worship. Puritanism was very strong in the New England region. The town recommended that all tradesmen consider the religious end of their callings and how they can and will be serving God. (Doc E) Education was of high importance; towns of fifty families had to provide primary education and towns of one hundred had to proved secondary education. They established their first college, Harvard College, only eight years after settlement unlike Virginias college, William and Mary, which took eighty years. New Englanders became great traders because they had a lack of soil and planting area. Which made it less ethnically mixed because there was no need for black slave labor. Fishing and ship building were other main occupations of New England. Weather was extreme and rivers were fast-moving which contributed to their isolation from England. Because of this New England colonist were very stern, stubborn, self-reliant, resourceful, and energetic. The English settling in America led to the development of The Chesapeake and New England regions. The final result from these settlers was two distinct societies. Although they came to the New World on the same voyage, they were more different than you could imagine. The Chesapeake region achieved their pursuit of wealth and maintained an upper class society. They kept slaves on their plantations, and built bigger and better homes for themselves. The New England region prospered within their families, freedom to practice their religion, and kept and enjoyed a simple life. They maintained the value of a proper education, and continued to teach their children scripture. As far as dreams go, both regions succeeded in fulfilling them. A North and South of the New World were born. Bibliography Halcon, Ronald. AP US History Lecture. 2006

Is it necessary to have VAT/GST in Hong Kong?

Is it necessary to have VAT/GST in Hong Kong? Limitations of Research: the researcher could not use all the internet sources because some of them are written in Chinese, the researcher followed the structure that is provided by you but I have noticed that there is repetition in the points that are mentioned in the objectives and the points that are mentioned in the chapter plan, also there is a repetition in the resources that are mentioned in the data and information needs and the points in relevant literature consulted. The researcher shall bear no responsibility for any confusion caused by the un-clarity of the attached document. Introduction: More than 120 countries have imposed Goods and Services Tax, the only developed country that has not imposed this tax is Hong Kong. VAT or GST has been introduced by France in 1954(Ministry of Economy, Finance and Industry). All the developed countries (except Hong Kong) and most of the developing countries have followed France in imposing VAT/GST because this tax is considered: Fair: VAT/GST is considered a fair tax because it relates the amount of collected tax to the amount of consumption; the more you consume, the more you pay VAT. Simplicity: unlike any other taxes, VAT/GST is considered a straightforward tax; it is imposed according to a known percentage on the value of the products and services Efficiency: this tax is very efficient, it is very easy to collect it and it is very difficult to avoid it. Chapter2: Objectives: The purpose of this research is to find out whether VAT/GST is a suitable tax for Hong Kong or not. The research has covered very large material and literature about Hong Kong and similar economies to Hong Kong such as Singapore. The research also aimed to show that most of the governments of the world are broadening their budgets by imposing VAT/GST on customers while they are trying to reduce income and corporate taxes. Chapter3: Literature consulted: The research has covered a large part of literature published by global accredited organizations such as Price Waterhouse coopers, Ernest Young and the government of Hong Kong. The major text books have been used to give us a broad idea about the issue in research while the specialized working papers, Internet articles and government websites have been used in order to give us a clear idea about the issue in research. The research consulted working papers published by several universities and bodies in order to explain the theoretical principles behind imposing VAT/GST (Hubbard,G,R(1997)and the impact of VAT/GST on the informal sector in developed countries. Chapter4: Proposed Methodology: we can see from the above chart the deficit that have faced Hong Kong from 1997 until 2003, the revenue was very low compared to the spending which proved to be steady. †During the same year, about 70% of the total revenue collected by the Inland Revenue Department came from profits tax and salaries tax. Nevertheless, the profits and salaries tax nets are very narrow and shrinking. Less than 40% of our workforce of 3.2 million people pay any salaries tax, and only 10,000 people pay the maximum salaries tax rate of 15%. About 5% of the payers of profits tax contribute to 80% of the profits tax revenue. Further loss of profits could occur as a result of globalisation. Besides, the spread of e-commerce will have implications on all governments abilities to assess and collect business-related taxes. In this regard, both the Financial Secretary and the Secretary for the Treasury expressed their concerns on the impact of the exponential growth of e-commerce on Hong Kongs territorial-based tax system. The Government will set up a Task Force to review public finances and an independent committee on new broad-based taxes†, Wong, J(no date given) The research has depended on major questionnaire that have been distributed to citizens and companies in Hong Kong in order to get their opinion about VAT/GST tax. The response that I have got from this questionnaire has been used in predicting the change in consumption behavior by the citizens of Hong Kong. The research has also depended on comparative analysis in order to see how Hong Kong economy will be affected and how the whole tax system will be redesigned. The research depended on some graphs to illustrate the topic further. Chapter5: Data and Information needs and sources: This research needs theortical as well as practical data and comparative analysis. This research is different because it assesses the potential of something that might happen in the future. The researcher has conducted a questionnaire in order to measure the acceptance of the people to VAT and their views about the fiscal position of their country. The researcher tried to make sure that the sample is random, so the results are random too and not biased. The research required me to use some theoretical concepts in order to assess the impact of VAT. The research also depended on comparative analysis in order to see what happened to similar economies that have implemented VAT/GST. Chapter6: Chapter Plan: Understanding the principles behind using an expenditure tax like GST/VAT: Definition of GST: Goods and Services tax is imposed on: Goods and Services tax is broad-based and equitable and is capable of yielding sizeable and steady revenues. VAT or GST is a consumption tax, it is paid by the consumer of the product or the service as a percentage of the final price. It is related to all commercial activities involving the production and distribution of services; it is not charged on companies which mean that companies can deduct from their VAT liabilities the amount of tax they have paid to other taxable persons on purchases for their business activities. Hong Kong government is considering introducing VAT/GST tax in 2009(Hong Kong’s Inland Revenue). Difference between VAT and Sales Tax: VAT is imposed on every stage of production while Sales tax is actually collected in the form of extra charge by the retailer, who remits the tax to the government. VAT and the Theory of Economics: There have been a long debate between different economic schools of thought around the world about tax reform. Some economists prefer income tax to VAT/GST because it provides fair treatment to the citizens of the country while others prefer VAT/GST. According to Hubbard,G,R(1997), some economists support VAT for the following reasons: Imposing VAT instead of income tax will encourage capital accumulation and savings. Removing income and profit taxes will remove distortions in the allocation of capital among different economic sectors. A broad based consumption tax would avoid potential costly distortions of firm’s financial structures. Importance of VAT: Today it is a key source of government revenue in over 120 countries. About 4 billion people, 70 percent of the worlds population, now live in countries with a VAT, and it raises about $18 trillion in tax revenue, Liam E., Michael K., Jean-Paul B. and Victoria S(1991) VAT has advantages and disadvantages: Disadvantages of imposing VAT: VAT discourages specialist economic activity and fragmentation in the production because VAT will be fragmented; VAT encourages integration in order to avoid compounded VAT. VAT encourages financing big governments: in the 1960s, the size of governments in the US and the UK were approximately equal, in the year 2002, the size of the government in Europe have exceeded the size of the US government, many analysts attribute the difference between the sizes of the two governments to VAT, The expansion of the government will lead to higher prices and inefficient production, the thing that will lead to more taxes in the future. VAT will reduce the available capital to private businesses and raise interest rates, increasing interest rates will stifle economic growth and reduce the potential growth. Advantages of imposing VAT: VAT could finance the debt of the government because it provides stable and steady stream of income that is capable of financing development projects. VAT could reduce consumption and make the citizens of any country save and invest more money. By encouraging integration, VAT could push the economy towards mergers that will reduce the stages of production; VAT simply tends to encourage big businesses to get bigger by buying other companies, this could yield economies of scale and generate synergies.. Selectivity: the government can select the products and services that it needs to impose VAT on, for example, most government exclude food from VAT, by using VAT governments could take into its consideration the difficult economic situation of the poor and decide the exclusions that apply to them. VAT is a secure way to finance the government’s structural deficit, VAT covers most of the economic segments in the economy and it is very difficult to evade it. Introduce a historical background, economy and tax system in Hong Kong: The Modern History of Hong Kong: Hong Kong was a British dependency from the 1840s until July 1, 1997, when it passed to Chinese sovereignty as the Hong Kong Special Administrative Region (SAR), Pannell,C(1998). The British control of Hong Kong began in 1842, when China was forced to cede Hong Kong Island to Great Britain after the First Opium War. In 1984 Great Britain and China signed the Sino-British Joint Declaration, which stipulated that Hong Kong return to Chinese rule in 1997 as a Special Administrative Region (SAR) of China. The Joint Declaration and a Chinese law called the Basic Law, which followed in 1990, provide for the SAR to operate with a high degree of economic autonomy for 50 years beyond 1997, Reference: China Connection. In the Fifties of the last century, the threat of the cold world was looming over the world. Investors were looking for a safe heaven to locate their businesses and investments in a neutral place away from the eastern and the western camps, investors found in Hong Kong a promising country that is able to deliver good business environment that could foster growth and political stability at the same time. Growth in Hong Kong depends on several other economies such as the growth in the US economy and the growth in China and Southeast Asia in general. Growth in Hong Kong is related to oil prices and world wide prices; Hong Kong is a small island with very little raw resources, it depends on exporting raw materials from abroad in order to manufacture them on its land and re-export them again to other parts of the world. Manufacturing: In 1950s, Hong Kong attracted manufacturing jobs and the vast majority of its work force where working in factories. In 1980s, Hong Kong had about 905,000 manufacturing workers and manufacturing was the most important economic sector, Economist Intelligence Unit (2003). Until 1990s, Factories were manufacturing products that depended on labour intensive work force, after that manufacturing jobs started dropping because of the climbing costs of labour and land. In 1990s, the number of manufacturing jobs was about 575,000 jobs. In 2001, the manufacturing sector contributed to less than 5% of the GDP, Economist Intelligence Unit (2003). Like most of the developed nations, Manufacturing in Hong Kong is becoming concentrated on manufacturing hi-tech products and services. The manufacturing sector has been replaced by rapidly expanding service sector, in 1991; the service sector has generated 72.3% of the GDP in Hong Kong and in 2002, the service sector has generated about 83.9% of the GDP, Economist Intelligence Unit (2003). Services: A- Banking: The banking sector is now the most important economic sector in Hong Kong, Hong Kong is currently the fifth largest banking centre in the world. Hong Kong offered investors a very good opportunity to invest in a growing emerging economy. Investors benefited from tax free capital gains and high dividends. B- Tourism: Tourism is a significant source of economic growth in Hong Kong; nearly 9 million people visit Hong Kong every year, Tourists spend around $7 billion every year. Tourism is the third source of foreign exchange reserves in Hong Kong. The banking and the tourism sectors have delivered a very good growth to the Hong Kong economy. In 1996, Hong Kongs per capita gross domestic product (GDP) was second to Japan and Singapore in Asia and exceeded that of the United Kingdom, Canada, and Australia, Reference: internet article: Marimari (no date given). . Sources of Success: Hong Kong offered investors business-friendly laws and gave complete freedom to the movement of capital in order to encourage investments and promote growth. Hong Kong is duty free zone and there are few barriers to trade goods and services; this has made the country an important link ring between the east and the west. Hong Kong left market forces decide wages and prices; the government did not legislate any minimum wage requirement or anti-trust laws. Competition in Hong Kong: The decline of the manufacturing sector has caused the decline of competition in Hong Kong. Competition is considered an essential part of the market system. Competition benefits consumers and businesses, it benefits consumer by lowering prices and it benefits businesses by allocating resources in a more efficient ways. Competition is very important to the health of Hong Kong economy, competition gives world economies the flexibility to adjust its prices in the case of external shock (macro-economic shock) Sturm,P, Jahangir,A, Breuer,P, Nishigaki,Y (2000). Emerging economies that depend on fixed exchange rates usually suffer from real exchange rate appreciation. The real exchange rate appreciation could be treated by either: Switching to a flexible exchange rate: according to the â€Å"law of one price† flexible exchange rate will adjust exchange rates in order to make tradable products have the same price everywhere in the world. Lowering prices: lowering prices of products is an important toll in avoiding international competition, lowering prices could only happen if the structure of the market is competitive. Having a competitive market structure in lowering prices and keeping international capital flows coming to Hong Kong. Tax Regime in Hong Kong: Hong Kong tax regime is based on a territorial-based tax regime; the tax is imposed on incomes that arise from Hong Kong, Hong Kong’ Inland Revenue. The economy of Hong Kong has gained a competitive advantage because it imposes no taxes on capital gains and dividends; this has encouraged many investors to invest in that country and established an important financial centre in Asia. Hong Kong has the following simple tax structure: Property Tax: Property tax is levied on rental income from land and buildings situated in Hong Kong. Salaries Tax: Salaries tax is imposed on incomes derived from working in Hong Kong or if incomes derived from services rendered from Hong Kong. Profits Tax: profits that are generated in Hong Kong are subject to taxes, profits of unincorporated business stands at a rate of 15% and corporations at 16.5%. The relationship between Hong Kong and the foreign exchange rate: The currency in Hong Kong is Hong Kong dollar which is pegged to the US dollar, if Hong Kong government wanted that peg to continue, it should tighten its fiscal deficit. The currency of Hong Kong is an investment asset, many investors diversify their currency allocations, this diversified allocation to the funds of the global investors results in an important cash inflow to Hong Kong. For the Hong Kong dollar to get part of the allocation, Hong Kong should stabilize its budget in order to attract more foreign investment. Analyze why the government considers launching a broad-based tax; Narrow tax base: Hong Kong has very narrow tax base, narrow tax base means that the collected revenues do not provide enough revenue to cover the expenditure of the country. If we compare TAX/GDP ratio in Hong Kong compared to other Asia Pacific and OECD countries we find out that Hong Kong has the lowest ratio of TAX/GDP. Hong Kong has a narrow tax base because the tax base is shrinking since 1998; sound tax systems are based on growing and stable (not volatile) tax base. Hong Kong has the lowest corporate tax rate among the OECD countries, the current corporate tax stands at 16%. Erosion of Tax Base: The erosion of tax base is actually a result of several factors, such as: sliding house prices, illegal betting, e-commerce and online stock trading. In the following section I will explain each of these factors separately: sliding house prices: For a long time, Hong Kong depended on land and property transactions to contribute to government revenue of Hong Kong. Collected tax from property in Hong Kong(stamp duty, rates and shares and estate duties) is well above the international benchmarks as a percentage of GDP, Property from taxes/GDP=24% for Hong Kong against 5% for the OECD and 10% for the Asia Pacific countries), Reference: Hong Kong Government, Tax Base Study. Hong Kong depends on Land sales revenues in financing its budget, this has made Hong Kong increasingly dependent on non-tax revenues. In the tax base study that has been conducted by the government of Hong Kong and KPMG consultancy, the study reports the fact that Hong Kong’s non-tax revenue is about 80% of its tax revenues against 16% for OECD benchmark. Because Hong Kong has enjoyed a buoyant business environment for years, banks started granting credit very easily to businesses, the expansion of credit was accompanied by rising house prices, land prices started going up sharply from 1984 to 1997, Gerlach, S Peng, W(2002). Many companies found working in the construction sector very profitable because they can make profit from two sources: Net profits from building new houses and buildings. Profits from capital gains resulting from continuous increase in house prices. The construction sector was one the most attractive economic sectors in the country. Foreign and national banks expanded credit to companies which operate in the construction sector; the banking sector played an â€Å"accelerator† role in the run-up of the property prices. The government in Hong Kong has constructed its tax system around the fact that land prices are going up all the time because they are in demand. Because of the financial crises of August 1997 that hit south east Asia and also because of the government policy on housing, Revenues from land sales and land utilization(lease, rent) dropped dramatically, suddenly the government found its huge revenues from land dwindling. On the 16th of January 2000, the secretary for the treasury stated that: â€Å"The other significant factor supporting our finances, in recent years, has been the high levels of revenue from land and property transactions. But as property prices stabilize, the huge windfalls are unlikely to recur in the future† illegal betting: Hong Kong’s treasury depended on revenues from betting activities in the country. Hefty taxes has made too many people start thinking about illegal betting, Schuman,M(2004). On the 16th of January 2000, the secretary for the treasury stated that: â€Å"The impact of illegal gambling and the rise of gambling through the Internet threaten to erode our income from betting tax† Hong Kong’s Home Affairs bureau said handle plunged 30% from 1996-97 to 65 billion Hong Kong dollars (US$8.3 billion; euro6.5 billion) in 2003-04, while government revenue from betting dropped from HK$12.3 billion (US$1.6 billion; euro1.24 billion) to HK$8.78 billion (US$1.13 billion; euro882 million). Meanwhile, the amount of cash and betting slips seized from illegal soccer and horse gambling operators jumped from HK$9.38 million (US$1.20 million; euro942,000) in 2001 to HK$19.7 million (US$2.53 million; euro1.98 million) in 2004, according to the government. The government said handle is projected to drop another 30% by 2007-08 if no action is taken, Reference: the associated press (2005). e-commerce: Hong Kong tax system is based upon territorial system, which means that profits and incomes that are derived from Hong Kong should be taxed according to Hong Kong tax laws, the development of e-commerce and the expansion in on-line selling to customers who are not based in Hong Kong through websites that belong to the global network makes hard for the government of Hong Kong to draw a clear line between the income that is derived from the internet and the income that is derived from Hong Kong. On the 16th of January 2000, the secretary for the treasury stated that: â€Å"The spread of e-commerce will have implications on all governments abilities to assess and collect business-related taxes. For us, the impact will be further accentuated by the territorial-base of our taxation regime† online stock market trading: the development of modern communications and the development of the financial markets made trading on-line possible from all over the world, trading has been made very easy by websites that are based on the web, the development of futures, options and spread betting markets have made possible to trade 24 hours a day. It is very hard to impose taxes on online trading because the companies who established these websites do not have a physical place in Hong Kong. On the 16th of January 2000, the secretary for the treasury stated that: â€Å"The acceleration in global stock market trading through the Internet will require us to consider whether the stamp duty we charge on stock transactions can be maintained at its present level, or whether by doing so we would impede the further development of the Hong Kong stock market† Hong Kong has a prolonged problem in tax revenues resulting from low income tax on working population and the constant decrease in the number of working individuals because of aging. The secretary of treasury addressed this problem by saying: â€Å"For we all take for granted the low level of taxation which we enjoy in Hong Kong. For example, less than 40% of the workforce pay any salaries tax, and only 10,000 people pay the maximum salaries tax rate of 15%. Companies pay profits tax at 16%, and only profits arising in Hong Kong are subject to tax. Also we have no taxes on other income or capital gains, no sales or value-added taxes on what we buy, and duty is payable on very few commodities. So much for revenue, on the expenditure side, the community expects more and better public services. An ageing population will place increasing demands on our health and welfare services. The need to tackle pollution will bring substantial costs. We need to reconcile this need for additional spending with a contracting revenue base. Based on the above reasons the treasury of Hong Kong is considering widening the tax base a strategic option. Expanding the tax base is a constitutional obligation as well as an economical obligation. Hong Kong has to reduce its deficit if it wants to keep the value of its dollar strong and able to attract investors. †¦. These sound practices are now enshrined in the Basic Law. So we are under a constitutional obligation to keep our finances in a healthy state. With a fiscal deficit last year, and a projected deficit this year and next year, the law and prudent financial management demand that we bring our finances back into the black in the near term. This would also have the added advantage of maintaining our fiscal reserves at the level necessary to help support the Hong Kong Dollar, an indisputable requirement given the events of 1998. 5- Aging population: Hong Kong has an aging population; this has put an increasing pressure on the social security system and the infrastructure. This has made the secretary of the treasury to state: The directions indicate that the continuation of current revenue and expenditure policy is not an option Considered that introducing general consumption tax is the most suitable for Hong Kong? In order to see if the general consumption tax is the most suitable tax or not we have to evaluate all Hong Kong tax options. Tax Options for Hong Kong: 1- Reduce Personal Allowance: Hong Kong tax systems is one of the most generous tax systems in the world, as we have said earlier fewer than 40% of the work force pay taxes, some tax experts are suggesting the government reducing its tax free income allowance in order to increase tax collection revenues, experts say that a reduction in the basic allowance of 10% will raise about $2bn revenue, even if Hong Kong decided to reduce the personal allowance by 50% this will raise 90% of its traditional revenue from the existing tax base is simply contributing more revenue, this options will not be suitable to Hong Kong because it does not broaden the tax base, this option will increase the weight of salaries tax in the overall tax collection, KPMG Tax base study. 2- Expand the Existing Tax Base via imposing capital gains tax: this option is not considered the best option because it will affect investment decisions negatively and lead to capital outflow from the country and make the country lose its competitive advantage. Imposing capital gains tax may cause job losses and that will make the tax collection from salaries substantially less, so the gains from imposing capital gains tax will be offset by loss of tax from loss of income and salaries taxes. Imposing taxes on dividends may not lead to desirable results. 3- Increase corporate taxes: Increasing corporate taxes is one of the main issues that the government of Hong Kong is discussing, most of the analyst believe that this is not an option because increasing the corporate tax will simply cause damage to the position of Hong Kong in the global market, analysts think that there is a global trend to reduce corporate tax in all over the world. Analysts think that countries are in competition with each other to provide facilities and tax concessions to corporations. If Hong Kong increased its corporate tax, it would be very easy for corporations to shift their headquarters to somewhere else in the world. According to Hong Kong Institute of Certified Public Accountants the government of Hong Kong is suggesting giving more corporate tax concessions to corporations in the following three areas: A- Full profits tax exemption to regional headquarters/offices in Hong Kong in respect of management consultancy income Derived by the Hong Kong entity from associated entities Overseas. B- Exemption of interest income received by regional offices from Loans made in Hong Kong to their overseas associates. C- Group relief. D- Loss incurred in the current year of assessment should be permitted to be offset against the assessable profits of one previous year. 3- Introduce New Taxes: introducing new taxes (apart from VAT/GST) could an innovative solution to Hong Kong’s structural fiscal deficit. In fact, there is no limit to the number of taxes that a government could impose in order to provide suitable macroeconomic environment for development. For example, Hong Kong could introduce environmental taxes in order to reduce carbon dioxide emissions from cars and factories, we all know that developed countries contribute significantly to the increasing stock of greenhouse gas emissions that causes global warming. Because Hong Kong has very busy airports and sea ports, Hong Kong could impose new taxes on land and sea departures. Experts advise the government to outsource the activities that it does not usually do efficiently, outsourcing will help the government reduce the deficit that is caused by inefficient use of resources. Experts did not only advise the government to introduce new taxes but also to abolish some taxes. For example, abolishing taxes on alcohol beverages in order to encourage wine tourism Experts think that applying this option will not solve Hong Kong’s structural deficit problem completely for the simple fact that Hong Kong has a reputation that it is a low tax country and if the government imposed taxes on several economic activities, Hong Kong reputation will be affected and this may have a damaging effect on the position of Hong Kong in the financial and business world. What experts are trying to say that Hong Kong government should introduce new taxes and abolish old taxes in order to keep the current balance of taxes and respond to the modern needs of the society (such as environmental taxes). 4- Broad-Based tax on general consumption: this could be VAT (Value Added Tax), GST (Goods and Services Tax) or Sales Tax. Kong’s structural deficit problems. Government says that a 3% GST will yield about $18bn which stands for 1.5% of GDP. Analysts recognize that GST is a powerful solution to Hong Kong’s Problem, 3% GST is capable of solving the problem, and in addition to that, 3% GST is in line with international standards. This tax is not only capable of covering the government expenditures but also capable of broadening the tax base since it is imposed on nearly all kinds of consumption. There are few points that the government needs to take in to its account when constructing the VAT/GST: It is recommended that the VAT/GST should be simple; simplicity is the common feature of Hong Kong tax system and keeping the proposed VAT/GST simple is consistent with the rest of the tax system. It is recommended that the VAT/GST should be comprehensive; in other words, it should include most goods and services in the economy, making the VAT/GST comprehensive will guarantee stable revenue to the government and will prevent further increases in the rate of VAT/GST. Stability: it is advised that the rate of the VAT should stay constant for 5-10 years to come, stability in the tax rate is very important in creating stable consumption and investment decisions, consumers will base their consumption decisions upon the prices of products and s

Mechanisms of Musculoskeletal Pain

Mechanisms of Musculoskeletal Pain Musculo-skeletal pain is a complex sensation where sensory, affective and cognitive dimensions of pain alongwith parallel neural networks in brain are associated with constellation of factors. Though pain occurs to show protective gesture, but when it surpasses threshold, exerts debilitating effect upon health and triggers concomitant physiological and psychological concerns of perilous ramifications. Right from the activation of primary afferent nociceptors upto the cortical processing of the pain in the higher regions of the brain, pain trajectory can be dissected into transduction, conduction, synaptic transmission and modulation. Besides, environmental, behavioral and psychological risks involved, all these stages of pain sensitivity, severity and analgesic responses are mediated by different set of genes and genetic variants. Transduction of noxious stimuli is regulated by transient receptor potential cation channel subfamily M, member 8 (TRPM8) and transient receptor potential cation channel subfamily A, member 1 (TRPA1) encoded by TRPM8 and TRPA1 genes, which plays an important role in the inhibition of background potassium channels. SCN10A encoded, voltage gated sodium channel Nav1.8 is essential for signal generation in response to cold stimuli. The nociception, due to heat stimulus and red hot chili pepper activates the ion channel TRPV1 and capsaicin receptors. However, TRPV1 also regulates the inflammatory pain thresholds, TRPV4, in conjunction with TRPV1 and TRPV2, transduces both thermo and mechano-sensations. The pain related transgenic knockout studies offered significant information on the genes that influence pain transduction. (Lacroix-Fralish ML. etal, 2007). Three genes SCN9A, SCN10A and SCN11A which encode sodium channels are observed to be expressed in sensing neurons. . SCN9A carriers, who have defective Nav1.7 remains pain free, which makes it a novel target for sodium selective analgesic drugs. SCN10A (Nav1.8) is also a significant contributors to the transduction signaling of pain pathway. Though, encoded channel Nav1.8 does not induces action potential but plays a significant role in setting the pain thresholds. SCN11A gets activated, close to the resting membrane potential and mutations in this gene have been associated to the loss of pain perception. Voltage gated sodium channel nociceptors specific genes SCN1A, SCN3A, SCN8A, SCN9A, SCN10A, SCN11A along with potassium channel encoding KCNQ genes play a significant role in nociceptive conduction. Synaptic transmission is regulated by several genes such as GR1N1, GR1N2, GR1A1-4, GR1C1-5, NK1R. Some voltage gated calcium channels encoding genes, such as CACNA1A-S, CACNA2D1 mediates the neurotransmitter release in the pre-synaptic membrane.Several genes and genetic variants have also been implicated in the centr al, peripheral and microglial pain modulation. (Foulks and Wood. 2008). How damage sensing neurons submit input signals regarding the extent and severity of pain to central nervous sytem (CNS) is highly complex. Very many brain areas are involved in sensory discrimination and affective evaluation which determine the nature of pain perception. Genetic variation of COMT gene that encodes catechol-o-methyltransferase regulates the inactivation of catecholamines neurotransmitters and reduced COMT enzymatic activity which leads to increased pain sensitivity and temporal summation of pain (diatchenko L et al. 2005) Decreased adrenalin metabolism due to reduced COMT activity increases pain through the stimulation of ÃŽ ²2/ 3-adrenergic receptor antagonist. A few genome wide association studies (GWAS) on musculo-skeletal phenotypes have been carried out which revealed some strongly associated SNPs within CCT5 and FAM173B genes that influence chronic widespread pain in lumbar spine region. Over the past decade, an intriguing development in cellular genomics has aroused curiosity of the possibility of miRNA in pain research. MicroRNAs (miRNAs) are family of small, noncoding RNAs that regulate gene expression in sequence specific manner. Their non-perfect pairing of 6-8 nucleotides with target mRNA subsequently forming miRNA Induced Silencing Complex (miRISC) generally results in translational repression, destabilization of mRNAs and gene silencing. Some miRNAs have been implicated in pain mechanism including neuronal plasticity, neurogenesis, nociceptor excitability, chronic pain conditions and pain threshold. They engrossed the attention when observed that these miRNAs play an evident role in the conditional deletion in nociceptors of th e miRNA producing enzyme, Dicer and blocks inflammatory pain hypersensitivity. The pioneer studies on the role and relevance of miRNAs in pain demonstrated that miR-134 is modulated in the trigeminal ganglion in response to inflammatory pain. BDNF triggered miR-132 is upregulatedin cortical neurons which is identified as modulation of nociception signaling. miRNA Let-7 that target  µ-opiod receptors plays considerable influence on the opioid tolerance in mice. Activity regulated miR-188 is a significant player of synaptic plasticity tuning. Dysregulation of miR-29a/b is associated with structural plasticity in psycho-stimulant exposure. In the traumatized spinal injury miR-219 is downregulated 7 days after contusion whereby sciatic nerve ligation induces an up-regulation of this miRNA. In chronic pain miR-124 down regulates in dorsal root ganglion neurons in inflammatory muscle as well as in sciatic nerve crush. Researchers are instrumental in understanding the epigenetic mechanisms in relation to pain causation and alleviation. Epigenetic modifications play significant role in cytokine metabolism, neurotransmitter release and response, analgesic sensitivity and central sensitization. Changes in chromatin structure may lead to acute to chronic pin transition. Prior priming (sensitization) of spinal microglia with initial inflammatory challenge, subsequent challenges create enhanced pain intensity and duration. Effects of neonatal pain experience relates to adult pain sensitivity where they exhibit spinal neuronal circuits with increased input and segmental changes in nociceptive primary afferent axons and enhanced or altered pain stimulation. Histone modifications, a significant epigenetic mechanism which may alter the gene expression of pain is highly associated with glutamate decarboxylase (Gad2), Shal related subfamily member 3 (Kcnd3), melting CpG binding protein 2 (Mecp2), potassium vol tage gated channels, oprin 1, Scn9a Genes. Histone acetylation and DNA methylation have also been implicated in chronic pain conditions. Though an epigenetic alteration in relation to the risk of pain is in infancy but in near future, such knowledgeable musings will unravel several novel targets for analgesic drugs and preventive modalities. Brain does more than understanding and responding to pain irrespective of sensory inputs and even in the absence of external inputs. Why even cordectomy or anesthetic blocks of sympathetic ganglia do not stop phantom limb pain? Pain genetics have the capacity to enrich us of several such intricate and unforeseen consequences involved with pain etiology, risk factors and variable analgesia. In future, investigation of relevant genomic sequences has many revelations in store for us, by which we will be able to regulate or control pain by switching on or off various genes that causes it.