Inserting Foley Catheters and Infection risks involved with them Essay

Inserting Foley Catheters and Infection risks involved with them - Essay Example These considerations are based on evidence based practice (EBP) and associated with reduction of CAUTI risks and incidences in short term indwelling catheter patients. They include; educating staff on catheter management and monitoring of CAUTI incidences on regular basis, programs for prompt removal of catheters, cleansing of urethral meatus using perineal cleansers and maintenance of closed drainage system for urine. Introduction Self actualization is an important aspect of Maslow’s need theory which forms a central part of humanistic philosophy. This theory delineates self actualization which is the driving force behind reaching full potential and tantamount to self fulfillment. When basic and essential needs have been met, an individual moves to become self-actualized through doing what they are supposed to do. In the nursing context, this theory comes to life when nurses initiate the process of patient caring by using curative factors. By exploring self belief and utiliza tion of caring processes, nurses usually achieve self actualization for themselves as well as their clients. In Foley catheter insertion, Maslow’s theory is important in that it allows the application of nurses’ education to cater for the medical needs of their patients. ... Feedback by staff with regards to CAUTI prevention is very important coupled with principles of catheter care (Tenke, Kovacs, Johansen, et al., 2008; Trautner, 2010). Catheter Insertion and Removal There is mixed evidence that prompt programs for the insertion and removal of catheters can lead to reduction of CAUTI. However, a successful program needs to have different elements such as having a multidisciplinary team (nursing and medication). A team to control infection is important for catheter removal after 3-4 days. Besides these two, staffs also need to be educated about feedback of results and prompt removal of catheters (Trautner, 2010). Sterile Insertion of Catheter Evidence suggests that aseptic techniques such as use of sterile gloves, perineal washing and no touch techniques of insertion may very little influence on CAUTI and bacteriuria during or after indwelling catheter insertion. The use of aseptic techniques is often recommended as category II (Tenke, Kovacs, Johansen, et al., 2008; Willson, Wilde, Webb, et al., 2009). Routine Urethral Meatus Care EBP suggests that undertaking of meatal care by use of ointments or antiseptic cleansers should be part of genital and perineal care. Other studies have come with a contrasting opinion that shows the use of antiseptic agents may increase colonization of the meatal by bacteriuria which may increase CAUTI risk (Tenke, Kovacs, Johansen, et al., 2008; Trautner, 2010). Catheter Securement Apparatus Securement devices have little or no influence on development of CAUTI risks. However, further studies and research are needed on ability of securement apparatus to minimize CAUTI risks and urethral trauma (Tenke, Kovacs, Johansen, et al., 2008). Closed

Socrates and plato Essay Example | Topics and Well Written Essays - 250 words

Socrates and plato - Essay Example From this case, he followed common sense on the issues in order to rid his findings of any influence from preconceived ideas (Sanctasapientia). Plato, with Socrates as his teacher in philosophy, applied knowledge learnt from Socrates to come up with his own theories. This is through skills learnt from him, such as Socratic thinking that lacked prior conceptions, which are likely to influence findings. Socrates applies dialectic questioning to real life issues, which Plato later uses to his own advantage and creation of knowledge. The above is as seen in the case of the definition of philosophy as â€Å"love of wisdom†, as put by Socrates. On the other hand, Plato, following example of his teacher, defines philosophy by adding more terms and a broader scope based on the dynamism of knowledge and wisdom. This was done by adding a touch of metaphysics and epistemology to make it appear that no knowledge can be fully known, but can only be experienced in part (Plato and Socrates). Therefore, the relationship between Socrates and Plato is quite strong based on the formers influence on the latter. This is concerning the overt, direct impact on their teachings in philosophy and ways of creating

Group Excluded from International Human Rights

Group Excluded from International Human Rights Human Rights Human rights, as explained by the great English philosopher and thinker John Locke, are natural and unalienable rights (life, liberty, and property) inherent to all human beings, whatever our nationality, sex, color, religion or language. All men are created equal, everyone is entitled to the human rights without any discrimination. Most human rights are guaranteed by the Constitution, state laws, and international treaties. International human rights law promotes and protects human rights by laying certain pressure upon governments. But even though there are many laws created to protect everyones human rights, certain people are being excluded from their rights by different levels of government, such as the poor homeless whose liberty is limited by the state government, Zapatistas whose life and property is taken by the Mexican National Government, and French Muslims whose freedom of religion is violated by the French National Government. Los Angeles is once a beautiful and luxurious heaven. But now Los Angeles state government is fighting war, a war with its own citizens living inside the state. Fortress Los Angeles: The Militarization of Urban Space (Davis, 1), this is the title Davis gave to his research paper, but it is also his feeling toward the state of Los Angeles. Everywhere in the city is the frontline of war. Stop building toilets, special designed bus benches, fancy garbage to protect fishheads and stale French fires, and outdoor sprinklers, those are all policy decision made by the government to fight the citys war on the poor homeless. They tried their best to eliminate or remove homeless from the city by violating the human rights that homeless should be entitled to. But while the government is violating the human rights, they claim that they are promoting human rights by protecting people from danger, but they exclude homeless from the definition of word people. Collective human rights, those are what government is claiming about. They always try to protect majoritys rights by excluding certain peoples human rights. Rights and Human Rights, huge differences, but government never recognizes it, they just called them human rights regardless of the differences. They make the policy that will discriminate and deny the liberty of homeless to protect majority from possible danger. The government should not define homeless as dangerous just because some homeless people are dangerous and harmful. For public-housing tenants and inhabitants of narcotic-enforcement zones, the loss of freedom is the price of security (Davis, 6) As stated by the author Mike Davis, one of the three primary human rights, liberty is taken by the government from the homeless to ensure other peoples safety from possible danger, this should not be called collective human rights, but the power of government to protect people who make profit for the government. Similarly, people, especially children, in Central and S outh America are excluded from the protection of human rights imposed by the law. Their organs will be taken without their permission and sold to other rich countries, leave them with a horrible body for the rest of their life. The organ-stealing stories were told, remembered, and circulated because they were true at that indeterminate level between the real, the surreal and the uncanny (Scheper-Hughes, 36) Even though organ stealing is so wide spread and known by everyone, Government never tried to stop it, or maybe it is even promoting it to make profit. So it is clear that poor homeless is excluded totally from the protection of government for their human rights, even if the constitution, and international laws expressly guarantee everyone will be treated equally by the government. Only liberty is taken by the state government from homeless, but in some area even life and property is taken by the national government. On New Years Day, 1994, Zapatista rebels in Chiapas, Mexico, confronted the Mexican government with demands for basic human rights (Messer, 319). That is the start of the revolution inside the border of Mexico and the reason why Zapatistas fight against the Mexican government. People in Chiapas were discriminated against, their only property, land is also taken by the government. With nothing to lose, they started revolution, and created a border within the Mexican border. In the video, a place called Chiapas, the life of Chiapas people was presented. They were poor before revolution, but with the land they own, they can still live. But the Mexican government took the land from them to develop modern cities which cause Chiapas people to be abused by riches. Again, it is the problem of collective human rights conflicting with individual human rights. This time national government claims that they are protecting the benefit and rights of people inside Chiapas while taking away everythi ng they own and force people there to become terrorists. Maybe war is not a right choice, but it is Chiapas peoples only choice. Without revolution, they are all going to die due to the poor condition there. Collective Human Rights, as claimed by the national government, is just a joke. Without individual human rights, no collective human rights can be achieved. Without those lands, all Chiapas people are going to hunger to die, then what would be the use of collective human rights toward the dead people? Life, liberty and property, only those three primary human rights being protected well, then other things can be done by the government. Similar conditions occur in the process of progress. People and place which are being progressed have lost many. People would lose the right to their every day practice because the land is taken by the government. They are forced to change their diet which causes new diseases to appear in the local places, and reduce the health condition of the lo cal people. Overall, the available data seem to indicate that the dietary changes that are linked to involvement in the world-market economy have tended to lower rather than raise the nutritional levels of the affected tribal peoples (Bodley, 3) Progress is great thing, but with great prices. Freedom of choosing food and life of local people are taken during the process of progress. So individual rights should be considered first, and then collective rights can be done. So again, even though the international treaties lay down the obligation of protecting everyones human rights upon governments, some people are excluded from them because of collective human rights. Similar problem, but different salutation has occurred in France, this time it involves freedom of religion. Muslims in the France is always treated different, not only because of their religion, but also because of their dressing. So French government created laws that banned any Muslims to wear headscarves that have religious meanings. The reasons French government gave for this law is that For many non-Muslim French, they (headscarves) represent multiple dangers to the Republic: the oppression of women, urban violence, international terrorism, and the general refusal of Muslim immigrants to integrate into the broader society (Bowen, 31). So this seems to be a problem about collective human rights and individual human rights, but is it? It is not. A republic can exist with symbols of different religion. Freedom of religion, this should be guaranteed by any kind of republic. So this time there is no collective human rights involving at all. It is purely that French government taking away rights from Muslims without any legitimate reason. Liberty, one of the three primary human rights is vi olated by the French government. Not only that, the law they make actually may create diversity inside the nation since only Muslims are treated differently by the government. So with all those violations, Muslims in French are forced to change their way of life. They stop going to Mosques and practicing their religious activities. While all those rights are being violated, French government is still claiming they are promoting rights of the citizen living inside the republic. France is now outlawing Muslims and treats Muslims not as citizens of France, but a group of people who may cause diversity and terrorism inside France. French Republic is the official name of France, but is it a true republic? Before French government stop outlawing certain group of people inside the nation, France is never a true republic. So again individual human rights should always be the primary thing any government should think about before imposing laws or making decision. But there are always some pl aces where law cannot reach, thus create exclusion or discrimination. Bill of Rights are the first ten amendments of constitution created as the supreme law of the land to protect human rights in U.S. and other countries have similar laws. Above all, international human rights law is created to ensure everyones rights in the whole world. But it only lays down the obligation upon the government, if government will not enforce it, then human rights of people will not be protected. French Muslims, Zapatistas, and urban homeless are the examples of government exclusion. So even though every government claim that everyone will be treated equally and everyones human rights will be protected by the government, some people are not under the protection of government and suffering. Work Cited Bodley, John. The Price of Progress. Victims of Progress 1998, 137-151 Bowen, John. Muslims and Citizens. Boston Review Feb/Mar. 2004: 31-35. Davis, Mike. Fortress Los Angeles: The Militarization of Urban Space. City of Quartz, Fortress LA Messer, Ellen. Anthropologists in a World with and without Human Rights. Exotic No More: Anthropology on the Front Lines. Ed. Jeremy MacClancy. Chicago: The University of Chicago Press, 2002. 319-337 Scheper-Hughes. Nancy. Min(d)ing the Body: On the Trail of Organ-Stealing Rumors. Exotic No More: Anthropology on the Front Lines. Ed. Jeremy MacClancy. Chicago: The University of Chicago Press, 2002. 33-63 A Place Called Chiapas. 2006. online video clip. Google Video. Accessed on 05 December, 2009.

The Arguments For and Against Coastal Protection Schemes :: Papers

The Arguments For and Against Coastal Protection Schemes The sea is constantly eroding the coastline. This destroys property, and people living nearby have reduced value on their houses. Natural beauty spots and walks are lost, reducing tourism in seaside towns. Solutions to this are coastal protection schemes that slow the waves down and delay the process of erosion on the cliffs. The arguments for sea defence schemes are as followsà ¢Ã¢â€š ¬Ã‚ ¦ Sea protection plans help to prevent further loss of economy caused by coastal erosion, for example; reduced property prices in 'at-risk' areas, less tourism due to destruction of tourist spots (which results in less money), and the replacement of important sites e.g.: industrial areas, ports and places of historical and geological interest would be expensive. Coastal protection schemes protect the habitats of plant and wildlife, which cannot be replaced. The arguments against sea defence schemes areà ¢Ã¢â€š ¬Ã‚ ¦ Most sea defence schemes are expensive to build and maintain, and this money is taken from taxpayers. Some people say their money is wasted, because the coastal defences themselves will eventually be eroded away. Coastal defences create visual pollution, and ruin the natural atmosphere of the beach. Also, if they are poorly maintained, they may pose a hazard to swimmers and sunbathers. Methods of protecting the coast are: Sea wall. This is a barrier that reflects the waves and withstands storms, completely protecting the cliff. Although they effectively reduce erosion, they are costly at  £6000 per metre, and spoil the natural view of the coast. Beach Re-building. The sand on a beach inhibits the sea from eroding the coast as much, by absorbing some energy from the waves as they hit the shore and slows them down as they go up the slope to the cliff. This costs  £3 per cubic metre. Groynes are small walls that jut out into the sea to stop the sand (that protects the cliff) being washed away. These cost  £10000 each. But as groynes collect sand to stop it from being carried away, the amount of sand on the other side of the

Las Ferreterias de Mexico

Good management- Most of the Employees value rewards of different nature and they are therefore motivated by positive rewards. Employees are known to put less effort to those activities or tasks that are not well rewarded and hence in order to motivate them in their work, a good scheme for rewarding them is important. These rewards are different in nature and include compensation, awards, off duties and many others. Mr. Gonzalez came up with the idea of implementing compensation plan as a way of improving performance of the employees in the company.His intention was to include managers, buyers and salesmen in this new compensation incentive. However, the consultancy firm found this to be difficult since it was challenging to measure the performance of the salesmen and buyers. The consultancy firm therefore advised Mr. Gonzalez to use the plan for managers of the companies only without including other staffs. The success of any plan or policy depends so much on the involvement of peop le who will be affected by that plan in its development.Employees will always support implementation of a plan they were involved in its development. For instance, considering their views before the development of the scheme will make them to own the plan and therefore support it when it comes to the implementation of the plan. This means that for the success of the new compensation plan, Mr. Gonzalez had to make sure that he involved all the parties who will be affected by the new plan. In the development of the new compensation schemes, Mr.Gonzalez sought the services of the consultancy firm who worked together with the human resource and finance department representatives. The involvement of these two departments was important in order take care of financial and human resource considerations during the plan implementation. However, the plan did not involve other staffs who were to be affected by the plan. This include managers from other departments such as store managers and sal es manager who were the beneficially of the new plan.This could make it difficulty for the company to implement the plan since there may be tradeoffs between the performance of the whole team and that of individual managers (Gerhart et al, 2009). During the development of the plan, it was necessary to take and consider the views of other managers and not just human resource and finance managers. This would have made the plan makers to consider all the issues like bonus pool allocation, performance measures to be used and other important issues that may affect theimplementation of the plan. This would have ensured issues like how the bonus will be allocated among the managers. The plan allocated 70% of the bonus to the store managers and the rest to corporate staffs and regional managers. Though, store managers perform a crucial role in sales, other department managers may not be comfortable with the way the bonus is allocated. The allocation of the bonus could have been agreed by al l departmental managers before the implementation of the new plan.BONUS POOL ALLOCATIONAccording to the new compensation plan, the bonus pool would be allocated among store managers depending on the bonus units they have earned. A 5% earning in ROI would earn a store manager one unit of bonus. Any additional percentage earning in ROI would earn an additional bonus unit. This formula will continue to apply as the percentage in ROI earning increases. The allocation will also put into consideration those store managers who have been in their position for a period less than a year.The allocation of bonus among regional managers would be different where the formula used will consider the bonus unit that has been earned by stores in the managers’ region divided by all total unit bonus that have been earned by all stores in the company. Finally according to the new compensation plan, bonus pool for the corporate staff would be divided by the CEO, depending on the ROI earnings of the corporation in that year. The formula used in the compensation plan is very clear and simple hence understandable by all managers. A good bonus plan should be simple and clear to the parties who are affected by that plan.This would make it simple for those party affected by the plan to implement it. Clarity of the compensation plan means that the plan has little or no ambiguity and uncertainty about the standards that will be used to measure the performance of the beneficiaries. This means that the superiors are not in a position to show any favourism or bias when measuring the performance of their subordinates. In this company, the formula applied is based on the allocation of bonus pool among the store managers according to the unit bonus they have earned relative to the ROI earning.The formula is simple and managers can easily understand it and work hard to increase their ROI earning in order for them to increase their bonus units. Again, the formula is fixed and it may not be p ossible for those people who will be assessing the performance of the managers to show any bias or favouritism. This will ensure the efficiency of the compensation plan. This also applies to the formula used to calculate bonus for regional managers and corporate staffs. A good reward system should produce some impacts to the corporation.The system used should be aimed to improve the performance of the organisation after its implementation. Managers and other staffs ought to be motivated to work hard by the reward system as they strive to earn the promised bonus. Their increased performance will be reflected in the increased performance of the whole company. In addition, a good reward system ought to be timely where employees are rewarded immediately without any delay. This will motivate workers to work even harder in the next period thus improving the performance of the corporation in the long term.THE PRINCIPLLE OF CONTROLLABILITYAccording to the controllability principle, all empl oyees ought to be held accountable only for those variables that are within their control (Giraud et al, 2008). Employees ought not to be penalized when things fail because of bad luck as well as not being rewarded when things succeed because of good luck. Thus managers should be held accountable for the outcomes of the variables they control. At managerial level, many factors that affect the performance of an organisation are only partially controlled. However, managers are usually in a position to make decisions that may make the uncontrollable factors affect result in a positive way.The advantage of this method is that managers can be held accountable for the areas they are intended to influence. This will direct all the effort of the managers to the areas that can improve the performance of the organistion (profit centre). For instance, the compensation plan employed by Mr. Gonzalez will hold managers accountable for their profit centre.The main profit centre of the corporation are the stores thus basing the compensation plan of the managers on performance of this area will ensure that, managers effort are directed to the profit centre. Managers will also be more responsible since they will be accountable for all the factors they are controlling in the stores. However managers should also be rewarded for those factors they do not control and yet affect the outcome of their division outcome.BONUS DECISION ON CORPORATE PROFITThe new compensation plan is based on the ROI earnings at the end of financial year. The allocation of bonus among corporate staffs is based directly on the ROI earning of the corporate while among the managers it is indirectly based on ROI earnings. This means the bonus compensation plan may have impact on the corporate profit as it becomes expenses to the company.Increased ROI does not necessarily translate to increased profit and therefore basing bonus compensation on ROI may reduce the profit of the company due to increased expenses. The payment of all bonuses may be too expensive to the corporation thus reducing the profit of the organisation. However, this does not mean that the increased performance of the managers would not increase the profit of the corporation.QUESTION TWO CHALLENGES OF USING ROI Though the use of ROI to measure the performance of different division has a many advantages, it also has many disadvantages (Rachlin, 1997). Using this method to measure the performance of managers in the corporation may pose a number of challenges to Mr. Gonzales. According to Hoffman and Rogelberg (1998), the method may be referred to as a discretionary system since it does not include all the staffs of the corporation. The plan only covers the managers and does not cover other players in profit generation such as salesmen and buyers.This means that the plan will not motivate all the workers together since it only covers some of them and not all of them. This will be difficult for all the employees to be unite d in order to achieve a common goal of improving performance of the organisation. Increasing ROI earnings can only occurs when all the employees of the organisation combine their effort together to achieve a certain level of ROI earnings. This is not possible when all the staffs are not rewarded fairly for their effort.ROI performance measures show the ratio of the profit in relation to the investment used to generate it. This measure at times may be problematic for instance when it comes to the determination of the investments that were used to generate a given level of profit. It is difficult to measure the amount of fixed asset that was used to generate a given level of profit. Mr. Gonzalez may find it difficult to relate the profit generated in a given store with fixed assets that were used to generate that profit. This because fixed assets will be used in more than one financial year.The use of ROI earnings to measure the performance of managers may lead to sub optimization whe re managers concentrate only on the ROI earnings of their division without necessary working to improve the performance of the whole corporation. Improving the ROI of a certain division is usually a short term goal which may not increase the performance of the organisation in the long term. Managers and other staffs may work very hard only for the purpose of earning the bonuses in the new compensation plan without necessary aiming to improve the performance of the company.The measure of earning on investments may also include those factors that are not controlled by the managers. This may include liabilities and assets that are not controlled by division managers and yet they affect the profit of a given store. Division managers usually control receivables and payments within that division and they should only be accountable for that. Holding division managers accountable for factors they do not control may be unfair to them. Thus Mr. Gonzalez ought to look for a method of measuring performance that will be fairer to all the managers.The use of ROI method may also create unhealthy competition among the store managers. Bonus pool is allocated among store managers according to the percentage of ROI they have earned in their stores. The managers can therefore do anything possible to increase their ROI so that they can increase their bonus. This may involve manipulating their revenue and expenses in order to report high profit figures at the end of financial period. This behaviour will create unnecessary short term pressure among the managers which can be avoided using a different method of measuring the performance of the managers (Eva & Mika, 2010).This may have a negative impact to the long term performance of the company. Each division may also work more independent without co-working with other divisions since different divisions will be operating like rivals which may also not improve the long term performance of the company. It is also difficult to know whe ther the increase in sale in a certain store is as result of the new compensation plan (Sammer, 2006). It may take sometime before Mr. Gonzalez knows whether the implemented plan is successful.This is because there are other factors that are not controlled by the manager that may result in increased ROI earning. The use of the ROI method compare all managers on the same platform without considering differences in areas like their division, their region and many other differences. For instances, managers in different departments carry out different operations that have different expenses and revenues. These differences will also affect their department profitability and thus their earnings in ROI.Different regions also have different rate of sales and although efforts put by manager in that region matters, regional differences will also affect the outcome of those regions. The use of ROI to measure the profitability of the manager does not put into consideration factors like regional differences which will affect the outcome of a certain region. Thus rewarding managers using ROI earnings which do not consider such factors will be unfair to some managers who may come from those regions that are not favourable.

How to Conjugate Réveiller (to Wake up) in French

In French, the verb  rà ©veiller  means to wake up or to awaken. You can remember it by thinking of the reveille of a bugle waking soldiers up in the morning. When you want to say things like I woke up or he is waking, youll need to know how to conjugate the verb. A quick lesson will show you how thats done. The Basic Conjugations of  Rà ©veiller Some French verbs are simpler to conjugate than others and rà ©veiller falls into the easier category. Thats because it is a regular -er verb, meaning it follows the most common conjugation rules found in the language. If youve studied similar words, you should be a little more comfortable memorizing this one. As with all conjugations, we must first identify the verb stem:  reveill-. To this, a variety of infinitive endings are added to create the various conjugations. All you have to do to learn these endings is look for the subject pronoun and the proper tense in the chart. For instance, I am waking up is  je rà ©veille  and we woke up is  nous rà ©veillions. You can make these easier to remember by practicing them every morning when you wake up. Present Future Imperfect je rveille rveillerai rveillais tu rveilles rveilleras rveillais il rveille rveillera rveillait nous rveillons rveillerons rveillions vous rveillez rveillerez rveilliez ils rveillent rveilleront rveillaient The Present Participle of  Rà ©veiller As with most French verbs, an -ant ending is added to the verb stem to create the present participle. For rà ©veiller, that forms the word rà ©veillant. Rà ©veiller  in the Compound Past Tense A  common way to express the past tense in French is the compound known as the  passà © composà ©. To form this, youll need the  auxiliary verb  avoir  as well as the  past participle  rà ©veillà ©. It comes together quickly: I woke up is  jai rà ©veillà ©Ã‚  and we woke up is  nous avons rà ©veillà ©. Notice how  avoir  was conjugated into the present tense according to the subject. Also, the past participle doesnt change, but it does take over the job of indicating that the act has already happened. More Simple Conjugations of  Rà ©veiller At times, you may need a few more simple forms of  rà ©veiller. The subjunctive, for example, implies some uncertainty to the action while the conditional says someone will wake up only if something else happens (the alarm goes off, perhaps). The passà © simple  and  the imperfect subjunctive are used less frequently but are good to know nonetheless. Subjunctive Conditional Pass Simple Imperfect Subjunctive je rveille rveillerais rveillai rveillasse tu rveilles rveillerais rveillas rveillasses il rveille rveillerait rveilla rveillt nous rveillions rveillerions rveillmes rveillassions vous rveilliez rveilleriez rveilltes rveillassiez ils rveillent rveilleraient rveillrent rveillassent The imperative verb mood is very useful with a verb like  rà ©veiller. It allows you to quickly command someone to Wake up! When using it, skip the subject pronoun and simply say, Rà ©veille  ! Imperative (tu) rveille (nous) rveillons (vous) rveillez

Proposed Changes Of Medicaid Expansion On Florida And...

Proposed Changes There have been a few proposed changes to Medicaid Expansion in Florida and other states. These proposed changes have included 1915 and 1115 waivers, including long-term care programs. Florida has an uninsured rate of 20 percent (Rose, 2015). This represents a great need for insurance coverage expansion and cost savings in Florida. Previous proposed changes have been successful in some aspects, but do not answer all of these elements. Many forms of 1915 and 1115 waivers have been proposed and implemented in Florida and other states in the past. According to Holahan, Coughlin, Lipson, Rajan (1995), the section 1115 research and demonstration waivers are designed to allow states to develop new solutions to health and welfare problems. The federal government may waive some standard Medicaid rules if the change is deemed to be budgetary, no higher than it would have been expected without the waiver (Holahan et al., 1995). States using these waivers have proposed to save money by using managed care plans for current Medicaid patients, and limiting the cost of new Medicaid enrollees (Holahan et al., 1995). These proposals often focus on using hospital DSH payments to expand coverage rather than using these sums to make payments to hospitals, using savings from reductions in other programs, or proposing new revenues (Holahan et al., 1995). The goal is to expand coverage at small new costs to the government (Holahan et al., 1995). The key features ofShow MoreRelatedMedicaid Expansion Of The United States1108 Words   |  5 Pagesof the states that have not participated in the Medicaid expansion is Florida. States that are opting out in the Medicaid expansion can leave several citizens uninsured and their health will be at risk. 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