Public Private Partnership in Healthcare - Free Essay Example

Sample details Pages: 16 Words: 4755 Downloads: 1 Date added: 2017/09/19 Category Health Essay Type Argumentative essay Tags: Health Care Essay Did you like this example? Transforming Singapore Health Care—MK Lim 461 Commentary Transforming Singapore Health Care: Public-Private Partnership†  MK Lim,1FAMS, FRCP (Edin), MPH (Harvard) Abstract Prudent health care policies that encourage public-private participation in health care financing and provisioning have conferred on Singapore the advantage of flexible response as it faces the potentially conflicting challenges of becoming a regional medical hub attracting foreign patients and ensuring domestic access to affordable health care. Both the external and internal health care markets are two sides of the same coin, the competition to be decided on price and quality. For effective regulation, a tripartite model, involving not just the government and providers but empowered consumers, is needed. Government should distance itself from the provider role while providers should compete – and cooperate – to create higher-value health care systems than what others can offer. Health care policies should be better informed by health policy research. Ann Acad Med Singapore 2005;34:461-7 Key words: Health care costs, Health care regulation, Health economics, Health reform Introduction Should health care services be publicly or privately funded? And should these services be publicly or privately provided? The answers to these questions largely depend on whether one considers health care a public or a private good. Most people would consider the provision of street lighting and national security to be a public sector responsibility, and luxury items like cars and annual holidays abroad to be private consumption goods best left to the individual to purchase and the private sector to provide. When it comes to health care, however, the issues become highly contentious and the answers are not as clear-cut. While consulting a doctor is a very personal matter, the thought of denying a fellow human being access to the same level of health care because of his or her inability to pay, stirs deep emotions. Historically, the pendulum in the health care debate has swung back and forth between the state and the private sector. Definitions In this paper, the term â€Å"public sector† refers to that part f the economy concerned with providing basic government services while the â€Å"private sector† is that part of the economy not controlled by the government. The latter could be â€Å"for-profit†, or â€Å"not-for-profit† in nature. The term â€Å"public-private partnership† in health care finance refers to the situation where the government mobilises private sector sources of funds to finance health care services. Correspondingly, public-private partnership in health services provision entails government encouragement of private sector participation in the delivery of public services. The possible combinations of publicprivate mix in the health sector are shown in Figure 1. International Experience The ke y questions surrounding health care systems around the world are: (a) how to raise revenues to pay for health care; (b) how to pool risks and resources; and (c) how to organise and deliver health care in the most efficient and cost-effective manner. Whether the strategies adopted rely on public sources like taxes and social insurance, or private sources like private insurance and out-of-pocket payment, Department of Community, Occupational and Family Medicine National University of Singapore, Singapore Address for Reprints: A/Prof Lim Meng Kin, Department of Community, Occupational and Family Medicine, National University of Singapore, MD3, 16 Medical Drive, Singapore 117597. Email: [emailprotected] edu. sg †  Based on an invited lecture delivered at the 30th Medico-Legal Society Annual Seminar: Transforming Health Care at the Grand Hyatt, Singapore, 6-7 November 2004. 1 August 2005, Vol. 34 No. 7 462 Transforming Singapore Health Care—MK Lim Provision Public Publi c Finance Private Publicly financed Publicly provided Privately financed Publicly provided Private Publicly financed Privately provided Privately financed Privately provided for this include insufficient government resources and poor performance on the part of the public sector. State-run institutions are notoriously bureaucratic. There is a growing realisation that involving the private sector in health services provision could lead to improved systems efficiency. Even in Europe, the sustainability of health care systems founded on egalitarian welfarism is increasingly being challenged as growth in demand outstrips supply. 3 The debate is no longer about â€Å"who should pay? † or â€Å"who should provide? † but â€Å"who can do the job more efficiently? †. Singapore’s Experience Health Care Finance Singapore’s experience exemplifies an evolving publicprivate partnership in health care financing and provision. In the 1980s, the Singapore gov ernment reexamined from first principles the role of the state in health care financing and provision, and concluded that a British-style National Health Service was neither a viable nor a sustainable option. It decided that while the government would continue to subsidise health care (along with other important social areas like housing and education) to bring prices down to an affordable level, the people would have to share in the costs of the services they consume. The â€Å"3M† system — Medisave (1984), Medishield (1990) and Medifund (1993) — which forms the centrepiece of Singapore’s health care financing system, was therefore premised on the philosophy of shared responsibility, and the economic principle that health care services should not be supplied freely on demand without reference to price. In persuading the people to accept this hard-nosed policy, the government reasoned that the question â€Å"who pays? was not the right question to ask, f or â€Å"whether it is the government, Medisave, employers, or insurance, it is ultimately Singaporeans themselves who must bear the burden† — since insurance premiums are ultimately paid by the people, employee medical benefits form part of wage costs, and taxes are paid by taxpayers. Over the years, the demand for health care has increased in tandem with the key drivers of health care costs, such as the rapid ageing of the population, advancing medical technology resulting in the increased range and number of possible interventions, and rising public expectations. Singapore’s innovative 3M system of health care financing has proven to be very effective in mobilising private financial resources. Medisave, the state-run medical savings accounts, which is compulsory for the working population, today stands at a staggering S$30 billion, an amount that can underwrite Singapore’s total health care expenditure for the next 5 years. A most remarkable achieve ment has been the gradual Fig. 1. Public-private mix in health care provision and financing. will have a profound impact on heath care costs, quality, and access. In making the choice, technical efficiency is an important, but not the only consideration. Most health care systems in western industrialised countries assume a high degree of responsibility for personal health care because they are driven by values which lean heavily towards notions of equity, fairness and solidarity. With the notable exception of the United States, all the Organisation for Economic Cooperation and Development (OECD) countries (including Japan and South Korea) have opted for publicly financed health care systems that provide universal coverage. The United States relies heavily on the private sector to finance health care, with the result that in 2002, 15. 8% of its population (or 42. 3 million people) were not covered by health insurance of any form. 1 The Europeans and Canadians (and indeed many A mericans themselves) consider this to be highly inequitable. At the same time, they are saddled with runaway health care costs from which they are struggling to break free. The facts on the ground are often different from the official rhetoric. Thus, although the British in theory enjoy free health care under the National Health Service, 10% of the population have purchased private health insurance, with one-fifth of all elective surgery being performed in the private sector. Likewise, although New Zealanders may enjoy free health care, one-third of the population have private health insurance, with one-fourth of all surgery being performed in private hospitals. 2 In Canada, where the single-tier health care system is mandated by law, increasing numbers who are frustrated with the growing waiting lists for surgery simply cross the border to the United States to buy more esponsive, private health care. In fact, all the welfare states have, without exception, found it necessary to impose arbitrary limits on health care spending and to ration access to expensive medical technology — to the extent of compromising on health care quality. In recent years, the trend in both the developed and developing worlds has been towards greater private sector involvement in health care provision and financing. Reasons Annals Academy of Medicine Transforming Singapore Health Care—MK Lim 63 100% 80% 60% 40% 20% 0% 1965 1970 1975 1980 1985 1990 1995 2000 Year Government expenditure Private expenditure Fig. 2. Public versus private health financing, Singapore (1965-2000). shift of the financial burden from the government to the private sector (Fig. 2). 5 Since access to needed care is explicitly guaranteed for the poor,6 and the state-run Medishield insurance scheme protects against financial ruin from catastrophic illness, the system is on the whole no less humane than a state-funded one. Health Care Provision Health care provision comprises a mix of 8 public h ospitals and 5 specialty centres which together account for 80% of inpatient beds, with 13 private hospitals accounting for the remaining 20%. Primary health care is easily accessible through an extensive and convenient network of private general practitioners (80%) and public outpatient polyclinics (20%). In addition, an estimated 12% of daily outpatient attendances are by traditional Chinese practitioners in the private sector. The successful corporatisation of Singapore’s health care institutions between 1985 and 2002 has resulted in better efficiency and improved service levels. Market mechanisms and structures have replaced old bureaucratic ones. Presumably, better and more informed decisions are being made at the local level, compared to central planning by the Ministry of Health (MOH). Patient responsiveness today is a far cry from the overcrowded wards and specialist outpatient clinics of yesteryear. Patient satisfaction is reportedly high (85%); average waiting time for elective surgery is apparently a mere 2 weeks; and the average length of stay in a public hospital is 5 days. With first-world standards of health attainment (an average life expectancy of 78. 4 years and an infant mortality rate of 2. 2 per 10007) at an affordable 3% to 4% of GDP for the last 3 decades, Singaporeans appear to be getting good value for their money. Singapore Health Care at the Crossroads Looking ahead, a number of challenges place Singapore’s health care system squarely at the crossroads. These include (a) the need for cost containment on the domestic front; (b) Singapore’s push to become a regional hub of medical excellence; and (c) the ongoing quest for quality and patient safety. After years of continuous growth averaging 8. 0% between 1965 and 2000, the Singapore economy began to flounder during the 1997 regional financial crisis and the subsequent economic slowdown in 2003 associated with the SARS outbreak. Although it has since bounc ed back (8% to 9% projected growth for 2004), Singapore’s maturing economy faces tough times ahead, including the effects of lobalisation and increased competition from China as the emerging economic powerhouse. The government is committed to restructuring the Singapore economy and some recommendations of the Economic Review Committee (2002) have implications for the health sector such as (a) the reduction of the Central Provident Fund (CPF) contribution rate (thus affecting the Medisave contribution rate) and (b) the identification of the health sector as an important sector to target economic growth – in other words, to further commercialise medicine and turn it into a money spinner for the Singapore economy. Challenge of Cost Containment In theory, rising health care costs should not pose a problem if the rate of increase is matched by rising national income, just as the legendary Milo of Crotona grew stronger each day by lifting his calf every day — as th e calf grew, so did his muscles! Unfortunately, in Singapore’s case the calf is growing faster than our ability to carry it. Health care expenditure cannot remain at 3% of GDP for long. For one thing, as the economy matures and GDP growth inevitably slows, the masking effect of an expanding GDP denominator will disappear. Another factor is the rapidly ageing population, now constituting a mere 7. 7%, but projected to increase to 14% in 2010 and 25% in 2030. The 3M formula was not designed to take into account the long-term care needs of the elderly. Advancing medical technology in the era of genomic medicine will add to the mounting cost pressures. New schemes like Eldercare and Elderfund have been added. The government has acknowledged that the key parameters for Medishield (since 1990) such as premiums, deductibles and benefits have not been sufficiently updated to reflect the increased cost of hospitalisation. Hence, a major revamp is underway to fine-tune Medishield and to broaden its risk pool. However, a more fundamental weakness of Singapore’s cost containment strategy that has not been adequately August 2005, Vol. 34 No. 7 Percentage 464 Transforming Singapore Health Care—MK Lim addressed is its almost exclusive focus on the demand side. The 3M system was explicitly designed to curb overconsumption and to counter the â€Å"moral hazard† associated with fee-for-service, third-party reimbursement. The result has been the successful moderation of the government’s share of total expenditure, but not private spending. It can be observed that total health care spending has in fact risen exponentially, despite the 3M system being in place (Fig. 3). The focus has been on how to pay for health care, not how to purchase health care wisely. It is pertinent to point out that every dollar spent on health care is a dollar earned by health care providers. Hence, there is inherently no incentive for health care providers to want to contain costs. Indeed, providers could be expected to exhibit entrepreneurial behaviour. Casemix was introduced in 1999 as a cost containment measure to check supply-side moral hazard. But alas, since E = P x Q (where E = expenditure, P = price and Q = quantity) controlling price (P) alone (which is what reimbursement based on DRG attempts to do) is not going to curb the quantity (Q) of services supplied. There is also no evidence that the splitting of Singapore’s heath care institutions into 2 competing clusters has resulted in competition of the healthy kind that would justify the increased overheads of having 2 clusters, or that Singapore’s doctors are rendering health care at the economically optimal point, where the marginal benefits to patients would justify the marginal costs of treatment. Challenge of Becoming a Regional Medical Hub The fact that Singapore’s major private sector health care players are listed on the Singapore Exchange refle cts the government’s favourable disposition towards the commercialisation of health care services. The government has in recent years also allocated billions of dollars to attract foreign pharmaceutical and biotechnology companies to Singapore, including multinationals like ScheringPlough, GlaxoSmithKline, Merck, Sharp Dohme, Aventis and Pfizer. Realising that Singapore doctors enjoy a good reputation, as attested by the 200,000 foreign patients who came from the surrounding region in 2003,8 it wants to turn Singapore into the premier medical hub in the region. The Economic Review Committee, charged with making recommendations to improve Singapore’s competitiveness, has set an ambitious target of one million foreign patients a year by 2010, which would bring in an estimated $3 billion annually and create 13,000 jobs. In 2004, the Economic Development Board, Singapore Tourism Board (STB) and International Enterprise Singapore (IE) announced the launch of Singapore M edicine, a multiagency government initiative aimed at developing Singapore into one of Asia’s leading destinations for health care services. Who should drive the regional push: the public or private sector? As with health care financing, focusing on â€Å"who? † is to ask the wrong question. To use Deng Xiaoping’s metaphor, what matters is not the colour or breed of the cat, but its ability to achieve results. The challenge is not only to achieve the set targets, but to do so in a manner that enhances Singapore’s standing in the international arena and its relations with its neighbours. The last thing we want is to become a high-priced medical â€Å"tourist trap† founded on activity-based, rather than evidence-based medicine. This means a focus on the basics — ethical, cost-effective medical practice, with emphasis on quality and patient safety. This leads us to the third challenge, which has implications for both the domestic and regiona l/international fronts. Challenge of Quality and Patient Safety There is growing concern worldwide that the health care industry is plagued with unnecessary and inappropriate care, even replete with medical errors. The Institute of Medicine’s 1999 report, â€Å"To Err is Human†, has put the issue of patient safety and quality firmly on the public agenda. The 2001 sequel, â€Å"Crossing the Quality Chasm†, has described the wide gulf that exists between what is and what should be in terms of quality health care. 10,11 How does medical care in Singapore measure up in terms of safety, effectiveness, patient-centeredness, timely care, efficiency and equity? To safeguard patient safety and ensure quality care, it is essential that these unknowns about our health care processes and outcomes are measured — for what we do not measure we cannot manage. Singapore’s journey in quality and patient safety has been discussed elsewhere and will not be repea ted here. 12 5 4. 5 4 3. 5 $ billion 3 2. 5 2 1. 5 1 0. 5 0 1965 1970 1975 1980 1985 1990 1995 2000 Year Government expenditure Private expenditure Total expenditure Fig. 3. Trends in national health expenditure, Singapore (1965 to 2000). 4 Annals Academy of Medicine Transforming Singapore Health Care—MK Lim 65 One thing is clear, however: while professional selfregulation is important, it is insufficient. Regulatory structures external to the doctor-patient relationship are needed to protect the public interest and to align provider behaviour with desired goals. However, government regulation is also of limited effectiveness, for the government, too, faces the same problem of information asymmetry as the patient — given the large grey zone of clinical judgment and the delicate nature of the doctorpatient relationship, which precludes over-intrusive monitoring. What is needed is a new paradigm of health care regulation involving the participation of empowered consum ers, more of which will be described later (Fig. 4). Regulator Empowerment Price and Quality transparency Patient Trust Performance indicators Provider Fig. 4. Tripartite regulatory framework. The Way Forward The three challenges highlighted above — cost containment, developing a medical hub and ensuring quality and patient safety — are interrelated. A focus on costs without a corresponding focus on quality and patient safety is meaningless. Care that is cheap but of poor quality is surely not what Singaporeans want or deserve. Neither will a reputation for expensive or inappropriate treatment propel us towards our goal as a medical hub. Both cost containment and quality of care are critical factors to Singapore’s success as a regional medical hub. The international market competition, as with the domestic market competition, will ultimately be decided on the basis of both price and quality. A first step towards achieving all of these goals is to create the r ight conditions for (a) competition, (b) consumer choice, and (c) provider cooperation. Competition The literature on the effects of hospital competition in the US reveals that competition has been beneficial, lowering cost and increasing quality. Market competition is conducive to innovation and continuous improvement. It provides a more appropriate equilibrium of prices, technology, and capacity than would be possible by central planning. Furthermore, studies have shown that private delivery of health care services has efficiency advantages over public delivery. Still, whether private hospitals are more efficient than public hospitals is beside the point; what is important for market competition to work is that there is a level playing field for both public and private providers. Such a competitive model provides strong incentives for both technical and allocative efficiency. Those providers (public or private) unable to compete in terms of price and quality of their service s should bow out and let others step in. The government’s role would be to monitor and enforce contractual arrangements. It should provide oversight, not micro-manage, and should intervene only when there is market failure. It is telling that the imperative for cost control and increased efficiency has driven even the welfare states of Europe to introduce competition in their health care systems. In tax-based systems (e. g. , the UK), this has meant the establishment of â€Å"internal market† mechanisms, enforcing a split between purchasers and providers. The evidence from Scandinavian countries shows that competition and a split between providers and purchasers improve productivity, access and quality. 13 Singapore’s health care environment is presently competitive in form but not in substance. Despite restructuring, the Singapore government still multi-hats as regulator, policymaker, asset owner, and major purchaser and provider of services, remaining ef fectively in control of the 2 health care clusters. This makes arms-length regulation difficult. The inter-cluster competition is somewhat artificial and may even be counterproductive. The government should further distance itself from the public provider role and confine itself to being a policy setter and unbiased regulator, applying a consistent approach to all service providers. Public sector providers should be given greater exposure to market forces, including having to compete with the private sector for a share of statesubsidised patients. Consumer Choice Singapore’s regulatory framework should not merely consist of 2 parties, namely the regulator (MOH) and the regulated (public and private providers). It should ideally be tripartite, in which empowered and well-informed consumers play their rightful role in selecting health care providers on the basis of price and quality of care provided (Fig. 4). Information asymmetry would not be an insurmountable barrier on ce the full power of information technology plus the role of the media is brought to bear. The government’s role should be to ensure transparency of key performance measures across the system so that consumers will be well informed and able to make sound August 2005, Vol. 34 No. 7 466 Transforming Singapore Health Care—MK Lim decisions. The publication of selected prices of certain procedures on the Ministry of Health website in 2004 has already led to some dramatic price reductions. Once government websites start publishing reliable and valid provider data on quality, safety and health outcomes in addition to pricing, there will be a major shift in the balance of power, resulting in a more stable equilibrium of provider accountability. Providers would be motivated to improve responsiveness to consumer preferences, and consumers would be empowered to choose freely between providers, both public and private, on the basis of cost, quality and other desirable attribute s. Cooperation The twin notions of competition and cooperation among providers need not be contradictory. Providers already know there is advantage to be gained by cooperation (which was what â€Å"clustering† of public sector hospitals was supposed to do, except that it would have worked better if the cooperation had been spontaneous rather than forced). â€Å"Coopetition†, or cooperation amidst competition, should be the watchword as Singapore strives to become a regional medical hub. Ultimately, Singapore’s health care institutions must compete successfully with the â€Å"competition out there† on the basis of clinical quality and price, in addition to other desirable service characteristics such as â€Å"one-stop, seamless care†. For this to happen, Singapore providers must first get their internal act together. Only by cooperating can they leverage on the respective strengths of the public and private sectors, and can they hope to innova te and create higher-value health systems than what others offer. The Electronic Medical Records Exchange (EMRX) is a fine example of inter-cluster cooperation. In addition, Singapore’s first Cyclotron (at a shared cost of $5. million) to support the operation of positron emission tomography scanners is a good example of cooperation between the public (SingHealth) and private (AsiaMedic and MediRad Associates, a subsidiary of Parkway Holdings) sectors, contributing to the common goal of enhancing Singapore’s standing as a hub of medical excellence. Continuous dialogue is needed to build trust and to evolve a common strategic vision. Just as cooperating with competitors in the local market brings mutual advantages, avenues for strategic alliances with external partners or competitors to achieve win-win situations should also be explored. Conclusions Strength: Public-Private Partnership Foundations Already in Place Prudent policies involving public-private partnership s in both health care provision and health care finance have conferred on Singapore a distinct advantage over other nations facing similar challenges of diminishing resources in the face of increasing demands: It is far easier to set priorities when patients are conditioned to cost-sharing rather than free health care, and when the range of policy options available is broadened by a healthy mix of public and private providers. Weakness: Insufficient Evidence Base for Policy Making A key weakness of Singapore’s health care system is its lack of a culture of rigorous and transparent evaluation. For example, no major effort has been undertaken to gather relevant data in a systematic manner over time to assess the full impact of hospital corporatisation. Neither has the 3M system been subject to critical analysis with all the relevant data at disposal. Likewise, to be the market leader in health care provision in the region requires in-depth knowledge nd an understanding of th e nature and behaviour of crossborder trade in health care services, the cost and quality performance of self versus the competition, and the healthseeking behaviour of local and regional consumers. Formulating health policies without the benefit of health policy research is like flying an expensive passenger aircraft without instruments. Given that Singapore spends $5 billion on health care annually, and is set to invest millions more to build the base to attract the regional health care clientele, it would seem penny wise, pound foolish not to invest a tiny fraction of that to find out what works and what doesn’t. Going Forward If Singapore’s health care system is to be transformed into a modern and responsive 21st-century health care system, it needs to be decidedly consumer-focused. In particular, it needs to be competitive in terms of price and quality because that is what consumers everywhere expressly look for. A tripartite model of health care regulation, in volving the active participation of empowered consumers, is Singapore’s best hope for containing costs and ensuring quality of care. Getting the internal (i. e. , domestic health care) and external (i. . , regional medical hub) acts together are two sides of the same coin, involving the same principles of competition, consumer focus and cooperation. â€Å"Who (public or private) does what† is not as important as â€Å"what gets the job done†. Recommendations The devil is (as always) in the details, but it is proposed that the following broad principles should form the basis of strategic planning and structural reform aimed at getting our internal and external acts together: Annals Academy of Medicine Transforming Singapore Health Care—MK Lim 467 1. To contain health care costs, both sides of the equation must be simultaneously addressed: supply side control mechanisms in addition to demand side constraints. 2. To achieve greater efficiency, public sect or provisioning should be exposed more to market forces. 3. To grow as a regional medical hub, a coordinated effort involving greater public-private, private-private, and public-public partnerships is necessary. 4. To ensure a level playing field for market competition to take place, the government should further distance itself from the public provider role and confine itself to being a policy setter and unbiased regulator. . To empower consumers to choose providers on the basis of price and quality, the government should actively pursue a policy of transparency of information on the price and quality of care of providers. 6. To balance the need to grow commercial medicine on the one hand, and keep domestic health care costs affordable on the other, health policy makers need to pay attention to the alignment of incentives with goals, and anticipate unintended side effects. 7. To improve health policy-making, the evidence base should be strengthened considerably. Health policy needs to be informed by health policy research. REFERENCES 1. US Census Bureau. 2003 Current Population Survey (CPS) Annual Social and Economic Supplement, 2003. Available at www. census. gov/ apsd/techdoc/cps/cps-main. html. Accessed on 9 November 2004. 2. Goodman JC, Musgrave GL. Twenty Myths about National Health Insurance. NCPA Policy Report No. 166, 1991. 3. Duffy K. Final report of the HDSE Project. Opportunity and risk: trends of social exclusion in Europe. United Kingdom: Council of Europe Publishing, 1998. 4. Lim MK. Health care systems in transition II. Singapore, Part I. An overview of health care systems in Singapore. J Public Health Med March 1998;20:16-22. 5. Lim MK. Shifting the burden of health care finance: a case study of public-private partnership in Singapore. Health Policy 2004;69:83-92. 6. Goh CT, 1996. Speech by the Prime Minister at the National Day Rally on 18 August 1996. 7. Ministry of Health, Singapore. State of Health the report of the Director of Medi cal Services. Singapore: Ministry of Health, 2001. 8. Singapore Tourist Board Press Release. Singapore set to be health care services hub of Asia. Available at: https://www. app. singapore medicine. com/asp/new/new0201c. asp? id=881. Accessed October 20, 2003. 9. Anonymous. Singapore faces new competitors in services. The Straits Times. 2003 January 24:1. 10. Kohn LT, Corrigan JM, Donaldson MS, editors. To Err is Human: Building a Safer Health System. Washington, D. C. : National Academy Press, 2000. 11. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press, 2001. 12. Lim MK. Quest for quality care and patient safety: the case of Singapore. Qual Saf Health Care 2004;13:71-5. 13. Hjertqvist J. Competing hospitals and providers work miracles confirmed by Swedish experience. Policy Frontiers, September 13, 2004:12. August 2005, Vol. 34 No. 7 Don’t waste time! Our writers will create an original "Public Private Partnership in Healthcare" essay for you Create order

Transformational Leadership Theory By James Mcgregor Burns

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From its infancy, the study of history has been the study of leaders- what they did and why they did it.† (Bass,1990) â€Å"..the transformational leader articulates the vision in a clear and appealing manner, explains how to attain the vision, acts confidently and optimistically, expresses confidence in the followers, emphasizes values

Winter Weather Terminologies

The terms winter storms and snowstorms may mean roughly the same thing, but mention a word like blizzard, and it conveys so much more than just a storm with snow. Heres a look at the flurry of winter weather terms you may hear in your forecast, and what each means.   Blizzards Blizzards are dangerous winter storms whose blowing snow and high winds lead to low visibility and white out conditions. While heavy snowfall often occurs with blizzards it isnt needed. In fact, if strong winds pick up snow thats already fallen this would be considered as a blizzard (a ground blizzard to be exact.) In order to be considered a blizzard, a snowstorm must have: heavy snow OR blowing snow, winds of 35 mph or more, and a visibility of 1/4 mile or less, all lasting for at least 3 hours. Ice Storms Another type of dangerous winter storm is the ice storm. Because the weight of ice (freezing rain and sleet) can down trees and power lines, it doesnt take much of it to paralyze a city. Accumulations of just 0.25 inches to 0.5 inches are considered to be significant, with accumulations over 0.5 inches considered as crippling. (Just 0.5 inches of ice on power lines can add up to 500 pounds of extra weight!) Ice storms are also extremely dangerous to motorists and pedestrians. Bridges and overpasses are especially dangerous when traveling since they freeze before other surfaces. Lake Effect Snow Lake effect snow occurs when cold, dry air moves across a large warm body of water (such as one of the Great Lakes) and picks up moisture and heat. Lake effect snow is known for producing heavy bursts of snow showers known as snow squalls, which drop several inches of snowfall per hour. Noreasters Named for their winds which blow from the northeast, noreasters are low pressure systems that bring heavy rain and snow to the East Coast of North America. Although a true noreaster can occur any time of the year, theyre most fierce in the winter and spring and can often be so strong that they trigger blizzards and thundersnow. How hard is it snowing? Like rainfall, there are a number of terms used to describe snowfall depending on how fast or intensely it is falling. These include: Snow Flurries: Flurries are defined as light snow falling for a short duration. They can also be tiny snowflakes falling for longer periods of time. The most accumulation that can be expected is a light dusting of snow.Snow Showers: When snow is falling at varying intensities for brief periods of time, we call it snow showers. Some accumulation is possible, but not guaranteed.Snow Squalls: Often, brief but intense snow showers will be accompanied by strong, gusty winds. These are referred to as snow squalls. Accumulation may be significant.Blowing Snow: Blowing snow is another winter hazard. High wind speeds can blow falling snow into almost horizontal bands. In addition, lighter snows on the ground may be picked up and redistributed by the wind causing reduced visibility, white out conditions, and snow drifts. Edited by Tiffany Means

Aztec Advancement to Herbal Medicine - 557 Words

The Aztecs made great advances in many areas. One of their accomplishments was herbal medicine. Aztec medicine was based on two areas which are spiritual healing and herbal healing. Many of the illnesses that affected the Aztecs were caused to religious reasons: an angry god, bad birth signs, or something to that effect. The first step of treating an illness was a prayer and/or sometimes animal sacrifices. After that, herbal medicine would be used. Today, many herbal medicines can be found in Central America. The Aztecs knew how herbal medicines would work. They concentrated on finding out what herbal medicine could do. The Aztecs also concentrated on curing the symptoms of an illness than finding the cause of the illness. They believed that if a god gave a person an illness, they cannot anything to cure that patient. According to Aztec legends, Well, if the gods want this man to suffer, they can make my herbs powerless. If the medicine works, it means that the gods wish for the pat ient to be relieved. This statement was used to make herbal medicine useful. The Aztecs used leeches to help patients to ease their pain. The Aztecs developed a writing system in which they used pictographs. Pictographs were simple pictures that were used as a form of writing. With pictographs, they wrote many codices. The codices were a book or manuscript (written documents). The codices talked about ceremonies, the ritual calendar, and information about the gods and the universe. TheseShow MoreRelatedNative Americans and Their Contributions to the Advancement of Health and Medicine934 Words   |  4 PagesNative Americans and Their Contributions to the Advancement of Health and Medicine Stories of Native Americans contributions to the advancement of health and medicine traces were discovered in a small town in Nali, Africa. The very first onset of the beggining of modern pharmacology is the substance called quinine. This is the substance that came from a bark of a tree that grew in high elevations. The Indians has been using this substance to cure malaria, cramps, chills, hear-rythm disordersRead MoreA Short Note On 25 / 2016 Mesoamerican Medicine1590 Words   |  7 PagesMesoamerican Medicine As the institutes across the world progress in the fields of medicine, they still advance in the same manner as the ancient civilizations of Mesoamerica. The outlook on medicine was made more scientifically relevant throughout each of the Mesoamerican civilizations, Mayan, Incan, and Aztec. Each tribe had a different view when it came to the topic of medicine, but for the most part they utilized herbal ingredients and other natural remedies. Today, when we think of medicine we picture

Hedonism Free Essays

HEDONISM There is no doubt that pleasure is good. Whether the pleasure is emotional or physical; whether we get this pleasure through taste, touch, sight, scent, or hearing ;it makes no difference. Pleasure is always enjoyable. We will write a custom essay sample on Hedonism or any similar topic only for you Order Now In fact the words pleasure and good are often times interchangeable. After seeing a movie I liked, I may tell someone that the film was pleasurable or that it was good. Both descriptions have a positive connotation. But while pleasure is undoubtedly good, it is not the highest good and certainly not the only good, as the Hedonist would say. First, we must look at examples throughout the world which will prove that pleasure is not the highest good. One example would be a sadistic child molester who gets pleasure out of raping young children. According to the Hedonist this sickening act would be good because the molester is getting pleasure out of it. Of course they would argue that this is not the pleasure they speak of because it will turn out to be bad for the molester in the long run. He will be sent to jail and be ostracized from society, causing him much more pain than pleasure. Therefore this would not be an example of Hedonistic pleasure. But the Hedonist is making a very dangerous assumption: the molester will always get caught and always be punished. Unfortunately, this is not always the case. Many people get away with their crimes everyday without feeling the wrath of justice. So if a molester gets pleasure out of little children, is it good? If a Hedonist were to answer yes, then it does not seem like a sound philosophical viewpoint. For another example, we can turn to the Holocaust. Over six million Jews and countless others were killed at the hands of the Nazis. While many of the Nazis were disgusted by the killings (Oscar Schindler was one) an even greater amount got pleasure out of it. They thought that they were doing the world a good by ridding it of the inferior human elements. It was this idea that led to millions of brutal deaths. Yet very few Nazis were ever prosecuted. Many fled to other countries and continued their lives without ever taking responsibility for the heinous crimes they committed. In fact, many still felt inwardly proud of the duty they had done for the Aryan race. So according to the Hedonist the Nazis were doing nothing wrong as long as they were getting pleasure. Once again this is a hard concept to accept as true. A Hedonist will say to look closely at our society and lives and we will see that we live according to pleasure. Everyone wants to be happy and happiness is directly correlated with pleasure. But, in fact, our society is not run on the basis that pleasure is the highest good. If it were, our whole justice system would fail. In court, a murderers defense would be I got pleasure out of the killings. As a Hedonist, the judge would then have to set the criminal free. Our constitution is founded on the idea that every person has the right to life, liberty, and the pursuit of happiness, but not pleasure. Our founding fathers knew that if our society was based solely on pleasure then people would be doing whatever they wanted to do whenever they wanted to do it. A Hedonistic society would be chaotic and anarchic; it simply would not work. How to cite Hedonism, Papers

Hedonism Free Essays

HEDONISM There is no doubt that pleasure is good. Whether the pleasure is emotional or physical; whether we get this pleasure through taste, touch, sight, scent, or hearing ;it makes no difference. Pleasure is always enjoyable. We will write a custom essay sample on Hedonism or any similar topic only for you Order Now In fact the words pleasure and good are often times interchangeable. After seeing a movie I liked, I may tell someone that the film was pleasurable or that it was good. Both descriptions have a positive connotation. But while pleasure is undoubtedly good, it is not the highest good and certainly not the only good, as the Hedonist would say. First, we must look at examples throughout the world which will prove that pleasure is not the highest good. One example would be a sadistic child molester who gets pleasure out of raping young children. According to the Hedonist this sickening act would be good because the molester is getting pleasure out of it. Of course they would argue that this is not the pleasure they speak of because it will turn out to be bad for the molester in the long run. He will be sent to jail and be ostracized from society, causing him much more pain than pleasure. Therefore this would not be an example of Hedonistic pleasure. But the Hedonist is making a very dangerous assumption: the molester will always get caught and always be punished. Unfortunately, this is not always the case. Many people get away with their crimes everyday without feeling the wrath of justice. So if a molester gets pleasure out of little children, is it good? If a Hedonist were to answer yes, then it does not seem like a sound philosophical viewpoint. For another example, we can turn to the Holocaust. Over six million Jews and countless others were killed at the hands of the Nazis. While many of the Nazis were disgusted by the killings (Oscar Schindler was one) an even greater amount got pleasure out of it. They thought that they were doing the world a good by ridding it of the inferior human elements. It was this idea that led to millions of brutal deaths. Yet very few Nazis were ever prosecuted. Many fled to other countries and continued their lives without ever taking responsibility for the heinous crimes they committed. In fact, many still felt inwardly proud of the duty they had done for the Aryan race. So according to the Hedonist the Nazis were doing nothing wrong as long as they were getting pleasure. Once again this is a hard concept to accept as true. A Hedonist will say to look closely at our society and lives and we will see that we live according to pleasure. Everyone wants to be happy and happiness is directly correlated with pleasure. But, in fact, our society is not run on the basis that pleasure is the highest good. If it were, our whole justice system would fail. In court, a murderers defense would be I got pleasure out of the killings. As a Hedonist, the judge would then have to set the criminal free. Our constitution is founded on the idea that every person has the right to life, liberty, and the pursuit of happiness, but not pleasure. Our founding fathers knew that if our society was based solely on pleasure then people would be doing whatever they wanted to do whenever they wanted to do it. A Hedonistic society would be chaotic and anarchic; it simply would not work. How to cite Hedonism, Papers

Report Gives a Detailed Explanation of Management Accounting

Question: This Report Gives a Detailed Explanation of Management Accounting? Answer: Introduction Product costing is a methodology which associates itself with managerial accounting. This type of accounting is designed to help management in operations and not measure corporate performance. Thou, like any other cost accounting, product costing help in contributing to the overall results. It is used for determining the cost of production of an unit by studying all the resources used for its creation. Product costing helps us to identify cost components which can be handled in a specific order to take out cost from the product by redesigning, reengineering, purchasing, retooling, packing and other different interventions by the management. It is a traditional method of costing so it has certain inadequacies. Activity Based Costing (ABC) is a method of costing which identifies the activities in an organization and then allocates the cost of each of those activities with resources to all the products and services according to the actual compensation. With the help of ABC, a company estimates the cost elements of its products, activities and services. ABC not only identifies but also eliminates certain products and services which are not profitable and lowers the price of the products that are overpriced. It also identifies and eliminates products and services which are not effective and allocates processing concepts that leads the same product at a better yield. In our report, we will learn about product costing and ABC individually, and then compare both of them by applying them to the case of Frank Burgesss, New Age caravans and seeing which turns out to be a better option. Body Product costing evolved in the latter half of the 20th century, during the environment of mass production as more managerial attention was given on making the best use of production function. To derive corporate profitability, it is necessary to keep a track on raw materials, energy inputs, labor, and tooling and add them to derive production costs. Pricing of different products helped in finer variations and the costs of these products would be useful as a basis for differential pricing. It has certain limitations as it a traditional way of costing. Measurement Problems In product costing a lot of importance is made on representing all costs, including those that do not come to mind immediately, this is why ABC is more popular and useful. Measurement is rather easy even if it is complicated in the production process. For example, problem arises in appropriating the capital costs of the equipments to individual products that go through it and this also includes costs of suppose liquids and lubricants which are used in machines to make them function better. Other complexities for product costing are measuring the costs of developing good relations with supplier and also warranty service, which does not come to mind immediately but long after the sale is made. The main problem with product costing is that overheads can be under or over applied. We will see the causes and reasons for it, citing proper examples and see methods of how reconciliation can be done for the same. Under or over application of overheads The overhead rate is predetermined before the start of the period and is based on an approximate data; the overhead cost that is applied to work-in-progress can vary from the overhead cost that was actually sustained during the period. This difference between the preliminary estimates of overhead cost to work-in-progress and the actual overhead cost of the period is called under or over application of overhead. Example- If we look at Frank Burgesss, New Age Company we see that overhead rate was based on 60000 direct labor hours to be worked for the year and $1800000 in overhead costs. This comes to 1800000/12=150000 a month. But for the month of April, 5200 labor hours were recorded and the employees were paid $35 an hour, which sums up to 182000. So according to the problem the labor hours were under applied. Methods of reconciling over and under applied overhead cost In case there is over or under application of overheads, then it can be dealt in two ways: By allocating the difference between work-in-progress accounts, finished goods account and the cost of goods sold account. By shifting the difference completely to the cost of goods sold account. Cost Sheet for the month of April PARTICULARS $ Amt. ($) Opening Stock of Raw Materials 12,000 (+) Purchases of Raw Materials 160,000 (-) Closing stock of Raw Materials 12,000 Direct Materials Consumed 160,000 Direct Labour 182,000 Prime Cost 342,000 Add: Factory Overhead Expenses Depreciation on: Factory Building 8,000 Factory Equipment 16,000 Indirect Labour Cost 118,000 Insurance - Factory 14,000 Repairs Maintenance - Factory 8,000 Land Tax - Factory 4,500 (+) Opening stock of WIP 4,500 (-) Closing stock of WIP 33,500 -29,000 Works Cost 481,500 Add: Office Administrative Overhead Expenses Administrative Salaries 24,000 General Liability Insurance 2,400 26,400 Cost of Production 507,900 (+) Opening stock of Finished Goods 11,000 (-) Closing stock of Finished Goods 16,000 -5,000 Cost of Goods Sold 502,900 Add: Selling and Distribution Overhead Expenses Advertising Expense 12,000 Sales salaries 90,000 Travel and entertainment (sales) expenses 14,100 116,100 Cost of Sales 619,000 Above we have prepared the cost sheet for Frank for the month of April. We start by adding purchase of raw materials to the opening stock of raw materials and deducting closing stock of raw materials. We then add direct labor to get the Prime Cost as $342000. We then apportion all the expenses of the factory. After adding the opening stock of work-in-progress and subtracting the closing stock we get Works cost as $481500. We then come to the office and administration and after allotting all the costs we get cost of production as $507900. Then we add and deduct the stock of finished goods and get cost of goods sold as $502900. Then we apportion the expenses of selling and distribution and get the cost of sales as $619000. In the raw materials ledger we have balance brought forward of $12000. In the credit side we have accounts payable of $160000. In the debit side we have the prime cost consumption of $160000 and $12000 is carried forward to the next month Finished Goods Account To Balance B/f 11000 By COGS A/c 502900 To WIP a/c 481,500 (Consumption) To Ofc Admin Exp. A/c 26400 By Balance c/d 16000 518900 518900 In the finished goods account we have a carried forward balance of $11000. In the debit side we add the work-in-progress amount of $481500 along with expenses of the office and administration which is $26400. In the credit side we have the consumption of $502900 and a balance of $16000 is carried forward. WIP Account To Opening WIP 4,500 By Finished Goods A/c 481,500 To Prime Cost a/c 342,000 (Cost of Production- Balancing Figure) To Manufacturing O/hs 168,500 By Closing WIP 33,500 515,000 515,000 In the debit side of the work-in-progress account we have the opening stock of WIP, we then add prime cost of $342000 and manufacturing overheads of $168500. In the credit side after subtracting the closing WIP we get the balance figure of $481500 which is the cost of production which will be transferred to the finished goods account. Cost of Sales Account To Finished Goods A/c 502900 By Sales A/c 619000 To Selling Distn Exp A/c 116,100 619000 619000 In the cost of sales account we have finished goods of $502900 and then we add selling and distribution overhead of $116100. In the credit side we have sales of $619000. Account Payables A/c To Bank A/c 180000 By Balance B/f 12000 (Payments made) By Raw Materials A/c 160000 (Purchases for April - Balance) By Balance c/d 8000 (Advance paid) 180000 180000 Debit side of the account payable account has payments made of $180000 and in the credit side we have advance payments of $8000 and the balance brought forward of $12000. The remaining balance of $160000 is the purchase of raw materials for the month of April Manufacturing Overheads Account To Actual Overheads 168500 (Refer Cost Sheet) By WIP A/c 168500 168500 168500 In the debit side of the manufacturing overheads account we have the actual overheads of $168500 and in the credit side we have WIP of $1685 Activity Based Costing (ABC) Activity Based Costing (ABC) is the methodology for the accurate distribution of overhead to the items that use it. It gives us a targeted reduction of overhead. We will see the process flow of ABC. Process Flow of Activity Based Costing (ABC) Identify Costs: Identifying the costs that we want to allocate is the first step of ABC. This is one of the most important step of ABC, as we would not want to waste time on broad project scope. Load Secondary Cost Pools: the second step for ABC is creating cost pools which will provide services to other parts of the company, and not costs which directly support a companys products and services. Administrative salary and computer services are certain examples. These costs should be later allocated to cost pools which are directly related to it. Depending on the nature of costs and their allocation there might be many secondary cost pools. Load Primary Cost Pools: Creating cost pools which are related directly with the production of goods and services is the basic requirement for creating primary cost pool. A separate cost pool for separate product lines is very common. Research and development, advertising, procurement and distribution are such costs. Cost pools can also be created at the batch level, so assignment of costs can be done based on batch size. Measuring Activity Drivers: Collection of information about activity drivers which are used to distribute costs in secondary cost pools to primary cost pools, and also allocating costs in primary cost pools to cost objects. As it is expensive to collect activity drive information, so we use activity drivers. Allocating Costs in Secondary Pools to Primary Pools: We can use activity drivers apportioning the costs in the secondary cost pools to primary cost pools. Charge Costs to Cost Objects: Using an activity driver we can distribute the contents of each primary cost pool to cost objects. It is mandatory to have a different activity driven for each cost pool. In order to allocate costs, we should divide the total cost in each cost pool by the total amount of activities in the activity driver; this will give us the cost per unit o the activity. Then using the activity driver, we allocate the cost per unit to the cost objects. Formulate Reports: For management consumption we can convert the results of the ABC system. The management will get a full cost view of the results generated by each region. Acting on the Information: Reducing the number of activity drivers used by individual cost object is the most common management practice of ABC. This will reduce the overhead cost. We will now see the benefits and limitations of Activity Based Costing (ABC). Uses of ABC Activity Costs: ABC is designed to trace the cost of activity, to see if it is in line with industry standards. ABC is also an excellent feedback tool for cost reduction, as it measures the outgoing cost. Customer Profitability: Product costs as we know are the costs incurred for individual customers, but along with that there is an overhead component also, like product return handling, high customer service levels, and cooperative marketing. ABC system will be able to manage these additional overhead costs and state the customer which is earning the company a reasonable profit. This will lead the company to turn away unprofitable customers, and focus on customers giving the company the largest share of profit. Distribution Cost: A company uses different distribution channels to sell its products in the market, like retail, internet and distributors. The cost of maintaining a distribution channel is overhead, so the company can determine which distribution channel is using overhead, it can then drop unprofitable channels and change how distribution channels are used. Make or Buy: ABC gives the company an inside of each and every cost associated with the manufacturing of the product, so it can determine which costs can be eliminated if an item is outsourced, and also costs which wont be outsourced. Margins: If the company properly allocates overhead using the ABC system, it can decide on the margin of various products, line of products and entire subsidies. This will be useful to determine where to position the resources of the company for earning largest margins. Minimum Price: Product pricing is based on the price which is common in the market, so the marketing manager should have an idea of what the cost of the product is, so that the company doesnt lose money on every sale or every alternate sale. ABC is useful for determining which overhead costs needs to be included in its minimum cost; this will depend upon the conditions in which the product is being sold. Production Facility Cost: It is quite easy to separate overhead cost at plant-wide level, so it gives the company to compare the cost of the product between its different facilities. Limitations of ABC Cost Pool Volume: ABC system provides high quality information but only after using large number of cost pools. The more the cost pools, more the cost of managing the system. Installation Time: ABC is difficult to install, every year installations has to be maintained if a company attempts to install it in all its product lines and facilities. For such installations, it becomes hard to maintain a high level of management and budgetary support during the months when the installation is being done. Multi Department Data Sources: An ABC system sometimes requires data input from multiple departments. The more the number of departments involved in this system, the more the risk that the inputs might fail. Reporting of Unused Time: If the company asks it employees to report the division of time on various activities, the employees have a tendency to report the time on unused activities as 0%. Thou there will be a large amount of unused time in anyones work for the day as it involve breaks, meetings among employees and with other people and also playing games on the phone, etc. Employees hide activities like this by apportioning time to other activities. These false or inflated numbers gives rise to misallocation of costs in the ABC system, sometimes by great amount. Separate Data Set: An ABC system cannot be made up from the information from a single general ledger. It requires various different databases and gets information from separate sources. It is quite hard to maintain this extra database, as it requires extra bit of staff time and also needs a separate budget. Conclusion After the discussion of the broad range of issues we come to a conclusion that a single product company with stable stock levels, both traditional and ABC methods will yield the same results, but for a multi-product company the allocation of costs can make a huge difference on the profitability of the product or service. The methods popularity is inverse to the data processing cost. ABC follows a difficult path in some organizations, and we can see its usefulness declining over time. It is important to construct a highly targeted ABC system, which will be reasonably cheap and will produce critical information. Installing a large and comprehensive ABC system, will be expensive, will be more resistant, and will be more likely to fail. Usually ABC would work best in an environment where we huge number of machines and products and the processes are not easy to sort out. In our report Frank Burgesss, New Age Caravans sells rugged but luxury range of caravans. It comes in two styles and does not have a huge product diversification. He should adopt the ABC system of costing as its benefits are much more than its limitations. Proper implementation of ABC will benefit him in the long run thou initially Frank has to invest money for this costing method References wikipedia.org. (2017).Activity-based costing. [online] Available at: https://en.wikipedia.org/wiki/Activity-based_costing [Accessed 6 May 2017]. The Economist. (2017).Activity-based costing. [online] Available at: https://www.economist.com/node/13933812 [Accessed 6 May 2017]. com. (2017).Activity Based Costing - Accounting Tools. [online] Available at: https://www.accountingtools.com/activity-based-costing [Accessed 6 May 2017]. and Schmidt, M. (2017).Activity Based Costing: ABC Examples explained calculated. [online] Business Case Web Site. Available at: https://www.business-case-analysis.com/activity-based-costing.html [Accessed 6 May 2017]. Accounting For Management. (2017).Over or under-applied manufacturing overhead - explanation, journal entries and example | Accounting For Management. [online] Available at: https://www.accountingformanagement.org/over-or-under-applied-manufacturing-overhead/ [Accessed 6 May 2017]. chron.com. (2017).Difference between over applied under applied Overhead. [online] Available at: https://smallbusiness.chron.com/difference-between-overapplied-underapplied-overhead-65541.html [Accessed 6 May 2017]. com. (2017).Applied overhead Accounting In Focus. [online] Available at: https://accountinginfocus.com/tag/applied-overhead/ [Accessed 6 May 2017]. Raffish, N. (1991).How much does that product really cost? Finding Out May Be As Easy As ABC. Management Accounting. 1st ed. LXXII (9). Collins, F. (2000). ActivityBased Costing: Losing the Promise. Journal of Corporate Accounting Finance, 11(3), pp.15-18. Hsien, W. and Kuang, X. (2013). Implementing and Lunching Activity Based Costing. International Journal of Mathematics and Computer Sciences (IJMCS). International Researchers Group. 17(0). pp 13-22. Brimsom, J. A. (1997)Activity Accounting: An Activity-Based Costing Approach.New York: Wiley. Cokins, G. (1998). ABC Can Spell a Simpler, Coherent View of Costs.Computing Canada, 24(32), pp. 3435. Cokins, G. (1998). Why Is Traditional Accounting Failing Managers?.Hospital Material Management Quarterly, 20(2), pp.7280. Daly, J. L. (2001).Pricing for Profitability: Activity-Based Pricing for Competitive Advantage.New York: Wiley. Dolan, P. and Schreiber, K. I. (1997). Getting Started With ABC.Supply House Times. 40(4), 4152. Garrison, R. H. and Eric W. Noreen.(1999). Managerial Accounting.9th ed. Boston:IrwinMcGraw-Hill.

Concerts Essay Example For Students

Concerts Essay The Concerts of 2000What would you do if you had the chance to go see your favorite bands perform? I had gotten the chance to see my favorites in the year 2000. My friends and I had so much fun at the six concerts that we went to together. We learned what not to do at concerts, like crowd surfing and mosh pitting. This was one hell of a summer that I will never forget. The first concert of this year was KISS: The Farewell Tour. This was one of the most electrifying shows that I had ever seen. They always did something different. Each band member had a little bit of being solo and in the spotlight for a while. Gene Simmons, a guitarist, was flying up into the rafters onto another stage and blood was running out of his mouth. They were all spectacular in their own ways. The second concert of the year was the one and only, The Who. Roger Daltrey, the lead singer, still had his curly hair from way back in the sixties when he sang My Generation. This concert wasnt too bad. They still have it. The next concert that we went to was the Up In Smoke tour featuring Dr. Dre and Snoop Dogg. We could smell weed throughout the whole concert. There were rappers there like Ice Cube, Warren G, Eminem, and Mack 10 besides Dr. Dre and Snoop Dogg. I think I had gotten a contact high from all of the weed smoke in there. It was such an awesome concert. Ozzfest 2000, the biggest and best concert of my life, would be the fourth concert that took place at Pine Knob.There were eighteen bands and two stages from 10 a.m. to 11 p.m. Most of the bands on the second stage were all making their concert debuts. Disturbed, a hard rock band, and Kittie, an all girl band, blew away most of the second stage bands. The mosh pitting and the crowd surfing were unbelievable. I almost got trampled from everybody pushing me in the mosh pit. On the first stage were some widely known bands and some new bands returning from last year. Ozzy Osbourne was the main attraction of the whole concert. He is one of my favorite singers. Before he came out, he made some parodies of American Pie, the Whaaaaassssuuuuppp commercial, The Sixth Sense, and a Brittany Spears video. That was so hilarious. Nothing will ever compare to this awesome concert. The greatest concert of my life, number five, is a hip-hop group consisting of nine rappers called Wu-Tang Clan. We went to go see them in the ghettos of Detroit at the State Theatre. I knew just about every song they sang. I was about five or six feet away from the stage. It felt like the best feeling in the world, except for the mosh pitting. I thought that we were going to get shot while we were there. The last and final concert of the year 2000 was Pearl Jam that took place at the Palace of Auburn Hills. It was so cool to be there with a band that will be remembered forever in my mind. We sat behind the stage, which was different for me. I had always sat in front of the stage because other bands would have it blocked off. I was kind of disappointed because they didnt play some of my favorite songs, but it was still one hell of a concert. Before Pearl Jam played their last song, Eddie Vedder, the lead singer, wanted the lights turned on to see who the true fans were. Some people were leaving to try to beat the traffic before the concert ended. Then they started the song and I could hear everyone singing along. I surely wouldnt have traded my ticket for anything. It was worth the money. This past summer I have had fun going to concerts and seeing my favorite bands perform. I have seen a lot of different cultures and styles of music. I will never forget being in the ghetto, the wild mosh pits, and the crazy things that went on at the concerts. So if your favorite bands come to town, dont hesitate to go or you might regret it later.