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James Joyces Ulysses Critical …

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autism essay Each time you break through the. Joyces! barrier of silence and speak to edward fleming, me, I know again the first light of a. childhood Christmas Day, And I am blessed. so that you can see into my eyes, I know that somewhere in the vary. essence of you is a child like any other, And I am blessed. Ulysses! your autistic world, I know that you are not like other children and. I know again the darkness of Good Friday, Do people realize how lucky they are? Do we as one species realize how vulnerable we are? Do families who's worries revolve around picking Little Joey up from edward fleming dissertation practice and what they will do for family vacation this summer realize that they have been blessed with a normal family? And do families that have an autistic family member realize that they too, have been blessed? I have worked with autistic adults and children for two and a half years and in this time I have pondered the above questions.

I realize that I grew up in critical a family that didn't know how fortunate we were to the panda thumb, have four happy, healthy children. This realization led me to critical essay joyces ulysses, the topic of this paper: how does having an autistic family member affect a family? In order to understand the effects this disability has on a family it is first mandatory to understand the characteristics of an i want a special education essay individual living with autism. This paper will introduce the history, current theoretical causes and treatments of autism. After doing research to write a concise paper addressing the above topics I realized something was missing; the admiration I feel for the parents of essay james autistic children, the emotions behind working and american prohibition act of living with autistic children and the grief of realizing these children are autistic. So, also included in this paper are personal statements and stories of mothers and critical joyces fathers of autistic children. Thank you to all of them for sharing their stories, for their stories taught me more than any textbook or journal article could have. The word autism stems from the Greek word autos which means self. Edward Dissertation! This term was first applied to schizophrenics by james joyces ulysses, Eugen Bleuler, a Swiss psychiatrist. Prohibition Act Of 1920 Essay! Bleuler used this term to essay joyces, address the characteristic of certain schizophrenics who appeared to have their own style of thinking, autistic thinking. Listhesis! Autistic thinking is the view that the universe revolves around oneself and joyces ulysses that the outside world has no effect on the self (Nevid et al., 1994).

It was not until 1943 that another psychiatrist used the on loss word autism. Dr. Leo Kanner, a professor at Johns Hopkins University at the time, applied the word autism to a group of essay james children who he observed as having behavioral problems, social problems, communication problems and edward dissertation appeared to be self-absorbed (Edelson, 1995.). It is due to the lack of social interaction that Kanner applied the essay joyces term autism (Society For The Autistically Handicapped, 1996.). In the fifty three years that autism has been the term of choice for the developmental disorder consisting of avoiding social contact, stereotyped behaviors and slow, or lack of, development of american act of 1920 a useful language; much has been discovered. Much more needs to be. The diagnosis of autism is a difficult one to make. Critical Essay James Joyces! Autism, although one of the largest disabilities to to be education, affect children, five in every ten thousand births, is not constant. It affects individuals in critical ulysses varying ways and in varying degrees.

This is something I have noticed a great deal. Travel! I work with some autistic children who can have a complete, logical conversation with me. I have also worked with autistic children who don't seem to know I am three inches from their nose. A diagnosis of autism is usually made by the child's third birthday but, there are signs from birth that the child is different. Joyces Ulysses! An autistic child is more likely to why do education teacher essay, resist affection, arching back and not staying still when being held, than is a child without autism. Autistic children are also usually described as being easy babies to critical james joyces ulysses, take care of. It is not until the to be education essay child should be developing language and social skills that parents realize something is different about their child. One-third of autistic children develop normally until age two (Edelson, 1994.). The Diagnostic and Statistical Manual of Mental Disorders , 4th Edition, has changed the diagnosis drastically. The DSM-IV is the first psychologically based text that identifies the varying degrees of autism. Autism is now found on Axis I, the axis that deals with pervasive developmental disorders, instead of Axis II, which covers mental retardation and personality disorders.

For a diagnosis of autism to be made six symptoms from three major areas: social interaction, communication and stereotyped behavior patterns must be present before the age of three. There must be at critical james ulysses least two symptoms associated with social interaction and one in each of the other areas (Edelson,, 1994.). There are a number of other characteristics associated with autism although they need not be present for a autistic diagnosis. Features of autism may also include the following: resistance of spondylo being touched, ignorance of heat and cold, no sensation of pain, fascination with sounds and tastes, giggling or weeping for no apparent reason, absence of emotions or reactions, self-injurious behaviors and self-stimulatory behaviors (Society For The Autistically Handicapped, 1996.). I observe these associated features of autism on a daily basis. Joyces Ulysses! An example of an autistic child's ignorance of heat and spondylo cold occurred recently when we were at the beach. The water at the beach was very cold to the touch of james joyces ulysses my co-workers and yet, a young girl who is diagnosed with autism ran straight into the water with no reaction to the coolness of it. Another example of these associated features is the numerous children I work with who put everything possible into their mouths and then spit it out or throw it away.

Almost all of these children smell the object before placing it into their mouth. Self-stimulatory and self-injurious behaviors are the more prevalent of the associated features of autism and will be discussed in length below. Self-stimulatory behavior is on loss, defined as repetitive body movements or repetitive movement of an critical ulysses object. Self-stimulatory behaviors can be split into the five senses. Spondylo! An individual with a visual self-stimulatory behavior is likely to stare at lights, move fingers in front of james joyces his/her eyes and flap his/her hands. I have observed this behavior in an adult male living with autism. His hand flapping behavior is fleming dissertation, usually preceding a self-injurious behavior or an act of critical essay james injurious behavior towards another person.

The fact that his hand flapping precedes such events makes the point that those working with autistic individuals must realize that behaviors vary, for most autistic individuals hand flapping is purely a self-stimulatory behavior and not one that leads to violence. Auditory behaviors include tapping of the ears, snapping fingers and making vocal noises (Edelson, 1995.). Why Do A Special Teacher Essay! I am unclear as to critical james joyces, why but, the children I work with who are nonverbal are the children more prone to make vocal noises. I have also observed that these noises occur either in a time of excitement or fear. For example, I have three children who have never spoken a word but, each time I take them on the trampoline and jump with them they vocalize high pitched squeals and others scream. I will have to look into the reason for spondylo listhesis this.

I do notice that tactile stimulation is highly prevalent. Tactile stimulation can include any of the essay james joyces following: rubbing objects with hands, rubbing skin or picking at the skin and scratching (Edelson, 1994.). Scratching is definitely the biggest self-stimulation I have observed. This behavior is a varying one for if a child scratches to the point of bleeding, which most do because they like to watch the blood come out, it is then considered a self-injurious behavior. The Panda Thumb! The final two areas of self-stimulatory senses are taste, which an example has already been given for, and smell, which again has already had an example. There are many theories behind why autistic people perform these behaviors, none of which have been proven through research.

One theory states that these behaviors are performed for internal pleasure while another states that the behaviors are the critical only way an autistic knows how to calm oneself when overly excited or anxious (Edelson, 1994.). The best way to handle a child that is exhibiting a self-stimulatory behavior is to the panda thumb, redirect their attention with a more appropriate form of stimulation, such as a book or crayons. As seen in the above paragraph self-stimulatory behaviors and self-injurious behaviors can overlap. Self-injurious behaviors refer to those behaviors that an individual does to him/herself causing a bruise, red mark or open wound. The most common forms of such behaviors include head-banging, hand-biting and as noted above scratching to the point of bleeding (Edelson, 1994.). One of the most difficult things for me to critical essay james joyces, adjust to spondylo listhesis, at a previous job was the scars on children's hands from biting. Due to the lack of response to pain, autistic individuals will bite their hand out of frustration until they calm themselves, regardless of the joyces ulysses depth or size of the bite.

Again, theories behind these behaviors range from that of internal pleasure to over arousal. Edward Fleming Dissertation! Another theory suggests that these behaviors may be the result of sub-clinical seizures, which is an abnormality in EEG patterns (Edelson, 1994.). The characteristics of autism are universal but, vary from critical essay person to person. Although the characteristics are universal the guidelines for the diagnosis of autism are not universal which is why some countries report higher rates of occurrence whereas other countries, Japan for example, report lower rates of spondylo occurrence. Possibly the biggest barrier to joining psychology professionals on the diagnosis of autism is the cause, or more accurately the lack thereof.

The cause of autism remains unknown yet, many theoretical causes exist. Critical James Ulysses! Early views on the cause of autism focused on the family structure of the child. It was believed that parents of essay autistic children must be cold and detached. The term given to such parents, usually the mother, was that of emotional refrigerator or refrigerator mother (Nevid et al., 1994). There is no evidence to support this theory. Currently, there are many beliefs as to critical essay james, what may be the the panda thumb cause of this disability. Critical James! The general thought in the psychology field today is why do i want a special education teacher essay, that autism may be caused by essay joyces ulysses, a variety of the panda thumb essay coexisting problems (Edelson, 1995.). There is some evidence to support the claim that autism may be an effect of exposure to a virus.

The virus at hand is that of rubella. Studies have shown that there is an increased risk of a child being born with autism if the critical joyces mother was exposed to rubella during the first trimester of pregnancy. It has also been proposed that toxins and pollution may lead to autism (Edelson, 1995.). This theory has no scientific evidence at this time. The widest held beliefs about the essay of innocence causes of joyces ulysses autism appear to act of essay, be in the fields of joyces genetics and edward fleming dissertation neurology (Society For The Autistically Handicapped, 1996.). Researchers have identified four possible neurological explanations: over ulysses arousal of the reticular system, dysfunction of the limbic system, left hemisphere dysfunction and to be a special essay perceptual inconstancy associated with brain stem dysfunction (Society For The Autistically Handicapped, 1996). The hypothesis that autism may be due to over arousal of the reticular system has been set aside due to the results of recent studies that do not allow researchers to claim that there is in critical essay joyces fact a relationship between arousal and overt behaviors (Society For The Autistically Handicapped, 1996.). A recent theory uses behaviors of animals with hippocampal lesions to compare with behaviors of autistic children. Animals with lesions possessed the same behavior patterns as children who have autism.

Although this similarity suggests underlying mechanisms, there also appears to be behavioral differences which is why this theory is compatible with the current knowledge of autism (Society For The Autistically Handicapped, 1996.). The left hemisphere of the brain deals with language and some aspects of cognition. The fact that the areas of american prohibition essay language and cognitive thought are affected by autism has led researchers to the theory that the critical james joyces limbic system of those living with autism may have impairments. The only fault with this theory is that because the onset of on loss autism is at critical essay james ulysses a young age the right hemisphere of the brain should compensate for what the left side does not accomplish but, this does not appear to be the case (Society For The Autistically Handicapped, 1996.). Finally, the spondylo listhesis theory that those living with autism have an inability to regulate sensory input, which affects ones view of external reality, is known as perceptual inconstancy. Again, this theory has not been able to show the nature of these instabilities (Society For The Autistically Handicapped, 1996.). Although there is no or little evidence for the neurological theories concerning the cause of autism, there is some evidence that points to genetic causes. The idea that autism has a genetic basis has been in existence since 1964 when Dr. Bernard Rimland discovered that monozygotic twins had a more prevalent showing of autism than did dizygotic twins. Since 1964 this finding has been confirmed by other researchers. James Joyces! One supporter of the genetics theory is american prohibition act of 1920 essay, University of California Los Angeles (UCLA).

In the critical essay joyces 1980's UCLA did a study that resulted in the following findings: of eleven families where the father was diagnosed with autism twenty-five children, over fifty percent , were also diagnosed with autism (Edelson, 1995.). The general population only has an incidence rate of five autistic children born in every ten thousand births, thus giving further evidence to the genetics theory. The remaining two genetic theories; that of a genetic mutation and spondylo a genetic predisposition, I feel can be integrated together. The theory of genetic mutation is part of Darwin's theory of evolution, naturally occurring mutations through selection of partners . Genetic predisposition means simply that there may be a susceptibility to critical essay joyces, autism in some people (Edelson, 1995.). In combining these two theories it is i want a special teacher, my belief that if genetic mutation is due to the selection of a partner and james then a child is produced who has been diagnosed autistic, that there must have been a genetic predisposition to autism for the child due to the genes of the parents. Therefore the on loss predisposition is critical, not in the child's genes rather, it is the combining of the essay of innocence parents genes. An example of this would be the fact that exposure to rubella while pregnant may cause autism in some children but, all mothers exposed to rubella do not produce children with autism. There must be a missing link as to why some children do, and some don't, have autism; the genes of the parents and their predisposition to autistic characteristics. Although this is just my theory, it has been shown that there is evidence of genetics playing a part in the cause of essay joyces autism. I look forward to the day, if there is why do to be a special essay, one, when the true cause of autism is discovered.

Although there is no known cause for essay joyces ulysses autism there are numerous treatments that have been shown to help autistic people. Again, there are varying degrees of autism therefore the treatment given to an individual may work for thumb him/her but, may not work for essay ulysses another. Treatments for thumb essay autism range from medical findings to parents of autistic children developing their own treatments. Some therapies are: Anti-Yeast Therapy, Dimethylglycine (food substance) Supplements, The Son- Rise Program and Higashi (Society For The Autistically Handicapped, 1996.). Whereas the Anti-Yeast and critical joyces ulysses the Dimethylglycine therapies focus on medical findings and/or vitamins to why do a special essay, help modify the behaviors of an autistic individual, the Son-Rise Program and Higashi, which means Daily Life Therapy in critical essay ulysses Japanese, focuses on the roles that the people around an autistic person have in modifying behaviors (,A HREF=http://www.rmplc.co.uk/eduweb/sites/autism/autism5.htmlSociety For The Autistically Handicapped, 1996.). American Prohibition Act Of! The therapies that are most interesting to ulysses, me include Mega-Vitamin Theory and Facilitated Communication. Dr. Listhesis! Bernard Rimland researched the claims from essay james parents that certain vitamins and foods affected their autistic child's behaviors (Society For The Autistically Handicapped, 1996. Treatments). It was concluded that Vitamin B6 is an effective treatment for forty-five percent of a special teacher autistic people.

The taking of vitamin B6 helps to improve: speech, sleeping patterns, lessened irritability, attention span and decrease self-stimulatory behaviors (Society For The Autistically Handicapped, 1996.). This treatment once started takes sixty to ninety days for an observed affect to be seen. James Joyces! I know some children who are currently on this from of treatment. I have only experienced the full treatment with one child and there has been a noticeable difference in self-stimulatory behaviors and the panda thumb essay mostly with attention span. This child will now look me in the eye, which in itself is rare for autistic children, and listen to what I am saying.

I know that the child is listening because the actions taken are what I have instructed him to do. Critical James! I can see why this theory would be a blessing to the panda essay, parents. The type of therapy that I most intrigued by is Facilitated Communication. I first heard of this therapy in 1992. Facilitated Communication is a method of helping an autistic individual express him/herself by giving physical support to an arm or fingers, enabling the individual to critical essay james ulysses, use a typewriter, picture board or alphabet board.

This form of therapy is very controversial because of the spondylo fact that there is a facilitator and critical essay james ulysses that the autistic individual does not do this on his/her own. When using this form of therapy it has often been typed by the autistic individual that he/she is why do i want to be a special essay, not retarded or stupid but intelligent (Society For The Autistically Handicapped, 1996.). Through my own research of this treatment method, I have also come across stories where the critical james joyces autistic individual has expressed anger because he/she understands everything happening in daily life yet, can not express thoughts or feelings. There have also been stories of autistic children hiding under their covers at night with flashlights reading books and then typing the book word for word when using facilitated communication. I Want A Special Education! This amazes me! What if these children are just trapped inside themselves but, are cognitively and emotionally the same as you and I? Although this treatment has not yet withstood the rigors of scientific investigation I do not see the harm in allowing it to be practiced. If it does in critical essay joyces fact prove to edward, be a scientifically sound treatment then the essay james ulysses world of autistic individuals and the panda their families will forever be changed. It is clear that although autism has been a known disability for fifty years it remains a mystery. With so many varying characteristics, no sound cause and no treatment that is universal, there is much more that needs to be learned.

Working with autistic children has shown me that there are in fact many different types of critical essay james joyces autism. Also, working with these children has made me wonder many things: Am I going to be the mother of a child with a disability, is that why I have ended up in this type of work? How do the parents deal with having an coast autistic child? Why, do some parents appear so relaxed and comfortable with what life has handed them while others are clearly depressed? How does having an critical james ulysses autistic sibling affect brothers and sisters? Wanting answers for these questions I turned to those who could answer them, parents of dissertation autistic children. Donna Reagan, the mother of an autistic child, touched me with her story. David, her son, is now twenty years old. When asked how she felt finding out her child was autistic Donna responded, Basically, when I found out that my son was autistic, I was hopeful. Essay Joyces Ulysses! Since then I have moved pretty much into heartbreak and despair.

I imagine the next step will be acceptance. It seems to me that this is like the grieving process and we move from one step to essay on loss of innocence, another, it just takes longer when the object of your grief is living. Essay James Joyces Ulysses! Donna has experienced other effects of american prohibition 1920 having an critical essay autistic child. David was diagnosed at age four and a half as being severely mentally retarded but, Donna knew this was not the case because of spondylo listhesis her own experience with this population. Donna was labeled as being in denial. This is an example of how much more needs to be learned about the characteristics of autism and as previously discussed the DSM-IV has taken the first step in clarifying the varying degrees of the disability. James Joyces! Donna's husband, a minister, was in denial, believing that God would heal their son and make him a minister. Her husband had found an old encyclopedia that claimed the cause for essay autism was refrigerator mothers, as discussed earlier (Reagan, 1996).

This lead to the physical, emotional and ulysses mental abuse of Donna. And the physical abuse of a special essay David at the hands of his father. Donna moved her family away from the man that was once her husband. It is not uncommon for parents of an autistic child to divorce, most do with-in the first five years of the child's life. Atop of what was going on with her marriage and own life , Donna still had to care for a hyper autistic child. She tells of times she found David ready to jump from a bridge into a creek, on the window ledge on their third story apartment and she says there are many other stories she could tell. David's safety was her biggest concern, with reason. David was eventually placed into critical essay joyces, a special care facility, Placing him was the most heart-wrenching decision I have ever made.

David has been in placement care for ten years now. His father has seen him once. In two years he will again move to other placement. Donna's biggest worry, who will care for David when she is gone? More and more I understand why people with special children pray that they will out spondylo, live their children. I have begun to pray that prayer as well. Donna's story was the first I received and it made me eager to receive more. James Joyces Ulysses! I then received an email from Suzanne, the mother of i want teacher essay a seven year old autistic girl. Before I tell Suzanne's story I would like to point out a common theme I have found among parents of joyces autistic children, those who's children are young appear to be hopeful and optimistic whereas those who's children are older seem to amalfi coast, realize that autism is a lifelong disability with many hardships.

The most common theme I have found though is this; what will happen when I, the parent, am gone. Every parent I spoke with, those that I contacted through email and those I see each day at work with their children, expressed concern about essay joyces their child's life once they had passed on. Suzanne expresses this very well, as you will see. Spondylo Listhesis! Suzanne says that the diagnosis of her daughter was not a surprise, because the word had been thrown around so much in all of the critical essay joyces tests that were being done but, she does say that, It is certainly a life sentence. Suzanne expresses the feeling of loss that can be felt by parents upon hearing the diagnosis.

No longer are there hopes for on loss of innocence the child to accomplish all that the parents could not accomplish; no medical school, no academic scholar. Due to the stress of raising an autistic child Suzanne and her husband sought counseling for critical james joyces six months and why do to be a special education have now learned to work through all of the emotions and critical joyces responsibilities of having a special child together. Suzanne sounds tired and still in a stage of coast travel essays sorrow due to her daughter's diagnosis. She explains how the essay ulysses family doesn't go out on loss, much, It is very tiring to have this kind of kid. Her and her husband assume that their daughter will live with them until they are gone and yet, she speaks of the hope that maybe her daughter will be able to essay james joyces, buy her own groceries, pay taxes and get a job she will enjoy. Listhesis! There are plans to set up a trust for their daughter to ensure that when they, Suzanne and critical joyces her husband, pass on essay she will be taken care of. Essay! Suzanne ends by saying, We haven't given up on her yet but, we are also realistic about what may happen. American Prohibition Essay! I would like to essay joyces ulysses, point out a couple that I know through work.

Their daughter is nine years old and I have taken a liking to her. She amazes me each day and I look forward to what she will teach me next. There are times when I wonder what she would be like if she were not autistic but, then I realize she wouldn't be the same little girl I have grown so close to. I admire her parents greatly for their outlook on her disability. They both appear well adjusted and they treat her just as they do their other children. The mother even says that she is easier to care for than her children without disabilities. She, like Suzanne, says that she would like to see her daughter do things on her own when she grows up but, she has no need to rush that time.

As the mother of an autistic child, she says her daughter is her best friend, they do everything together. I know, from working with her daughter that she is not of the highest functioning autistic children but, she is not the lowest either. Edward Dissertation! Her daughter understands when spoken to james joyces, and will say things that are appropriate to the panda essay, the surroundings. I can not express how wonderful it is to work with this child. And I hope that if I do have a child with a disability that I will have the same outlook as her parents do.

Most of the research that has been done concerning autistic families is how siblings are affected. Critical James! In a study done by Royers and Mycke in 1995, it was found that siblings of autistic children had a fair understanding of the disability and essay on loss of innocence this finding was independent of age. Also found was the fact that children who have an autistic sibling rate their relationship with their brother/sister better than two siblings of which neither has a disability. From what I have seen at work, the critical essay joyces siblings of the american prohibition 1920 essay autistic children take responsibility for their brother/sister and at the same time do not truly understand why their brother/sister can't do such things for joyces him/herself. I believe that there is a very unique bond between autistic children and their siblings. Autism is a lifelong, developmental disability. The characteristics of the the panda essay disability; little or lack of speech development, avoiding social contact or awareness and routines of behaviors are not experienced in the same degree for everyone living with autism.

The lack of a single identified cause for autism leaves much to be discovered in the field. Theoretical causes, such as neurological and genetic, may prove to be a link to ulysses, the true cause of the essay on loss disability. It has been shown that those living with autism may be helped, not cured, with available treatments. Such treatments include a high dosage of critical essay joyces Vitamin B6 in listhesis the diet and the Son-Rise Program. A controversial treatment, Facilitated Communication, may allow autistic individuals a chance to communicate with the rest of the world without becoming frustrated at the inability to essay joyces, communicate. American Essay! Parents of autistic children deserve all the critical ulysses support and help they can handle. I Want A Special Teacher! By hearing Donna and Suzanne's stories I have learned more about autism and the range of emotions that are felt by parents than any textbook could of taught.

Donna's story of basically having to start a new life due to having an autistic child and all the critical essay james ulysses hardships she has gone through in trying to do the best for David. Edward Fleming! And Suzanne's hopefulness and clear feeling of critical joyces loss due to having a young autistic child. I am thankful for all of the to be education teacher children that I work with and I treasure each day I spend with them and all they teach me. I hope that their siblings realize how special their autistic brother/sister is. Doing this paper and the research involved in it I have come to realize that I am blessed for having known each and every one of the critical ulysses autistic individuals I work with, for i want education teacher essay they may live in a world all their own but, every so often they let you in and that, that is a blessing.

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James Joyce's Ulysses: Critical …

my bedroom essay boy record lockers are neatly tucked in critical joyces ulysses, the corner. On Loss Of Innocence! The rest of the room is hidden by another wall splitting the office and critical james, what seemed to prohibition essay, be rooms where patients could be checked upon. Each of critical joyces, them are identical to the first one with three in total. Thumb! The fourth and last room of the section is a closet, filled with medication and sterilized equipment. I am completely alone here, nothing to critical joyces, do or say I lay down on the exam bed in essay, one of the rooms and slowly begin to think who am I and why I am here. I fall. and how they talk e.t.c. “ The echoing of the critical essay james stir and crackling of the fire was no sort of comfort me.” In the story the mention of ‘The Red Room’ is repeated this is so that it engages interest to the reader’s attention. “I can assure you,” said I, “that it will take a very tangible ghost to frighten me. And I stood up before the fire with my glass in why do to be a special education essay, my hand.” This conflicts with the views of the old people. The narrator is quite cheery at first, and builds up tension “I must confess that the. returned to her home feeling more exhausted than when she had left.

For all of these reasons, Susan felt it necessary to seek out Room 19 in Fred’s Hotel. Joyces! This was Susan’s escape, not because it was a vast, open land like the mountains were, but because no one knew she was there. It didn’t even matter that “the room was hideous” because “she was free” (Lessing 541). The room she was shown was small and dingy, with only dissertation, one small window and cheap looking sheets on the sole bed that was there. All Susan. dancers from the corner of the room, just outside the changing area. At the foreground is a forgotten cello, not to essay, be used in the perform-ance. It has become a footstool for the dancer to adjust her shoe on. Then there are two other dancer still adjusting their costumes.

Degas has captured the exact fluffiness of a tulle skirt with help from the Impressionist influence. The dancers in the back are much smaller indicating that they are at the other end of the essay room. Critical Essay James! They have already begun to amalfi essays, warm. Boutique Hotels Boutique hotels are the hotel where luxurious facilities in home type atmosphere where specialised service is given all areas of the hotels. There are few suites in one hotel, many staffs are allocated for service for each rooms and butler service, separate living area, and kitchen area is there for guest. Dining is done on specification of the guest. 5. Critical James! Airport Hotels Airport hotels are located near airport.

Many of the guests are transit passenger and. The subject lies now detained within the walls of the ministry of love, under the i want teacher essay charges of thought crime and assault to authority. Room 101 is necessary for critical essay james the subject’s acceptance process and full conversion. I believe we can use the children, for even though they have some bonds with her mother; they can be easily broken with smart use of the panda thumb essay, doublethink. We use the children as a double bladed sword. First we shall use them to scare the subject, putting them in lethal situations where they are brutally. overemphasized. Identify the james joyces ulysses legal and statutory requirements that apply to rooms division operations Hotel are sometimes required by law to make all of their tariff information available, so that guest can see the options which they can chose, and so that guest can challenge rates which may differ from those disclosed by the hotel. For example, a hotel can state that premium rooms are available at a set prices which is higher during peak season, and if a guest visits during.

In the Brunei Hotel, there is only one meeting room and edward fleming, there is no swimming pool or gym. Ulysses! This shows that the edward housekeeping department in joyces, 5 star hotel has more job to why do a special essay, do than a 3 star hotel. (thebruneihotel.com, 2014) (www.rizquninternational.com, 2014) (www.rizquninternational.com, 2014) Front Office Department The Brunei Hotel, compared to Rizqun International Hotel is a really small hotel. Critical Essay James Ulysses! The front desk does not require a lot of staff. While in Rizqun International Hotel, it have a lot of staff. Management Functions in spondylo, Rooms Division Page 3/9 HC-3-730 Rooms Division Management Keeps track of the critical essay standard of services delivered, based on guest comments and quality audits Keeps close track of what the market and competitors are doing Is actively involved in amalfi coast travel, the local area to keep up-to-date with the needs Management and Administration (as a department administrator) Draws up the annual budget for critical james ulysses the department and listhesis, follows up implementation Implements the rooms pricing policy in. Although they may be wise, the older people have not ever dared to go to critical joyces, the red room. They have become wise as they have heard the stories about the room but none of them has ever had first hand experience of the room. This is the first example of what the old people are afraid of, the unknown. Amalfi Coast Essays! . Repetition is critical essay, also a device used by Wells to build tension. One of the amalfi coast most obvious examples is on the first page. It's your own choosing. The old man is trying to warn the young man, or.

It’s striking to watch Control Room seven years down the road, with Bush and his friends out of critical james, power and shamed for their now well-known abuses of power and shameful management of the truth. Al Jazeera was intentionally bombed by the US on multiple occasions; the US even considered bombing their Doha offices. Al Jazeera’s journalists around the world were discredited and some had their press permits revoked in a campaign of listhesis, what can only be called censorship. Despite what is know today, when. overcome racism. Everyone has their own idea or philosophy: the Narrator’s grandfather, Booker T. Washington, and his own family. These ideas only critical essay joyces ulysses, add to the narrator’s confusion of how to behave.

The Narrator’s grandfather says, “I have been a traitor all my born days, I want you to overcom’em with yeses, undermine’em with grins, agree’em to death and destruction” (Ellison, 278). On Loss Of Innocence! The Narrator says, “I could never be sure of what he meant” (Ellison, 278). The grandfather was ashamed of not fighting. and he despises Giovanni as well as he loves him. In the book, David is critical essay joyces ulysses, saying to him self: ?The beast which Giovanni awakened in me would never go to sleep again; but one day I would not be with Giovanni anymore'. When he finds joy in Giovanni's room, it quickly becomes clear that it cannot last, and that love does not always conquer all, and that it actually stands no chance against fear and self-delusion. He is fighting a constant battle against something he can't remove or ignore. Edward! David's. guard the public and those present in the court. There is a divider between where the joyces ulysses public sits with those involved with the legal proceedings. The role of the interpreter is to make sure the witness reads the i want education essay oath before testifying in the case.

My report on courtroom observation focuses on observations from two courts. The first one was the Civil Courts. The second one was the criminal court observations. James Ulysses! The Courts are held in order to resolve local disputes and maintain order in. How Are Suspense and Tension Created in The Red Room? Essay. “My precise examination had done me good…” So after looking around the the panda essay red room the critical james narrator has now managed to settle himself that he is alone in the red room. Amalfi Coast Travel Essays! It is james joyces, important that this is realised because it is lowering tension so it can be built back up again, so the tension does not reach a peak before the main events of the story. Tension reaches its peak in The Red Room when the narrator becomes extremely scared and by amalfi essays what is going on inside of the red room. “… speaking with a half-hysterical. Sample Room Lease Agreement Essay. personal or property loss for which the Owner is essay james, not responsible and which the Tenant's own insurance should cover.

OWNER AGREES TO THE FOLLOWING: 1) to provide the following furniture: sofas, chairs, and tables for the living room and dining room. Amalfi Coast Travel Essays! A bed, dresser, desk and chair for critical essay james ulysses each bedroom. Window treatment for the rented designated bedroom. 2) to provide the following kitchen appliances: a refrigerator, one freezer, one microwave, and one stove. Essay! 3) to critical james, provide laundry facilities. Comparing The Red Room and The Landlady Essay. He is greeted by a ;ady ho is around 45 to 50 years old.

She seems very pleasent to why do i want to be, Billy and offers him a room to stay at a very cheap price. At first Billy does notice that the critical joyces ulysses woman is a bit strange but he does not mind because he gets offered a very cheap place to stay. After he settles into thumb his room, he sign the guest book. He notices that before him there have only been two guests of which he had heard of them. He had read their names in critical james joyces, newspapers and he thought that they were very. court room from dissertation a door in critical essay james ulysses, the back.

The men sat on a wooden bench in the corner and remained handcuffed the whole time. None of these men appeared to be anyone you would want to run into in a dark alley. It did not seem that this was their first trip to coast travel essays, the court room. It appeared that they had been in this situation before. I would later find out for most of them this wasn’t there first rodeo. As time rolled on, at around nine thirty, people slowly started to essay james joyces ulysses, trickle into the court room. Before. A Comparison of The Red Room and The Signalman Essay.

warnings. At this point he tells the man about recent a ghostly warning but nothing had yet happened due to this and that he was worried about what might happen. This gives a feeling of dread in the same way that the old people in 'The Red Room' do when they say you are not going to stay there on this night because it implies that something is going to happen Their meeting continues for long enough for the man to get quite scared about ghosts even though he is not quite sure. Compare the ways in which the authors of The Red Room, The Black. No, nor at any other time. Amalfi Travel Essays! The Signalman is critical essay james ulysses, no longer able to keep things in perspective, he has isolated himself to such an extent that he is unable to think rationally. Dissertation! The Red Room,(H G Wells), also has a character that experiences isolation and this creates a feeling of awareness that he is alone against critical essay the surernatural and has no-one to help or protect him: Steady on! i said These candles are wanted, Speaking with a half - hysterical facetiousness. He tries to reassure.

arms room. (2) Train and supervise key custodian and alternate. (3) Periodically (minimum of quarterly) inspect custodial area. The Panda Essay! Record results on essay joyces, a memorandum for record. (4) Issue all keys and locks by serial number to american prohibition act of 1920, custodian using DA Form 2062. (Issue keys to depositories for james personal retention). (5) Maintain the the panda thumb essay alternate keys (in separate sealed envelopes, signed and dated across the critical essay ulysses sealed flap by the custodian) to the operational and alternate arms room key boxes. Essay on The Monkey#x27;s Paw and The Red Room. the sergeant exhibits the Monkey Paw to the White family up to this important perspective; it has been merely made believe. It is important to understand that the paranormal enters the household unexpectedly in contrast to The Red Room, where the 1920 essay paranormal is joyces, seeked out by spondylo listhesis the protagonist. James! In this the paranormal is brought into the White home by the Sergeant and education teacher essay, the White family accept the paranormal. In The Monkeys Paw takes the form of one. My Greatest Influence: My Mother Essay. history stored in those places.

One summer, while we still lived in Brooklyn, New York, my family and I headed up north to Canada. Joyces Ulysses! We stayed at a stunning hotel with an american act of 1920 essay outstanding view of the Niagara Falls splashing down menacingly into the water. During the essay night, the falls would change color due to the lighting it was given. Although I was still really young, I understood just about everything I learned from my mother in this trip. Once the light was seen through the the panda thumb essay thick fabric of the hotel curtains.

My Grandmother, My Guardian Angel Essay. appreciation-- a simple thank-you or a small compliment-- from most of my relatives. I don't think a lot of them knew just how much they should have said until the critical essay joyces day came when we all fell silently speechless. Recalling the day of August 4th, 2003, the day my grandmother was diagnosed with cancer, is difficult because I once had no words to describe my emotions or the situation I was faced with. Listhesis! I remember the critical cramped hospital waiting room where we all sat and waited for the news that none of us could. Compare and Contrast - to Room Nineteen Cathedral Essay.

nothing else in my life up to now” (p. 216), displaying how this moment completely changed his viewpoint. As they finish the thumb essay drawing, he decides to keep his eyes shut, so that if only for a moment, he can attempt to understand the blind man. Throughout “To Room Nineteen” and “Cathedral”, the protagonists display selfishness in their own way. As they have this in common, there are a few differences in the way they approach this trait, which are very important to analyze.

Susan in “To Room Nineteen”, Essay about Technology in The Class Room. fun, engaging format. I have also learned that educational technology is not only essay james joyces ulysses, a learning, instructional resource for the panda thumb students, but it is also one where teachers are able to collaborate together. A website I had reviewed and will definitely use in essay james ulysses, my future teaching career was at essay www.sharemylessonplan.com. This site brings together a whole community of essay ulysses, educators focusing on the same goals; creating and sharing lesson plans that ensure students learning objectives are met. While information on.

morning, and nobody was in my aunt’s house except my cousin and me. I went to my dad’s house, but nobody was there and amalfi coast travel essays, everything was dark. It seemed strange to me because last night everybody was there, so I knew that they took my dad to critical ulysses, the hospital. It was 8:00 in the morning, and nobody came to tell me what was going on, so I started to coast travel, pray with my cousin. Since she had already lost her dad, she told me that I have to be prepared for anything. Then, my mom came in and tried to. couch beside my brother I just stared at the baby. Essay James Joyces! She was so cute, her little eyes were closed and she had these tiny eyelashes that looked just perfect. Her nose was so petite it was like a little button; her cheeks had a dash of pink on them like a plum fresh off the tree. She had her lips puckered up and they were red and prohibition act of, had a lot of shape to critical joyces, them. Listhesis! I drew my face close to hers to give her a kiss on the head.

She smelled so good and fresh. Critical Joyces! I couldn’t help but smile, tears ran down my face uncontrollably. responsible, productive citizen. The teacher is the backbone of the community. SACRIFICE, DETERMINATION, COURAGE, DEDICATION, SELFLESS, PERSEVERANCE – these are the common qualities, portrayed by thumb essay the teachers, attributed to essay joyces ulysses, a hero. So, for me, my teacher is my hero. My teacher is a hero, indeed! She doesn’t have a pedigreed name.

She has no great influence and intense power to the society. But she is a hero in her very own ways that no other great and influential people could ever. Success comes from edward dissertation hard work, energy, dedication, and a support system. My mother is one of critical james, my biggest support systems and examples. During my first semester at college, my goal was to earn an A as a grade in my Anatomy and Physiology class for multiple reasons. One reason was because I strive for great grades, and after I received a grade I was not happy with, my mother was there to boost up my morale and to encourage me to try different studying methods that would be beneficial in the course.

systems in edward fleming dissertation, order for the athlete to perform in their chosen sport. (Beashal) I have introduced specificity in my circuit by having stations, which help improve football for example passing. Safety Aspects Here is a list of safety aspects I plan to have in mind when doing my circuit and why I think each is necessary. The most important aspect of safety in my circuit is critical essay ulysses, warming up and the panda essay, warming down to avoid injury such as pulling or staining a muscle. Firstly you. My Service Learning Experiences Essay.

The bulk of my time was spent working in critical essay joyces, the activity room. The room was big enough to hold people from different floors. It was located at the bottom of a ramp which made assistance necessary for the majority of residents coming or leaving the room. There was an amalfi elevator used near the room that required assistance operating and helping residents to their rooms. The room had a refrigerator filled with goodies as well as a small kitchen with an oven. Some of my time was spent in the residents. Essay about My Family: My Mother, My Role Model. do for the rest of james ulysses, my life. Guess who was there for me? Who was there to help me?

Of course my mom, and for that I admire her. My mother is a wise, smart and educated person, she has two masters degree and for me she’s an example of what intelligent person should be like. Sometimes she comes home tired from work, and edward fleming dissertation, she still makes time for her family. She makes sure that we have done our homework and is always making sure we have everything that we need. I learned from my mother that if I work. Questions: If Inn-Room decides to critical joyces, implement the newly proposed discount, what will be the additional profit contribution from an increae in american, sales?

If Inn-Room decides to implement the newly proposed discount, what will be the cost of the critical essay ulysses marginal investment in accounts receivable? If Inn-Room decides to implement the newly proposed discount, what will be the marginal benefit of reducing the bad debt expense? If Inn-Room decides to implement the newly proposed discount, what will be the. Waiting Times in spondylo listhesis, the Emergency Rooms in critical essay ulysses, Canada Essay. As the number of patients in the emergency room increases, so does the amount of patients leaving the emergency rooms without being seen by a physician ( Ducharme and Alder ,2009,p.456). The reasons for the panda thumb this was symptoms of the patient seem to be getting better or resolved, patient had other commitments and james, could no longer wait, or communication barriers with the triage nurse or registration. Those who registered in the emergency department tend to be patients living in close proximity, so they would. stairs up to my room two at a time. I pivot quickly in the hallway to my room and reach for on loss of innocence the brass knob, turning it. I listen closely to critical essay joyces, the sound of the spindle inside the knob turn, taking the latch out. I listen closely, always interested in thumb, the faint sounds of my door.

Hearing the click of the latch opening, I enter my room. The sight makes my eyes soften, and my makes my body relax. There’s a bed next to the door, set against the corner and my bookcase, which is at critical essay the end of edward dissertation, my bed. An empty. Room 101 Speech Against Smoking Essay. people who selfishly smoke around them. Critical Essay James Ulysses! It really is not fair. Additionally children who grow up in families of smokers have 50% more chance of to be a special, being tobacco users when they are older than children brought up in a smoke free environment. Many times my friends and I have had to choose between suffocating in cigarette smoke and holding our breathes for, well too long whilst our eyes water from the smoke, smudging all our make-up just before meeting up with some friends in town as we have to walk by. guidelines for the students to follow and most importantly I have to critical james ulysses, decide how I want to run my own classroom.

I believe there is various different ways a classroom can be ran, but I also believe that each teacher is entitled to run their room the best way they see fit, as long as it is amalfi coast essays, a safe environment for the students. Upon realizing all these facts, I am faced with the problem of finding my own unique and interesting teaching philosophy, one that suits me. I find this to be an. schedule, he always made time for us. When my mom was pregnant, he would always answer to her needs, even if it meant being absent from work.

With my mother getting close to having me, he bought my mom to work with him during his night shift so he could take care of essay james joyces, her. He made a little bed for my mom in the back room of his shop so she can rest while he worked. He was the essay bread-winner of the family, yet he never neglected us. He cares a lot for us. My dad will do anything for his children.

Since. there would be bedroom and bathroom. Critical Essay! Also, my bedroom would reflect my inner world and privacy so it would be painted with my favourite colour which is blue. My view is that blue is the colour that represents my feelings of harmony and peace. In short I can say that, the interior of my dream house is like my spiritual world so I'd decorate it in spondylo, such a way that all the essay ulysses rooms, objects and colours would symbolize my true feelings. The outer design of my dream house should be attractively decorated. Case Analysis of Room Board (Strategic Management)) Essay. the economic conditions don’t affect the company’s market performance and sales have increased from 1995 to 2007. Social – High employee turnover, using part-time employee and commission-based compensation are to lower fixed costs in the market. The Room Board is creating an environment of collaboration and american 1920 essay, engagement. The engagement was evidence by deep relationships with customers, fellow employees, and suppliers.

The company provides harmony environment to its employees and customers. The “walk. In the forest, a trail is leading to a man made pond, constructed for me by my husband, and of course, animals that need to take a rest and have a drink. The pond is essay joyces ulysses, thirty feet in diameter and the panda thumb essay, six feet deep it is essay, a hundred feet away from my backyard, and can be seen from my balcony Surrounding the pond are two layers of flagstone. One end of the pond has several layers of stones that make a waterfall from the trickling water coming from an underground water spring that comes out the panda thumb essay of the critical james joyces mountains; or with one thought. Of course, I never physically leave the windowless art room when I travel. I don't get any less out of it though. My postcards don't require stamps. It is forty minutes of my day, and an exotic voyage each time. Educator Mortimer Adler says that the primary cause of genuine learning is the activity of the learner's own mind.

I read the words over and over, and pack a paper-bag lunch to send with my imagination on its trek. I have traveled the world several times over. Descriptive Essay - My Daughter#x27;s Birthday. Shortly after a lengthy nap I heard the nurse say, “I’m calling the doctor, it’s time to start pushing.” By this time, mom and edward dissertation, my sisters had arrived at the hospital and were also in the room. Of course my husband was also in the room which made the room headcount to about eight or nine people. My nurse told me, “just remember, screaming doesn’t help get the baby out you need to push with all you have”.

I hung on to those words thinking I needed to focus and not be so dramatic which is ulysses, pretty. Essay on My Childhood Memories of Grandpa. to reality by the most gentle kiss on my forehead. I awoke to the sight of dissertation, my grandpa's soft eyes and warm smile. He pushed my hair away from my face and told me, It's time to wake up, sweetheart. He had developed an art of critical essay james joyces ulysses, waking his sleepyhead grandchild.

Although I knew I was not the the panda thumb essay only girl to wake up by ulysses a kiss from grandpa, he made me feel like the most special little girl in the entire world. Because of those few seconds, I would always remember my grandpa as the essay on loss of innocence most gentle and loving. Its 8:15 and I have the long walk of approximately twenty metres to get to my bus stop, also known as a video shop. As I walk my shoe's make a loud sound like a horse walking. After five minutes of talking about essay james ulysses girls and essay of innocence, music the 'Red Submarine' bus arrives. Yet again we have the same cheery driver with a chin ring, six earrings and a nose stud.

All eighteen of us at the bus stop run onto the bus like a herd of galloping rhinos. I jump onto a seat with Sean and Adam near. Although my brother took it to the extreme, I could definitely relate to Larry's decision to put himself between any conversations his parents had. At one point in the story, Larry commented While [Father] talked to Mother I played loudly with my toys to show my total lack of concern, (102) and I pictured my brother doing the exact same thing while Rodney talked. While he never repeated his actions of that first night, he continued to do everything he could to inconvenience any conversations the.

I belong to a middle class family. Critical James Joyces! My home is a cosy little flat on the 1st floor in Lajpat Nagar in i want to be a special teacher essay, Delhi. Our drawing-cum-dining room is tastefully decorated. It has a TV set, a sofa, a refrigerator and dining table. The decoration pieces remind me of our visits to various places. There are two bedrooms. Joyces! One is used by amalfi coast travel essays my parents and the other is critical joyces ulysses, shared by the three of us. The study-table is used by my brother and sister as well for their homework.

The kitchen is act of 1920 essay, small but the big windows let. Comparison of critical joyces, The Red Room and Farthing House Essay. his imagination takes over. He sees shadows weep up against him as he climbs the spiral staircase. Spondylo! This is the critical james first sighting of thumb, anything 'unusual, and builds up a lot of suspense. Once inside the red room the man starts exploring it. The old fashioned furniture in the room makes the essay joyces ulysses man lose his confidence. He again starts to remember the story of the dead duke, how he had 'fallen headlong down the steps' and lost his life. This makes him even more nervous and scared. He.

Personal Narrative - My Father Essay. wattage and voltage and Ohm-age, when he explains torque and amalfi coast essays, elasticity and inertia, when he pulls a mechanical pencil and essay, tiny tablet from his front pocket to draw grids and listhesis, circles and squiggles. I’m eight. After he hangs the new reading lamp over critical, my bed, he splices an egg-sized hand switch into spondylo listhesis the lamp’s cord so that when I wake up in the night I won’t have to reach up to the fixture itself to turn it on. I hand him the stubby red-and-blue-handled Phillips head, and he screws together the critical joyces halves.

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Critical essay james joyces ulysses - …

An Essay on the Types of People I Dislike Most. No two men are alike. People differ widely in their nature. Essay James? Some people are of sweet nature. I Want To Be Education Teacher? They are loved by all. Everyone wants to win their friendship.

On the other hand, there are people who are ill-tempered. They easily offend others. Joyces? “Birds of american prohibition 1920 essay a feather flock together”, is an oft quoted saying. It simple means that only people of the same nature can be friendly with each other. Some people dislike others due to their ugly appearance-black color, bad features, fat body etc. but on my part, I can say that I never disliked anyone on james joyces, an account of his ugly appearance. I only dislike those nature is edward not good and who have a defective character. Thus, I dislike ill-tempered people. Image Source: bdb3b8.medialib.glogster.com/thumbnails/fee7ff2f0dbb2ca37a228b0e07904dbc07947b6efff8ecf9f5537508891c6ba8/i-dislike-you-source.jpg.

Fashion is critical essay joyces ulysses another of my pet aversions. Now-a-days people are becoming more and more fashion-minded. They may not eat well, but they like to why do teacher essay, put on costly dresses. Students come to the classes with combs in their pockets. They comb their hair while the professor is james joyces lecturing. Similarly, some English educated girls do not appear to her Indians at the panda essay, all.

They madly copy the western culture. They waste hours together in critical essay james joyces dressing their hair and painting their faces with cream, powder, lip-stick, cheek-stick and what not. Such people, who go beyond their means to satisfy their craze for fashion, are not liked by me. Moreover, in thumb their lust for fashion, our young men often show a womanish character and they take pride in it. Such people are dislike by me. I am not against English literature, or the English language itself. Critical James Ulysses? But at the same time I abhor those who talk in English even in their homes. I have seen people who talk in English even to to be a special education, those who know little of it. Ulysses? They want to impose and show their superiority over others by doing so. I consider this habit, mean and objectionable. Even after fifty years of freedom such people have not developed love and pride for their own language.

They have slavish mentality. Hence they are the objects of my dislike. Of the various evils of which we have become victims, smoking is one. Wherever you go smokes will be there with cigarettes in their mouth. They make the atmosphere of the already congested and crowded buses, trains and cinema halls suffocating. They may not smoke outside of the cinema halls but they cannot help smoking as soon as they occupy their seats there in. they care neither for the law which prohibits them from smoking at such places nor the displeasure of their neighbors. Some are so obstinate that they do not stop smoking, Even if they are requested to do so by some non-smoker. I do not simple dislike such people, I heat them.

There are people who make promises but do not keep them. They borrow money, promises to return in the next week, but do not so even the next year. Students borrow books from their friends for a day, but do not return them ever after a month. I do not like this habit. Indeed, such people consider this habit of to be a special teacher making false promises a fine art. Essay James Joyces? They do not think about the loss which they cause to others. American Prohibition 1920 Essay? I always try to keep such people at an arm’s length.

The problem of indiscipline is not confined to the class rooms or to critical, the school and colleges alone. Even mature and responsible people behave in an indiscipline way go to the office, or the railway station, or the cinema hall and essay on loss you will find men of position behaving in an in disciplined way. They think it an insult to stand in the queue. They pushed others and james try to get their work done at earliest. Amalfi Travel Essays? I dislike such in critical essay james joyces ulysses disciplined persons. I am very particular about good manners. So those who are ill-mannered are not liked by me. There are persons who never thanks others however kind a deed others may do for them. Spondylo Listhesis? Similarly, if you go to them, they will never offer a seat although there may by so many vacant. They do not address their juniors and sub-ordinates properly.

They do not show even ordinary courtesy to others. Such discourteous and ill-mannered people are never tolerated by me. Many people act like spies. Those who have served in critical essay james joyces any office must have had a bitter experience of such people. They are known as black-sheep. Such people appear to be very friendly, but they try to thumb, harm you in joyces ulysses very possible way behind your back. If you happen to utter some words against your friend, or your superior, they work like telegraphic wires. I always avoid the company of such people. This habit of fleming dissertation back biting is essay joyces ulysses strongly disliked by me.

Some people think themselves to be very clever and shrewd. They seem to think that three-fourths wisdom of the fleming, world lies in their head and that the critical james joyces, remaining one fourth is distributed among the rest of the world. The main characteristic of such people is why do a special education their habit of boasting. James Ulysses? They are never tired of praising themselves. Besides this, they never find any good in others. They always find fault with the ways of living and thinking of other people. I feet that no sensible man would like to keep company with them.

I have a particular dislike for such people. But today, the world is changing swiftly. Only those persons are successful, who can adjust themselves to every company? Those who have strong likes and essay on loss of innocence dislikes find it very difficult to march ahead smoothly. So in spite of my strong dislike, I try to joyces, adjust myself even to people I dislike.

But however much one may try to why do to be a special education teacher, hide one’s aversions, sometimes they become quite apparent. PublishYourArticles.net is home of thousands of articles published by users like YOU. Here you can publish your research papers, essays, letters, stories, poetries, biographies and allied information with a single vision to liberate knowledge. Before publishing your Articles on this site, please read the following pages:

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James Joyce's Ulysses: Critical …

CO-OP health plans: patients’ interests first. By Louise Norris healthinsurance.org contributor August 27, 2017. It’s been a rough few years for the ACA’s Consumer Operated and Oriented Plans. There were 23 CO-OPs when the first open enrollment period got underway in the fall of 2013, but by the beginning of 2016, only critical essay ulysses 11 of them were still operational. By July 2016, four additional CO-OPs – in Ohio, Connecticut, Oregon, and Illinois – had failed. And in September, Health Republic Insurance of New Jersey stopped offering new plans and the panda thumb essay, announced that their existing plans would terminate at the end of 2016 (unlike the other CO-OPs that have failed, state regulators in New Jersey were initially saying that it might be possible for Health Republic to be rehabilitated enough to return to the market in 2018, but that ultimately was not the case, and an order of liquidation was filed in February 2017). In December 2016, more than a month after open enrollment began for 2017 coverage, Maryland regulators announced that Evergreen Health CO-OP would not renew or issue individual market plans for 2017, leaving just five CO-OPs offering coverage in 2017 (Maryland regulators made an administrative order in July 2017 that is expected to lead to receivership for Evergreen Health). In June 2017, Minuteman Health announced that they would no longer offer coverage as a CO-OP after the end of joyces ulysses 2017.

Their intent at that point was to of innocence, reopen in 2018 as Minuteman Insurance Company (and to have plans available for sale during open enrollment in the fall of 2017 under that name), which was to have been a for-profit insurer rather than a CO-OP. But by mid-August, they had failed to raise enough capital by joyces the deadline to secure a license to sell coverage for 2018, and fleming, would not be able to re-open as Minuteman Insurance Company in critical ulysses, 2018. Minuteman Health has been placed in the panda thumb, receivership by the Massachusetts Division of Insurance, and critical essay, their plans will terminate at the end of essay 2017. After all the closures, there are just four CO-OPs slated to offer coverage in 2018, in five states: Maine, Montana, Idaho, New Mexico, and Wisconsin. The CO-OP failures have been due in large part to a combination of joyces ulysses premiums that were too low, benefits that were too generous, enrollees who were sicker than anticipated, competition from bigger carriers with larger reserves, the the panda thumb essay risk corridor shortfall that was announced in the fall of 2015, and the risk adjustment payment announcements that were made in joyces, June 2016 (see below for a timeline of the closures). The Trump Administration’s approach to health care reform, and GOP lawmakers’ efforts to repeal and replace the ACA (via bills written in secret that bypass the normal bipartisan committee process), have further increased the uncertainty that insurers are facing, making the dissertation situation even more precarious for small insurers like the critical essay joyces remaining CO-OPs. 2018: 4 CO-OPs selling plans in 5 states.

There are four CO-OPs that are expected to travel essays, offer plans in five states in 2018. Although the vast majority of the original CO-OPs have failed, these four are showing signs of ulysses overall stability. Spondylo! It’s important to note, however, that if the essay Trump Administration continues to cause uncertainty and instability in the insurance markets (including Trump’s recent threats to to be a special teacher essay, cut off federal funding for joyces ulysses, cost-sharing reductions), the remaining CO-OPs will be among the most vulnerable. Community Health Options (CHO) This was originally called Maine Community Health Options, but the name was changed to spondylo, reflect the critical carrier’s expansion outside of fleming Maine. Critical Essay Joyces! 44,000 people enrolled in coverage through the exchange in 2014, and 83 percent of them selected Community Health Options, making the CO-OP’s first year an amazing success. CHO expanded into New Hampshire for 2015, fueled by their initial success in edward fleming, 2014 and by a new loan from CMS. During the second open enrollment period, CHO once again dominated the Maine market, securing about 80 percent of the exchange market share. They also enrolled about 5,000 people in New Hampshire. However, CHO reported significant losses in the third quarter of 2015, and decided to limit enrollment in individual plans for 2016. Enrollment directly through Community Health Options ceased December 15, 2015; enrollment in Community Health Options plans through Healthcare.gov ceased December 26. CHO ended 2015 with $74 million in losses – a far cry from the joyces profitable year they had in 2014.

In early 2016, Maine’s Insurance Superintendent proposed putting the CO-OP in receivership and canceling a portion of prohibition act of 1920 its plans (about 20,000 members would have been transitioned to other coverage). Critical Essay James Ulysses! But CMS didn’t allow that, saying that the prohibition act of 1920 plan cancellations would run afoul of the ACA’s guaranteed-renewable provision. The CO-OP is under increased oversight from the james joyces ulysses Maine Bureau of Insurance, which puts out thumb monthly reports that detail how the CO-OP is critical joyces ulysses faring relative to its business plan. According to thumb essay, the July 2017 report from the Bureau of Insurance, CHO’s net income in May 2017 was considerably lower than projected, but year-to-date claims were running just about as-projected. CHO is the only remaining CO-OP that received money—as opposed to having to pay out money—under the risk adjustment program for 2015 and again for joyces, 2016. For 2017, Community Health Options had an average rate increase of 25.5 percent in Maine, where bulk of their members live. They exited New Hampshire entirely at listhesis, the end of 2016, and reverted to operating solely in Maine, as they did in james, 2014. American! They have proposed roughly a 20 percent average rate increase for critical essay james ulysses, 2018 in the individual market, where they have about listhesis three-quarters of essay ulysses their membership. Their total membership was 67,539 at the end of dissertation 2016, and had dropped to 44,015 by the first quarter of 2017 (all in Maine, since they’re no longer offering plans in New Hampshire). Mountain Health Cooperative Montana Health CO-OP started in Montana, and expanded to Idaho in 2015.

The CO-OP seems to be on essay relatively solid financial ground. CEO Jerry Dworak noted that the CO-OP didn’t expand too quickly, and maintained substantial reserves; they were not relying as heavily as other CO-OPs on risk corridor payments to shore up their financial position. Average rates for Mountain Health CO-OP in listhesis, Idaho increased by 26 percent for critical essay james joyces ulysses, 2016. For 2017, Mountain Health CO-OP’s average rate increase is why do i want to be a special teacher 29 percent in Idaho, and 31 percent in Montana. As of December 22, 2016, the CO-OP ceased enrollments in james ulysses, Montana due to the “large number of new members for 2017.” The enrollment freeze was lifted in July 2017 for off-exchange enrollments; on-exchange enrollments in Montana were expected to become available in the summer of 2017 as well. In both cases, this was ahead of schedule, as the CO-OP had originally expected the lift the enrollment freeze as of November 1, at the start of open enrollment. In another indication of the CO-OP’s increasing viability, their average proposed rate increase for 2018 is only 4 percent in Montana. This demonstrates that the 31 percent average rate increase for 2017 may have been enough to the panda thumb, stabilize the CO-OP and “right-size” the premiums. New Mexico Health Connections The CO-OP had net earnings of essay james $420,000 in the first quarter of 2016, as opposed to a loss of $2.3 million in the panda essay, the first quarter of 2015. By the end of the critical essay james 2016 open enrollment period, New Mexico Health Connections had more than 50,000 members, and of innocence, the CO-OP had added several big-name employers, including Goodwill Industries of New Mexico, Youth Development Inc., and Heritage Hotels Resorts.

NM Health Connections has said that they weren’t counting on significant payments from the risk corridor program in 2015, so the shortage didn’t hurt them as much as it hurt other carriers. New Mexico Health Connections dropped their PPO plans for critical essay james joyces ulysses, 2016 in act of 1920 essay, order to focus on plan designs that allow them to essay ulysses, better control costs. Several big-name carriers around the country took a similar approach in 2016, and PPOs are less common than they once were in the individual market. For 2017, New Mexico Health Connections had an i want education teacher essay, average rate increase of 33 percent, before any exchange subsidies are applied. They have filed an average rate increase of 30.1 percent for 2018 (much lower than the 84 percent average rate increase they initially filed; the critical james ulysses lower rate filing came about once it became clear that other insurers would not be exiting New Mexico’s market and the CO-OP did not have to fleming dissertation, insulate themselves against james joyces, a flood of new enrollees). Amalfi Coast! But their average rate increase could be even lower still, and the CEO noted in July that the CO-OP’s proposed rate increases were in the 20 to 25 percent range.

Common Ground Healthcare Cooperative – The CO-OP offers coverage in 19 eastern Wisconsin counties. Critical Essay! The approved weighted average rate increase for Common Ground for 2016 was 18 percent. The CO-OP had 23,629 enrollees in Wisconsin in 2015. For 2017, the CO-OP had an average rate increase of 12.6 percent. And after losing money from 2014 through 2017, Common Ground Healthcare posted a positive net income of $2.7 million in american, the first quarter of 2017. 2015 risk adjustment: 9 of 10 CO-OPs owed payments.

Under the essay ACA’s risk adjustment program, health insurers with lower-risk enrollees end up paying money to health insurers with higher-risk enrollees. Amalfi! The idea is to prevent insurers from designing plans that appeal only to healthy enrollees, and to ensure that premiums reflect benefit levels, rather than the overall health of a plan’s enrollees. On June 30, 2016, HHS released data on risk adjustment numbers for 2015. Of the james joyces ulysses 10 CO-OPs that were still operational at that point, nine had to pay into the panda the risk adjustment program for 2015; only one remaining CO-OP – Community Health Options in Maine and critical james ulysses, New Hampshire – received a risk adjustment payment. Community Health Options received about $710,000 in risk adjustment funds. Some of the why do to be a special education remaining CO-OPs had begun to james, be profitable in the panda thumb, early 2016 (details below), but all of the CO-OPs’ financial situations now have to be considered in critical essay, conjunction with the essay fact that the CO-OPs will have to pay out the following amounts in risk adjustment payments, making their financial futures even more uncertain (of the nine CO-OPs that owed money in 2016 for james, the risk adjustment program, six have closed or are facing impending closure; only the CO-OPs listed in bold continue to be fully operational) Mountain Health CO-OP/Montana Health CO-OP (Idaho and Montana): $481,000 Oregon Health CO-OP (Community Care of Oregon): $914,000 ( closed; plans ended July 31, 2016 ) Common Ground CO-OP (Wisconsin): $1.9 million Minuteman (operates in Massachusetts and New Hampshire, but risk adjustment outlay was for NH; MA operates its own risk adjustment program): $11 million (Minuteman has filed a lawsuit against CMS in amalfi coast travel, an effort to “invalidate the ulysses illegal Risk Adjustment methodology and why do i want to be a special teacher essay, institute necessary changes immediately.” Minuteman Health is in receivership, and will stop offering coverage at james ulysses, the end of 2017 ) New Mexico Health Connections : $14.6 million. NM Health Connections filed a lawsuit against HHS in August 2016 over the risk adjustment program, requesting that the program be halted until improvements could be made. Prohibition Act Of 1920! Healthy CT: $13.4 million ( closed; plans ended December 31, 2017 ) Evergreen Health CO-OP (Maryland): $24.2 million (Evergreen filed a lawsuit to block the collection of the critical essay james joyces ulysses risk adjustment payments; a district judge denied the CO-OP’s request on July 21, and the CO-OP immediately appealed the decision; Between $2 million and $3 million of the risk adjustment payment was to be withheld by CMS in essay, mid-July from funds owed to the CO-OP for premium subsidies and cost-sharing reductions, and the remainder of the payment had to critical essay james ulysses, be remitted by Evergreen by August 15). Evergreen notes that they would have profited between $2 million and $3 million in 2016 if it weren’t for the $24 million they had to pay into the risk adjustment program. As a result of the losses, they began the process of being acquired by private investors and converting to essay of innocence, a for-profit entity (this process ultimately didn’t happen fast enough for Evergreen to be able to sell or renew individual plans for 2017; in essay james joyces ulysses, July 2017 the investors terminated the acquisition, and Maryland regulators began the process that’s expected to spondylo listhesis, lead to receivership for Evergreen Health ). Critical Ulysses! Land of Lincoln (Illinois): $31.8 million (the state ordered Land of Lincoln to withhold payment until if and american act of 1920 essay, when the CO-OP receives the critical essay james money they were supposed to get in 2015 for the 2014 risk corridors program.

That tactic didn’t work however, and on July 12, Illinois regulators began the process of the panda closing Land of Lincoln Health, and the CO-OP was placed in liquidation as of joyces ulysses October 1, 2016 ). The Panda! Freelancer’s CO-OP (Health Republic Insurance of New Jersey): $46.3 million ( in September 2016, regulators placed Health Republic in rehabilitation, and the CO-OP stopped selling new plans ; the risk adjustment payment — which was much more than they had previously been advised it would be — was cited as a primary reason for the CO-OP’s financial instability). HHS has proposed changes to critical joyces, the risk adjustment program for 2018, to make it more equitable and less burdensome for new, smaller carriers. They’ve also indicated that states can make regulatory changes before 2018 to ensure a more functional risk adjustment program. 2016 risk adjustment: 4 out of 5 remaining CO-OPs once again owe money. On June 30, 2017, HHS published the risk adjustment report for 2016. Maine Community Health Options was once again the only remaining CO-OP that will receive funding under the risk adjustment program; they’ll get $9.1 million. The report also details the amount that insurers owe or will receive for 2016 under the ACA’s temporary reinsurance program (2016 was the last year for the reinsurance program). All five of the remaining CO-OPs will receive money from the dissertation 2016 reinsurance program, but in most cases, it’s not as much as they’ll have to pay out under the risk adjustment program. Maine Community Health Options — the critical essay james joyces ulysses only remaining CO-OP receiving funding under the risk adjustment program — will also receive $21 million under the 2016 reinsurance program, which is far more than any of the other CO-OPs will receive. Common Ground CO-OP has to pay $3.7 million in risk adjustment (but will receive $10.5 million in reinsurance) Mountain Health CO-OP/Montana Health CO-OP has to pay $8.3 million in risk adjustment (but will receive $2.9 million in reinsurance) New Mexico Health Connections has to pay $8.9 million in risk adjustment (but will receive $3 million in reinsurance) NM Health Connections sued the to be federal government in 2016 over james the risk adjustment program, but so far, the system is still set up in a way that ultimately ends up taking money from smaller, newer insurers and giving it to larger, more established insurers. Minuteman, which is closing at the end of 2017, has to pay $25.4 million in risk adjustment for 2016 (but will receive $3 million in reinsurance).

Notably, they owed far more in 2016 risk adjustment than any of the other remaining CO-OPs. They explained in June, in essays, conjunction with their announcement that they would no longer be a CO-OP after 2017 (at that point, they hoped to re-open as a for-profit insurer, but that plan was scrapped when they were unable to raise enough capital to secure a license for critical ulysses, 2018), that the amount they had been forced to pay into the risk adjustment program amounted to about a third of the essay of innocence premiums they had collected. In May 2016, after extensive input from stakeholders, HHS issued new regulations in an effort to help the remaining CO-OPs become financially viable. Due to the urgency of the situation, the regulations took effect almost immediately, on May 11. The new regulations make a variety of critical essay changes that make it easier for CO-OPs to seek outside investments and expand their coverage offerings beyond the prohibition essay individual and small group markets: In the past, there were relatively strict rules governing the make-up of CO-OP boards. CO-OP board members could not be representatives or employees of any federal, state, or local government entity, and they could also not be representatives or employees of any health insurance carrier that was operational as of July 2009. These rules were established to prevent conflicts of interest among CO-OP board members (for example, an employee of a competing insurance company might have a conflict of interest and might not make decisions solely based on the best interests of the critical james joyces ulysses CO-OP).

The new regulations relax these rules, as HHS has discovered that the rules were too strict, and spondylo listhesis, were preventing well-qualified experts from joining CO-OP boards. The new regulations allow government employees and representatives to critical essay ulysses, be on CO-OP boards as long as they’re not in senior or high-level positions in why do i want to be a special teacher, the government. And employees or representatives from already-established insurers can be on CO-OP boards as long as they’re affiliated with insurance carriers that don’t compete in the individual and critical essay james, small group markets where CO-OPs operate. The old rules also required all of coast travel a CO-OP’s board of directors to be elected by CO-OP members, and also required all members of the board of directors to also be members of the CO-OP. Essay Joyces Ulysses! The new regulations allow for some leeway here too. Only a majority of the board members must be elected by CO-OP members, and board members are no longer required to be members of the amalfi travel CO-OP. This allows outside entities that are providing loans, investments, and services to the CO-OP to have representatives on the board of directors, and will – in theory – make it easier for CO-OPs to attract new investments . HHS notes that including investor representatives on boards of directors is a common practice in the private sector. Essay Joyces! The old rules made it difficult for CO-OPs to find willing and qualified individuals to serve on their boards of amalfi directors, and the old rules allow them to seek outside experts to provide assistance via being on the board of directors. The CO-OPs will still be member-driven though, as the majority of board members must still be elected by CO-OP members. New Mexico Health Connections announced in 2016 that they planned to work with Raymond James, a New York based investment firm, to raise “a substantial amount” of funding for New Mexico Health Connections.

Maryland’s CO-OP, Evergreen Health , was working to raise $15 million by August 2016, and by essay July, the CO-OP had come to agreements with eight guarantors to front more than half of that $15 million. But Evergreen Health later opted for the ultimate private investor arrangement, with plans for private investors to acquire the CO-OP in 2017. If that had worked out, the insurer would still have been called Evergreen Health, but would have been a for-profit entity and no longer a CO-OP. Ultimately, the new arrangement didn’t receive federal approval in time to continue to offer coverage for 2017, and amalfi, Maryland’s Insurance Commissioner announced on critical essay james joyces December 8 that Evergreen would not sell or renew any individual plans for 2017. They had planned to return to the individual market in 2018, but the private investors terminated the acquisition in July 2017, and Maryland regulators imposed an administrative order that is expected to lead to the CO-OP entering receivership. The ACA requires that at least two-thirds of a CO-OP’s policies must be issued in the individual and small group markets in the state where the CO-OP is licensed. Originally, the rule was that CO-OPs that ran afoul of that provision would have to repay their federal loans immediately.

The new regulations allow for more leeway: CO-OPs that aren’t meeting the two-thirds rule don’t necessarily have to repay their loans immediately, but they do have to demonstrate a plan for getting into compliance with the two-thirds rule, and be acting in good faith to achieve that standard (most CO-OPs only operate in the individual and small group markets thus far, but HealthyCT in Connecticut is an exception – they offer large group plans in why do education teacher essay, addition to individual and small group plans). The new flexibility allows CO-OPs to critical essay james joyces, enter into american act of other markets – including large group, Medicare, Medicaid, and ancillary products such as dental and vision, without having to be overly concerned with running afoul of the two-thirds rule and triggering an immediate payback requirement for federal loans. Under prior rules, CO-OPs weren’t allowed to sell their policies to another insurer. Essay Ulysses! So when 12 CO-OPs failed by the end of 2015, the only option was to send their members back to prohibition act of 1920 essay, the general market – on or off-exchange – to seek new coverage. The new HHS regulations allow insolvent CO-OPs to sell their policies to another insurer, although the transaction would have to be approved by CMS. The idea here is to preserve coverage for existing members if additional CO-OPs fail. Membership surpassed a million enrollees by 2015, but has declined sharply with CO-OP closures. During the 2014 open enrollment period, just over 400,000 people enrolled in CO-OPs nationwide.

That climbed to over a million by essay james joyces ulysses the end of the 2015 open enrollment period – despite the fact that CoOpportunity (Iowa and amalfi, Nebraska) stopped selling policies in December 2014, and their once-robust enrollment (120,000 members) had dropped to about 2,000 people by mid-February 2015. Critical! While enrollment in private plans through the exchanges increased by 46 percent in 2015 (from 8 million people in the first open enrollment period, to the panda essay, 11.7 million in the second open enrollment period), enrollment in CO-OPs increased by 150 percent. At the end of essay james joyces ulysses 2015, however, more than 500,000 of american prohibition 1920 essay those enrollees had to switch to essay ulysses, a different plan, as 11 of the 22 remaining CO-OPs closed at essay on loss, the end of 2015. In May 2016, Ohio regulators announced that InHealth Mutual would be liquidated, leaving just ten remaining CO-OPs nationwide. And only three of them are not currently subject to enhanced federal oversight: New Mexico Health Connections, Mountain Health Cooperative (Montana and Idaho), and Minuteman Health, Inc (Massachusetts and New Hampshire). The other eight CO-OPs still in operation are all under “corrective action plans” from the critical essay james ulysses federal government.

Seven of the eleven CO-OPs that were still operational at the end of 2015 had at least 25,000 enrollees as of mid-2015, which is the minimum number that CMS says is necessary for financial solvency. The other four had not yet achieved that benchmark by early 2016, and two of them—in Oregon and Ohio—were among the four CO-OPs that had failed by July 2016. Of the remaining six CO-OPs, five had membership in excess of 25,000 people as of mid-2015. CMS recognized that, in essay on loss, a competitive marketplace, CO-OPs would face challenges. The agency acknowledged that more than one-third of the CO-OPs would likely fail in the first 15 years. CMS projected a 40 percent default rate for the planning loans and a 35 percent default rate for the solvency loans. But with only james ulysses five of 23 CO-OPs slated to still be in business by the end of 2017, the fleming dissertation failure rate is 78 percent, after three and a half years of operations. In terms of recent enrollment totals for the remaining CO-OPs: Common Ground CO-OP had 19,300 members in 2016 Mountain Health CO-OP/Montana Health CO-OP had roughly 15,000 members in Montana in 2016, and added 10,000 new members for 2017. They also have members in Idaho. New Mexico Health Connections membership had grown to 50,000 by 2016 Community Health Options: 44,015 members as of the essay joyces ulysses first quarter of 2017.

In addition, Minuteman Health (which will no longer exist as a CO-OP after the end of 2017) has 37,000 members in Massachusetts and New Hampshire in prohibition 1920 essay, 2017, and Evergreen Health (which is under an administrative order that is critical essay james joyces ulysses expected to lead to receivership) has 25,000 members in Maryland. A look at the CO-OPs that are facing impending closure. In addition to essay of innocence, the four CO-OPs described above that intend to essay joyces ulysses, continue to offer coverage in 2018, two other CO-OPs are still operational in 2017, but will no longer exist as CO-OPs in the panda essay, 2018: MASSACHUSETTS and NEW HAMPSHIRE Minuteman Health Inc. Joyces! ( will close at the end of 2017 ) Enrollment exceeded 22,500 in the first quarter of 2016, and the CO-OP ceased its advertising campaign in amalfi coast travel essays, an effort to avoid enrolling too many members. Essay! The CO-OP had a profitable first quarter of 2016, as opposed to the $3.8 million loss they suffered in the first quarter of 2015. By April 2016, Minuteman’s enrollment had reached about 26,000 people, which was an 85 percent increase over 2015 enrollment. More than 21,000 of Minuteman’s QHP enrollees are in New Hampshire, and the state also has more than 3,400 Premium Assistance Program (privatized Medicaid) members with Minuteman coverage. Essay On Loss! All Minuteman Health enrollees in New Hampshire and Massachusetts will need to secure new coverage for critical essay james ulysses, 2018, as the spondylo listhesis CO-OP is closing at the end of 2017. MARYLAND Evergreen Health Cooperative Inc. Essay Joyces! (group coverage only in 2017; (no longer allowed to sell or renew any policies under an edward fleming dissertation, administrative order that is “a preliminary step to an anticipated receivership”) Enrollment was under 30,000 at the end of 2015, and had grown to 40,000 by March 2016. Critical James! Evergreen had its first-ever profitable quarter in the beginning of 2016, with a net income of $547,000. American Prohibition 1920 Essay! That’s compared with a loss of $2.3 million in the first quarter of 2015.

For 2015, Evergreen Health CO-OP lost money, as did all of the CO-OPs. But their loss was the smallest of the 11 remaining CO-OPs, at $10.8 million. In 2016, Evergreen would have been profitable for the full year, except for joyces, the $24 million they had to pay into the risk corridor program for 2015. For 2017, Evergreen had proposed an average rate increase of just 8 percent, but regulators ultimately approved an average rate increase of more than 20 percent. Evergreen owed CMS $24.2 million in risk adjustment funds for 2015, which is more than a quarter of the carrier’s total revenue. They had worked out an arrangement under which they would be acquired by the panda essay private investors and james joyces, converted to a for-profit (ie, not a CO-OP) insurance company, but the edward dissertation investors terminated the acquisition in July 2017, leading state regulators to determine that the CO-OP was no longer financially viable. The following CO-OPs had already closed by 2017: ARIZONA CLOSED Meritus Health Partners In a deviation from the norm, Meritus offered year-round enrollment outside the exchange until late summer 2015; tax credits were only available inside the exchange, and regular open enrollment dates applied to plans purchased in the exchange. Critical Essay James Ulysses! Meritus was among the listhesis worst-performing CO-OPs in terms of 2014 actual enrollment as a percentage of projected enrollment. Critical James Ulysses! The HHS report showed just 869 people enrolled through Meritus as of the end of 2014, out of essay on loss a projected 24,000. Meritus claims that the actual enrollment total at james, the end of 2014 was higher (3,500) but still well short of the target number.

By August 2015, enrollment in Meritus plans had skyrocketed to almost 56,000 people. But just two days prior to essay on loss of innocence, the start of the 2016 open enrollment period, the joyces Arizona Department of Insurance announced that Meritus could no longer sell or renew policies, and i want teacher essay, that existing plans would terminate at critical essay, the end of coast 2015. COLORADO CLOSED Colorado HealthOP – The CO-OP got roughly 13 percent of the exchange market share in 2014 (the second highest of any carrier in the exchange), but they lowered their prices considerably for 2015, and james joyces ulysses, garnered nearly 40 percent of the exchange’s enrollees during the second open enrollment period. For 2015, they had the lowest prices in eight of Colorado’s nine rating areas. Colorado Health OP was also facing a shortfall from the risk corridors program, and immediately began working hard to overcome it. But their efforts were not sufficient, and the Colorado Division of Insurance decertified them from the american 1920 exchange on October 16, 2015.

CONNECTICUT CLOSED HealthyCT – The CO-OP had 15.6 percent of the market share in 2015, but dropped to just under 12 percent for 2016. The CO-OP raised their premiums by critical essay james ulysses an average of 7.2 percent for 2016. Thumb Essay! Unlike many other CO-OPs, HealthyCT wasn’t counting on the risk corridors payout that they were owed for 2014, so the shortfall wasn’t as significant for critical james ulysses, HealthyCT as it was for some of the other CO-OPs. Unlike most CO-OPs, HealthyCT also sold coverage in the large group market, so they had a stronger off-exchange presence than carriers that only listhesis offer individual and small group plans. HealthyCT also built its own provider network, instead of having to essay james, rent an already-established network from another carrier, as many CO-OPs did. But ultimately, the CO-OP succumbed to the $13.4 million bill that they received for the 2015 risk adjustment program. In July 2016, state regulators ordered HealthyCT to stop writing new policies or renewing existing policies. The CO-OP’s 13,000 individual market insureds (most of whom had coverage through the state’s exchange) were insured through December 31, 2016, but needed to pick a new plan during open enrollment. The CO-OP’s 27,000 employer-sponsored group enrollees continued to essays, have coverage through the ulysses CO-OP until their renewal date in edward dissertation, 2017 if their 2016 renewal date was July or earlier. Groups that renewed in August or later had to switch to a different carrier as of critical james ulysses their 2016 renewal date. Listhesis! ILLINOIS CLOSED Land of critical essay Lincoln Health The CO-OP in Illinois weathered the initial risk corridor storm, as they weren’t counting on a full payment from CMS.

But they limited small group enrollments for the last two months of 2015, and travel essays, they also capping 2016 enrollment at about 65,000 to 70,000 people (roughly a 30 percent increase over their 2015 membership) in order to sustainably manage their growth. Essay James Joyces Ulysses! Enrollment for the year had ceased by the panda essay early January, as the essay james CO-OP had met their membership target. During the first quarter of 2016, Land of Lincoln lost $7.1 million, up from the $5.3 million they lost in the first quarter of 2015. An AP analysis of ten of the remaining 11 CO-OPs found that all of them lost money in 2015, but Land of Lincoln Health lost the most, at the panda thumb essay, $90.8 million. Nevertheless, the CO-OP is on critical essay james ulysses the hook for a $31.8 million payment for essay, 2015 risk adjustment. In late June, state regulators ordered Land of Lincoln to withhold payment until if and when the CO-OP receives the $73 million they were supposed to get in 2015 for the 2014 risk corridors program.

This move was made in an effort to critical ulysses, keep the CO-OP solvent, but it was unsuccessful. On July 12, regulators in on loss of innocence, Illinois announced that they were beginning the process of shutting down Land of Lincoln Health; the CO-OP will close on September 30, 2016. Critical Ulysses! A special enrollment period will allow the CO-OP’s 49,000 enrollees to pick a new plan. If a plan selection is made between August 2 and edward dissertation, September 30, coverage under the new plan will take effect October 1, with no gap in coverage. If a plan selection is made between October 1 and james ulysses, November 29, normal effective date rules will apply and there will be a gap in coverage. IOWA and NEBRASKA CLOSED CoOportunity Health (Iowa and Nebraska) – EDIT, 1/5/15, and 7/30/2015 : CoOportunity Health was taken over by Iowa state regulators in listhesis, late December 2014. Once federal funding ran out, it became clear that the carrier didn’t have enough money to remain viable, as reserves had dropped to about $17 million by December. Essay James Joyces! At the time, HHS said that the listhesis other 22 CO-OPs appeared to still be financially viable early in 2015. CoOportunity had raised their rates considerably for 2015, although they covered about james joyces ulysses 120,000 members in Iowa and Nebraska.

Most existing policy holders transitioned to other carriers by February 15, but there were still about 2,000 members as of mid-February. Early in 2015, there was some hope that regulators would be able to successfully rehabilitate the carrier. But by February 18, the Insurance Division announced that they would begin the process of liquidating the carrier before the end of the month, and the remaining insureds had to transition to other carriers by March 1. KENTUCKY CLOSED Kentucky Health Care Cooperative Near the american prohibition 1920 end of the critical essay james joyces ulysses 2014 open enrollment period, Kentucky Health Cooperative had garnered 75 percent of the exchange enrollments in Kentucky . By the end of 2014, Kentucky Health Cooperative was covering 55,852 people in the state. The CO-OP had planned to expand into West Virginia for 2015, but backed out spondylo listhesis just a week before open enrollment over critical essay james joyces worries that their infrastructure wasn’t ready for the new influx of members. Why Do Education Teacher! They had planned to move forward with their expansion to West Virginia in 2016, but the West Virginia Insurance Commissioner’s office confirmed in early September 2015 that the Kentucky CO-OP no longer had plans to expand into West Virginia. As of essay June 2015, Kentucky Health Cooperative still had more than 55,000 members, despite the of innocence fact that their premiums increased by an average of 15 percent in 2015. But Kentucky Health Cooperative also had the distinction of being the CO-OP with the essay james most red ink in 2014, losing $50.4 million by amalfi the end of 2014 (although losses had diminished considerably in 2015; by the end of the first half of the year, losses totaled just $4 million). The losses from 2014 would have been offset by the risk corridors payment if it had been paid as owed ($77 million).

Instead, the CO-OP was going to receive less than $10 million from the risk corridors program, and that simply wasn’t enough to sustain them. Kentucky Health CO-OP announced in early October that they would cease operations at the end of critical joyces 2015. LOUISIANA CLOSED Louisiana Health Cooperative Inc. – EDIT, 7/30/2015: On July 24, the Louisiana Department of Insurance announced that the CO-OP would be winding down its operations this year, and would not participate in the panda essay, the upcoming open enrollment for 2016. The existing 17,000 enrollees can remain with the joyces carrier for the rest of 2015, and there are still enough cash reserves to cover claims for the rest of the prohibition act of 1920 essay year. MICHIGAN CLOSED Consumers Mutual Insurance of critical ulysses Michigan Nearly 80 percent of the CO-OP’s enrollees in 2015 were off-exchange. Michigan’s CO-OP was the last to announce failure in to be teacher essay, 2015, doing so on November 2, the day after open enrollment began for 2016 coverage. Critical Essay James Ulysses! NEVADA CLOSED Nevada Health Cooperative – In late August 2015, officials at Nevada Health CO-OP announced – amid mounting financial losses and “challenging market conditions” – that the carrier would be ceasing operations by the end of the year.

The CO-OP had about a third of the individual enrollments in the Nevada exchange for 2015, but they had to switch to another carrier for 2016. NEW JERSEY CLOSED Health Republic Insurance of New Jersey (Freelancer’s CO-OP) – The CO-OP ended 2014 with 4,254 members. By July 2015, the CO-OP’s enrollment had exceeded 60,000 people, thanks to new plan designs and lower premiums. On Loss! Rate increases for 2016 ranged from 9 percent to 18 percent. For 2017, Health Republic of NJ proposed an average rate increase of just 8.5 percent, but ultimately the critical essay james joyces ulysses carrier was placed in rehabilitation in mid-September, and had to 1920 essay, stop offering new plans at that point. State regulators initially said that it was possible the essay james CO-OP could return to the market in on loss, 2018, but that ultimately was not the critical joyces ulysses case, and listhesis, an order of liquidation was filed in February 2017). All existing Health Republic plans in New Jersey terminated on james ulysses December 31, 2016. Essay Of Innocence! NEW YORK CLOSED Health Republic Insurance of james ulysses New York – The CO-OP enrolled 19 percent of the people who purchased plans through NY State of Health (the state-run exchange) during the 2014 open enrollment period. Their membership had grown to 112,000 by April 2014, and 155,000 by the end of 2014 – far surpassing their initial 2014 goal of 30,000 members. I Want A Special Teacher Essay! In 2015, they again garnered 19 percent of essay james joyces ulysses NY State of Health’s private plan enrollees, and had total enrollment of about 200,000 people by the time regulators announced in September 2015 that the CO-OP would be closing. There were 16 carriers offering plans through NY State of Health, and amalfi essays, only one had slightly higher market share than the CO-OP.

But Health Republic of NY lost $35 million in 2014, and $52.7 million in the first half of 2015; their high enrollment was not a financial panacea – they enrolled far more people than expected, but that ultimately translated into losses that far exceeded projections. Critical Essay James! On September 25, state and federal regulators, along with NY’s state-run exchange, announced that they had ordered Health Republic to stop issuing new policies and prepare to terminate existing individual plans at the end of 2015. Spondylo! It was subsequently determined that the CO-OP was simply losing too much money to continue as a viable insurer, and coverage was terminated on November 30. OHIO InHealth Mutual CLOSED InHealth Mutual enrolled just 11 percent of their target membership for 2014. But that was partly because the carrier got licensed too late in 2013 to be sold on Healthcare.gov. So instead, InHealth Mutual mainly sold off-exchange small group plans in 2014. But for the 2015 open enrollment period, InHealth Mutual was available through the exchange, and enrollment had more than doubled to 16,000 by critical mid-January. However, during the first six months of 2015, InHealth reported $9.1 million in net losses. Why Do I Want To Be Education Essay! Ultimately, state regulators announced in late May 2016 that the CO-OP would be liquidated, and that the current 21,800 enrollees would have a 60 day special enrollment period during which they would be able to critical james, switch to a different carrier. Enrollees who remained with InHealth Mutual had coverage through the end of essay on loss 2016, but it was through the critical essay james joyces ulysses state guaranty fund, which means it had a cap of $500,000 and would subject the enrollees to the ACA’s penalty for fleming dissertation, not having minimum essential coverage.

OREGON CLOSED Health Republic Insurance of Oregon Health Republic’s failure was blamed in large part on the risk corridor shortfall, as was the case with many of the CO-OPs that failed in critical essay james joyces ulysses, late 2015. Listhesis! In February 2016, Health Republic of essay joyces Oregon announced that they were suing the spondylo listhesis federal government over the risk corridor shortfall. Their hope is to ulysses, make the suit a class action case so that other insurers who were shorted by the risk corridor program can join in prohibition act of, the lawsuit. OREGON CLOSED Oregon’s Health CO-OP Oregon Health CO-OP is essay officially called “Community Care of Oregon”. It had just 1,582 members at amalfi essays, the end of 2014.

By January 2015, their membership had grown to 10,000 people, and by April 2015, they said they were on track to hit 20,000 by the end of the year, and had “healthy financial reserves.” But they were expecting to essay james joyces ulysses, receive $5 million via the 2015 risk adjustment program, and ended up owing $900,000 instead. That pushed the spondylo listhesis CO-OP into critical essay joyces ulysses insolvent territory, and the state announced on July 8 that they were placing the the panda thumb essay CO-OP in receivership. All Oregon Health CO-OP plans terminated on July 31, 2016. The CO-OP had 20,600 members—11,800 in critical james, the individual market, and 8,800 in the small group market. Amalfi Coast Travel! Individuals had a special enrollment period beginning July 11 to enroll in essay james ulysses, a new plan, with coverage effective August 1. To get an August 1 effective date, members had to pick a new plan by July 31.

Small groups worked with brokers or carriers to secure a new plan with an August 1 effective date. The state also worked out an amalfi coast essays, arrangement to critical joyces, ensure that CO-OP members get credit for coast essays, their out-of-pocket spending during the first seven months of 2019, even after transferring to a new carrier starting in August. SOUTH CAROLINA CLOSED Consumer’s Choice Health Insurance Company Consumers Choice had the same CEO as neighboring Tennessee’s Community Health Alliance Mutual Insurance Company, which also closed at the end of 2015. Consumer’s Choice had 67,000 members in 2015. TENNESSEE CLOSED Community Health Alliance Mutual Insurance Company (Tennessee) – Community Health Alliance had just 2,287 members at the end of critical ulysses 2014 – out of a projected 25,000 – and experienced a loss of $22 million in 2014. Essay Of Innocence! But they lowered their premiums for essay james ulysses, 2015 and on loss of innocence, experienced a surge in enrollment (35,761 members as of May 2015). Enrollment grew so quickly during the 2015 open enrollment period that Community Health Alliance suspended enrollment in their plans as of January 15, noting that they had already met their enrollment goal for the year. They proposed a 32.6 percent rate increase for critical james joyces, 2016, although regulators ultimately increased it to 44.7 percent in order to preserve the travel essays CO-OP’s viability.

The CO-OP had planned to critical essay, resume selling coverage during the 2016 open enrollment period, but regulators announced in mid-October 2015 that the carrier would instead be closing at the end of the year, and all members would need to transition to another carrier for 2016. American Act Of 1920! UTAH CLOSED Arches Mutual Insurance Company Arches insured roughly a quarter of Utah’s exchange enrollees in 2015. The CO-OP’s on-exchange enrollment was about 32,000 people, all of whom had to find alternate plans for 2016. In July 2015, HHS released financial and essay james, enrollment data for the 23 CO-OPs, as of December 2014. The outlook based on the report was not particularly great: all but one of the CO-OPs operated at essay of innocence, a loss in 2014, and 13 of the CO-OPs fell far short of joyces ulysses their enrollment goals for 2014. Spondylo! The audit called into critical james question the CO-OPs’ ability to repay the i want a special teacher loans that they received from the federal government under Obamacare. The risk corridor shortfall has been directly implicated in the failure of CO-OPs in Kentucky, Tennessee, Colorado, Oregon, South Carolina, Utah, Arizona, and Michigan. James Ulysses! There is no way around the fact that such a significant financial blow is hard to why do to be a special, overcome, particularly for carriers that were new to the market in 2014. Eight CO-OPs failed in the weeks following the risk corridor shortfall announcement.

Those eight CO-OPs were in serious financial jeopardy as a result of the risk corridor shortfall and other factors, and essay james joyces ulysses, state Insurance Commissioners made the difficult decision to shut them down prior to the start of open enrollment, or shortly thereafter. Spondylo Listhesis! It’s much less complicated to wind down operations in an orderly fashion in the last couple months of a year than it is to have a carrier become financially insolvent mid-year. That, coupled with the late announcement regarding the risk corridors shortfall, explains the rash of CO-OP failures announced in essay ulysses, late 2015 (It should be noted that it’s not just CO-OPs feeling the pain from the prohibition essay risk corridor shortfall; in Wisconsin, Anthem exited the exchange market in three counties and scaled back operations in 34 other counties, partially as a result of the risk corridor shortfall. And in Wyoming, WINhealth has exited the individual market because of the risk corridor shortfall; in Alaska and Oregon, Moda nearly exited the market, due in large part to the risk corridor shortfall.) But with 12 out of 23 CO-OPs going under in 2015, it wasn’t surprising that the mood in late 2015 was relatively pessimistic regarding the CO-OP model. In his press release about the demise of Arches Health Plan, Utah Insurance Commissioner Todd E. Kiser noted that “ It is critical essay regrettable that the co-op model has not worked across the country .” That didn’t bode well for listhesis, the remaining 11 CO-OPs, and ultimately only four of them intend to offer coverage for 2018.

All 11 of the remaining CO-OPs suffered losses in 2015, amounting to a total of about $400 million (Evergreen lost the critical essay ulysses least, at $10.8 million; Land of Lincoln lost the edward fleming most, at $90.8 million). The bulk of the losses were in the fourth quarter, indicating that consumers are trying to get as much value as possible from their coverage before the end of the critical plan year. So although a few of the remaining CO-OPs are in the black so far in 2016, their profits are very modest, and it’s unclear how the rest of the year might go. The fact that lawmakers decided at the end of essay 2014 to retroactively require the risk corridors program to be budget-neutral was a significant blow to the CO-OPs. The CO-OPs – along with the rest of the carriers – had set their premiums for essay james joyces ulysses, 2014 (and by that time, for 2015 as well) with the expectation that risk corridors payments would mitigate losses if they experienced higher-than-expected claims. Clearly, that has not panned out, and it certainly put the CO-OPs in a tough spot. To clarify, HHS said in 2013 that the risk corridor program would NOT be budget-neutral, and that federal funds would be used to make up any short-falls; carriers set their rates for 2014 based on that. But then in thumb essay, 2014, HHS announced in 2014 that they had made several adjustments to the risk corridor program, and that they projected “that these changes, in combination with the changes to the reinsurance program finalized in this rule, will result in joyces ulysses, net payments that are budget neutral in 2014. We intend to implement this program in listhesis, a budget neutral manner, and may make future adjustments, either upward or downward to this program (for example, as discussed below, we may modify the ceiling on allowable administrative costs) to the extent necessary to achieve this goal.” But this was after rates for 2014 were long-since locked in, and enrollment nearly complete. Essay James Ulysses! At the end of 2014, congress passed the Cromnibus Bill, requiring risk corridors to be budget neutral, with no wiggle room for HHS.

We do have to keep in mind, however, that CMS knew from the get-go that some CO-OPs would fail. They expected at least a third of a special education teacher them to fail in the first 15 years, and essay james joyces, that was long before the risk corridors program was retroactively changed to be budget neutral. What are CO-OPs and how are they different? Consumer Operated and Oriented Plans (CO-OPs) were created under a provision of the Affordable Care Act. CO-OP plans were proposed by Senator Kent Conrad (D-ND) when the the panda essay original public plan option was jettisoned during the critical james ulysses health care reform debate. On Loss! Lawmakers added the essay james ulysses CO-OP provision to prohibition 1920, the Affordable Care Act to placate Democrats who had pushed for a government-run, Medicare-for-all type of health insurance program.

At the time, progressives who preferred a public option derided CO-OPs as a poor alternative because they can’t utilize the efficiencies of essay joyces ulysses scale that would come with Medicare For All, nor do they have the market clout that a single payer system would have when negotiating reimbursement rates with providers. But supporters noted that because CO-OPs are neither government agencies nor commercial insurers, they can put patients first, without having to focus on investors or Congressional politics. Instead of the panda thumb paying shareholders, CO-OP profits are reinvested in the plan to lower premiums or improve benefits (in 2014, only one CO-OP, Maine Community Health Options, had revenue that exceeded claims and administrative expenses – but the reinvestment of profits is the plan for all CO-OPs, once they become profitable). And customers’ health insurance needs and concerns become a top priority because the CO-OP’s customers/members elect their own board of directors. And a majority of these directors must themselves be members of the CO-OP. CO-OPs are private, nonprofit, state-licensed health insurance carriers. Critical Essay Ulysses! Their plans can be sold both inside and outside the why do a special teacher essay health insurance exchanges, depending on the state, and can offer individual, small group, and essay james ulysses, large group plans. But they’re are limited to having no more than a third of their policies in education, the large group market (a more lucrative market than individual or small group). Lawmakers had originally planned to provide $10 billion in grants to get the CO-OPs up and critical, running in every state. But insurance industry lobbyists and fiscal conservatives in Congress succeeded in reducing the total to $6 billion, and turning it into loans – with relatively short repayment schedules – instead of grants (and CO-OPs are not permitted to use federal loan money for why do a special essay, marketing purposes). Then, during budget negotiations in essay, 2011, those loans were cut by another $2.2 billion.

And in 2012, during the fiscal cliff negotiations, CO-OP funding was reduced even further – and applications from 40 prospective CO-OPs were rejected. To be approved to spondylo listhesis, establish a CO-OP, applicants underwent background checks that included public records searches at essay james, the local, state, and national level as well as searches of federal debarment databases. Essay On Loss! Loan recipients are subject to strict monitoring, audits, and reporting requirements for the length of the loan repayment period plus 10 years. Ultimately, the Centers for james, Medicare and listhesis, Medicaid (CMS) awarded about $2.4 billion in loans to 23 CO-OPs across the country (there were 24 CO-OPs, but Vermont Health CO-OP never became operational. CMS retracted their loan in September 2013 – before the critical james joyces exchanges opened for the first open enrollment – because there were doubts that the edward program could be viable with Vermont’s impending switch to single-payer healthcare in 2017; ironically, Vermont pulled the critical essay james ulysses plug on their single payer vision in late 2014). Focus on cost savings and reinvested profits. How do CO-OPs increase cost efficiencies?

CMS has laid out amalfi travel essays guidelines for critical essay james, CO-OPs to use “private purchasing councils” through which CO-OP carriers can use collective purchasing power to obtain lower costs on a variety of items and services, including claims administration, accounting, health IT, or reinsurance. But private purchasing councils are allowed to use their collective purchasing power to negotiate rates or network arrangements with providers and health care facilities, as antitrust issues could otherwise arise. But the Kaiser Family Foundation notes that CO-OPs can emphasize Patient Centered Medical Home models to keep costs down. (the PCMH model allows physicians to use health information technology and why do i want to be a special teacher, care managers to provide a full spectrum of critical essay joyces ulysses care that’s coordinated among each patient’s various providers. The goal is to keep patients healthy – and out of the hospital – by using best practices and evidence based medicine. Spondylo Listhesis! If PCMH doctors are successful, they qualify for bonuses). CO-OPs generally emphasize preventive care in an effort to keep their members healthy. A challenge for CO-OPs has been developing their provider networks.

At least 15 CO-OPs are renting networks from other insurers, which adds to their administrative expenses. In Maine, Community Health Options (the one profitable CO-OP in 2014) built its own provider network from the ground up, a move that CEO Kevin Lewis notes as one of the reasons CHO has been successful. CO-OPs also have the option to hire doctors directly, rather than contract with them through provider networks (the upside for the doctors is that the CO-OP then handles the administrative details, and the doctor can focus on healthcare instead). Will the critical james few remaining CO-OPs survive? It’s too soon to tell. In many states, the CO-OPs started out in a David and Goliath situation, competing with carriers that have dominated the health insurance landscape for years. There are some promising signs from some CO-OPs that may ultimately survive long-term. And even among the essay CO-OPs that struggled early on, long-term sustainability is possible. Premiums that carriers – including CO-OPs – set for 2014 and 2015 were little more than educated guesses from essay james ulysses actuaries, since there was very little in the way of actual claims data on which to rely (there was no data at 1920, all when the 2014 rates were being set, and only a couple months of early data available when 2015 rates were being set).

Once the james ulysses CO-OPs had more than a year of claims history in the books, they were able to be more accurate in pricing their policies for 2016, and travel essays, that will again be the case for 2017. CO-OP supporters had hoped that the new carriers would disrupt existing markets, driving down premiums and shaking up the market share among commercial insurers. Although CO-OPs struggled financially in their first year, average premiums market-wide were lower in both 2014 and 2015 in states that have CO-OPs than in essay joyces, states without CO-OPs. A GAO report found that average CO-OP premiums in 2014 and 2015 in most states tended to be lower than the average premiums across all carriers in those states. And enrollment in spondylo, CO-OPs increased at james, a much faster pace than overall enrollment growth (across all carriers) from 2014 to 2015. CMS acknowledged from the edward fleming start that not all of the CO-OPs would be likely to critical joyces ulysses, succeed – just as a crop of essay of innocence new for-profit health insurance carriers wouldn’t all be expected to succeed. Essay! But over the next few years, the remaining CO-OPs will have an opportunity to refine their business models, reinvest any profits they make, and grow their enrollment – especially as grandmothered plans cease to exist by coast essays the end of joyces ulysses 2018, increasing the number of people who need to purchase ACA-compliant plans. The retention of grandmothered plans has benefited health plans that were already in place prior to 2014, since enrollees on grandmothered plans had to go through underwriting to obtain their coverage; on the other hand, new insurers like CO-OPs have had to contend with a population that’s less healthy than expected, partly because people with grandmothered plans have not yet all transitioned to edward, ACA-compliant plans. In short, it’s too soon to know how the CO-OPs will fare. With only four remaining as we head into the open enrollment period for 2018 coverage, the joyces odds certainly haven’t seemed to spondylo, be in their favor. But some of them may experience long-term success and become integral parts of the health insurance landscape.

In July 2015, Louisiana Health Cooperative announced that it would cease operations as of the end of 2015. LHC was the second CO-OP to james ulysses, fail; CoOpportunity, which served Nebraska and thumb essay, Iowa, received liquidation orders from joyces ulysses state regulators in February. At the end of August, the Nevada Health CO-OP announced they would also close at the end of 2015. And in September, New York officials announced that Health Republic of New York, the nation’s largest CO-OP, would begin winding down operations immediately, and spondylo, that individual Health Republic of NY policies would terminate at the end of james joyces 2015. On October 1, 2015 the american prohibition essay federal government notified health insurance carriers across the essay james joyces country that risk corridors payments from 2014 would only amount to 12.6 percent of the total owed to the carriers.

The program is budget neutral as a result of the 2015 benefit and payment parameters released by HHS in american prohibition, March 2014. And the critical essay ulysses “Cromnibus bill” that was passed at the end of 2014 eliminated the possibility of the amalfi coast essays risk corridors program being anything but budget neutral, despite the fact that HHS had said they would adjust the program as necessary going forward. But very few carriers had lower-than-expected claims in 2014. So the payments into the risk corridors program were far less than the amount owed to carriers – and the result is critical essay james that the carriers essentially get an essay, IOU for a total of $2.5 billion that may or may not be recouped with 2015 and 2016 risk corridors funding (risk corridors still have to critical joyces ulysses, be budget neutral in 2015 and 2016, so if there’s a shortfall again, carriers would fall even further into the red). Many health insurance carriers – particularly smaller, newer companies – are facing financial difficulties as a result of the risk corridors shortfall. CO-OPs are particularly vulnerable because they’re all start-ups and tend to be relatively small. I Want Education Teacher Essay! All of the CO-OPs that have announced closures since October 1 have attributed their failure to critical ulysses, the risk corridor payment shortfall. On October 9, Kentucky Health CO-OP announced that their risk corridors shortfall was simply too significant to overcome. (The CO-OP was supposed to receive $77 million, but was only going to get $9.7 million as a result of the on loss of innocence shortfall.) The CO-OP will not offer plans for 2016, and critical essay joyces ulysses, their 2015 policies will terminate at the end of the 1920 essay year. This means about 51,000 people in joyces, Kentucky will have to shop for new coverage for 2016, as they will not be able to keep their Kentucky Health CO-OP plans.

And then on October 14, Tennessee regulators announced that Community Health Alliance would also close at the end of the year. CHA stopped enrolling new members in on loss of innocence, January 2015, but it had planned to sell policies during the 2016 open enrollment period, albeit with a 44.7 percent rate increase. Ultimately, the critical essay joyces ulysses risk of the of innocence CO-OP’s failure in 2016 was too great, and it will wind down operations by the end of the year instead. Two days later, on critical joyces October 16, Colorado Health OP was decertified from the exchange by the Colorado Division of Insurance, resulting in the CO-OP’s demise; Colorado Health OP’s 80,000 individual members will all need to transition to essay on loss, new carriers for 2016. Almost immediately after that, Oregon’s Health Republic Insurance, also a CO-OP, announced that it would not offer 2016 plans, and would wind down its operations by the end of 2015. Critical Joyces Ulysses! Health Republic currently has 15,000 members. On October 22, The South Carolina Department of Insurance announced that Consumers Choice would voluntarily wind down its operations by year-end, and would not sell plans for 2016. Consumers Choice was run by the same CEO – Jerry Burgess – as Community Health Alliance in coast travel essays, Tennessee. 67,000 Consumers Choice members will need to switch to a new carrier for 2016. The South Carolina Department of Insurance has put together a series of FAQs for impacted plan members. On October 27, the Utah Insurance Department announced that they are placing Arches Health Plan in receivership, and the carrier will wind down operations by the end of the critical joyces year.

Arches Health Plan garnered roughly a quarter of Utah’s exchange market share in 2015, but those enrollees will need to switch to a new carrier for 2016. On October 30, just two days before the start of the 2016 open enrollment period, the Arizona Department of Insurance announced that Meritus would cease selling and renewing coverage, and existing plans would terminate at the end of of innocence 2015. Healthcare.gov removed Meritus plans from the exchange website, and current enrollees – who comprise roughly a third of the critical joyces private plan enrollees in the Arizona exchange – will need to obtain new coverage for 2016. Meritus was unique in that they allowed people to enroll off exchange year-round up until late-summer 2015. They were also among very few CO-OPs that had requested a rate increase of less than ten percent for 2016. Open enrollment began on November 1, and coverage was still available at that point from the listhesis remaining 12 CO-OPs. But on November 2, it became clear that Consumers Mutual of Michigan was in financial trouble. The carrier announced that they would not offer plans in the exchange in 2016, although at that point, there was still a possibility that they would continue to offer plans outside the exchange. But on November 4, they announced that they would wind down their operations by critical essay james joyces ulysses the end of the year, and all 28,000 members would need to find new coverage for thumb essay, 2016. In May 2016, state regulators in james ulysses, Ohio announced that InHealth Mutual would shut down and that members would have a 60 day special enrollment period to select a new plan. In July 2016, state regulators in Connecticut announced that HealthyCT would shut down at essay on loss, the end of 2016 (employer groups were able to keep their coverage through the critical ulysses renewal date in thumb, 2017, as long as the plan’s renewal date in 2016 was July or earlier).

In July 2016, state regulators in Oregon announced that Oregon Health CO-OP would shut down at critical essay james joyces ulysses, the end of July 2016. In July 2016, state regulators in Illinois announced that they were beginning the act of 1920 essay process of james taking over essay on loss Land of Lincoln Health and winding down the CO-OP’s operations. A special enrollment period was created for critical essay james joyces ulysses, the CO-OP’s 49,000 enrollees. In September 2016, state regulators in New Jersey placed Health Republic Insurance of New Jersey into rehabilitation, and the CO-OP ceased selling new plans. Health Republic’s existing plans terminated at the end of american act of 2016. In June 2017, Minuteman Health announced that they would no longer offer coverage as a CO-OP after the end of 2017. Essay Joyces! At that point, they intended to transition to dissertation, a for-profit insurance company (Minuteman Insurance Company). However, they were unable to raise enough capital by the August 2017 deadline for critical ulysses, securing a license for 2018, and will thus not re-open as a for-profit insurer.

Minuteman Health is in receivership, and enrollees will need to obtain new coverage during open enrollment in the fall of 2017. In July 2017, Maryland regulators issued an administrative order blocking Evergreen Health from selling or renewing any plans (they only had group plans in force at that point, having terminated individual market plans at the end of 2016). The order notes that it’s expected that the process will culminate in receivership. Louise Norris has been writing about health insurance and american prohibition 1920, healthcare reform Read more. RT @LouiseNorris: 1. Avg rate increase in critical ulysses, Nevada 31.6%, but for the only returning carrier in the exchange, it's 36.8% https://t.co/AYXmXMK… After subsidy, Minnesota health exchange insurance rates largely stable or dropping for 2018 | from @kpottermn… https://t.co/DabHX4CtIk. RT @LouiseNorris: If initiative is essay approved, they have until April to get enough signatures to get it on the ballot. Spread the word! https… Copyright ©1994-2017, healthinsurance.org llc, 5353 Wayzata Boulevard, Suite 300, St. Louis Park, MN 55416. For quote requests or help in essay ulysses, purchasing insurance, call toll-free 1-855-367-0132. or use our quote form.

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James Joyces Ulysses Critical …

How to Write an Evaluation Paper with Sample Essays. VirginiaLynne has been a University English instructor for over 20 years. She specializes in critical essay joyces ulysses helping people write essays faster and easier. Evaluation essays are just like reviews. They judge whether something is prohibition good or bad, better or worse than something comparable.

We are familiar with this sort of writing if we've read book, movie, restaurant, or product reviews. Essay James Ulysses? Evaluation papers can be serious or funny, earnest or sarcastic. We all love to read the dissertation, review of a really bad movie or restaurant experience. If you like to write satire, this can be a great opportunity to display your humor. Chances are you will have a great time, and so will your reader. Your topic can be something you've experienced once or many times. Keep in mind that you will write a better paper if you: Have a strong opinion—positive or negative—about this topic. Choose something you've experienced recently or that you can review again before you write your paper. Know a lot about this type of experience. Use the critical essay joyces ulysses, following list of categories to brainstorm ideas for what you might want to evaluate.

Finding Criteria for Evaluation Essays. To turn your opinion into an evaluation, you will need to use criteria to judge your subject. What are criteria? Criteria are the parts of american, your topic that you will judge as good or bad, better or worse than something else. How can you find criteria? Criteria are the essay james joyces, parts of the thing you are evaluating. Here are some examples of criteria: movie criteria : plot, actors, scenery, score, directing, chemistry between actors, humor. restaurant criteria: service, atmosphere, food quality, taste, value, price. website criteria: ease of navigation, design, visuals, writing, content. Finding the best criteria for your evaluation: In order to do this kind of writing well, you need to determine what sort of a topic you are evaluating.

If it is amalfi coast travel essays a movie, then what genre is it: horror, romance, drama, etc.? Then you need to decide what would make an excellent movie in that genre in critical essay ulysses your opinion. The Panda Thumb? For example, you may decide that a good romantic comedy has to have three things: humor, surprising plot twists, and critical essay ulysses actors you enjoy getting to know. Next, you will evaluate the movie you have chosen to see how well it matches those criteria, giving specific examples of how it does or does not fulfill your expectations of an i want a special education, excellent romantic comedy. In order to evaluate something, you need to compare it with the best example of james, that particular thing. Coast Travel Essays? So, to critical essay ulysses help you develop your topic into an essay, there are two important questions to thumb ask when you are choosing your topic to evaluate: First question: What category of a thing is it? Second question: What is the ideal example of something in that category? What category is it? For the best evaluation essay, you want to compare your topic with things that are very similar, so try to essay ulysses narrow the amalfi coast, category as much as possible. To get there, you want to keep on asking the question, What kind is critical james it?

What category does McDonald's fit into? Answer to amalfi coast travel essays first question : Restaurant. (What kind of restaurant?) Fast food restaurant. (Better, but what kind of fast food?) Hamburger-serving fast food restaurant. Critical James? (This is on loss of innocence what you want!) So if you were evaluating McDonald's, you would want to compare it to other fast food restaurants that mostly serve hamburgers. Now the critical essay joyces ulysses, second question: What is the ideal example of something in that category? What makes that example better than others? Thinking about what you consider to be the very best example of something in the category of what you are reviewing can help you decide what criteria you will use, and also what judgement you can make. Essay On Loss Of Innocence? For example, here is james joyces a list of criteria my students have come up with for an ideal burger fast food restaurant:

looks clean serves food fast makes it easy to order has great fries has options on the menu offers large drinks with free refills serves juicy burgers with lots of grease doesn't cost a lot of money. No two people will come up with exactly the same list, but most restaurant reviews look at the following criteria: Answer to second question: A great fast food burger joint offers great service, atmosphere, and food at a fair cost. Now you know what your paper is why do education teacher going to joyces ulysses be about edward dissertation, how close McDonald's comes to this ideal. Is This an Effective Advertisement? Using the list of criteria above, we can make a very fast outline for an essay about an critical, imaginary fast food hamburger restaurant called Bob's Burgers: Thesis Statement : While you may have to amalfi coast travel essays wait a while to get your meal at Bob's Burgers, that is because everyone finds the meal is worth the wait; Bob's Burgers offers not only great service, but a fun atmosphere for eating with friends or family, terrific food, and ulysses a good value for the price. Topic sentence for why do to be a special essay, paragraph 1: Service : Bobs Burgers offers great service that makes you feel at james home. Food served quickly Easy to order Friendly Not pushy They get the order correct. Topic sentence for paragraph 2: Atmosphere : Walking into Bob's, you know you will enjoy eating there. Looks clean Attractive colors Interesting pictures or other decorations Comfortable tables and chairs.

Topic sentence for paragraph 3: Food: Most importantly, Bob's burgers are the best in town. Juicy burgers with lots of grease Many choices for toppings, including grilled onions, mushrooms, and american prohibition peppers Small or large burgers Have great fries One downside: No options for those who don't like burgers. Topic sentence for paragraph 4: Value : While Bob's doesn't have the cheapest meals, they do offer a good value for the price. Quality ingredients Burgers and fries fill you up Toppings on critical joyces ulysses, burgers are free Large drinks with free refills. Using this quick outline, most of you could probably write your own essay on Bob's or another fast food hamburger joint pretty easily. Comparison/Contrast: Evaluate your subject by travel comparing it to one of the best of that genre (use something everyone would know to save time). You will not do an extended comparison, but just use the comparison as a lead-off into your own judgment. Expectations Unfulfilled: This is especially easy to critical james joyces ulysses do for this essay type. Use the intro to describe what you were anticipating before seeing the subject, then describe how the subject was either better or worse than you expected. Frame : Use a description of the subject to frame the essay.

That way you get right into the action. Then break off half-way through to essay keep your reader in suspense. Give your evaluation and critical then conclude with the end of spondylo listhesis, your frame. Define Genre and Compare: In this essay, you would start out by describing the typical expectations of whatever subject you have (ex: rock album, romantic movie, baseball game, jazz club). After describing the “typical,” you will then tell how your subject either exemplifies the genre or deviates from the norm. Probably this type of organization is best used for a satire or for a subject that deliberately tries to james break out of the normal expectations of that genre. Analysis by Criteria: In this type of paper, you introduce the subject, tell why you are evaluating it, what the coast travel essays, competition is, and how you gathered your data. Then you order your criteria chronologically, spatially, or in order of importance. Essay Joyces Ulysses? Chronological Order : You might use this for american prohibition 1920 essay, all or part of your paper. Critical James? It means telling what happened in the order it happened. This is particularly useful for a performance or restaurant review.

Causal Analysis: This measures the effect on the audience. How does this subject cause a certain effect? Analysis Focused on the panda essay, the Visual: This organization plan works well for critical essay james, analyzing works of dissertation, art and pictures. Critical Essay James Joyces? The analysis focuses on essay on loss of innocence, composition, arrangement, focus, foreground and background, symbols, cultural references, and critical essay james joyces key features of that visual genre. It also notices the tools of the american prohibition essay, artist: color, shape, texture, pattern, and media. This paper analyzes these details in order to explain how they are related to the cultural and historical context of the work of art and then tells how they relate to the overall meaning of the piece. Be sure to evaluate if and why this piece is effective or ineffective.

Analysis Focused on critical ulysses, the Social Context or the Story : This type of evaluation takes an image and analyzes how it is edward effective for essay joyces, a particular point. Usually, the image is about a controversial or emotionally charged cultural or historical event. Your analysis can describe how this image either demonstrates or contributes to the emotion or debate surrounding the event. It may be that the image is ironic or misleading. The only listhesis, problem with our example above is that it is ulysses so easy to write, and act of 1920 so it might seem rather trite and unoriginal. How can you make your essay stand out? Describe vividly, using interesting verbs, adjectives, and adverbs. Critical Essay Ulysses? Make the essay of innocence, reader feel that they have been to the restaurant with you. Use the introduction and conclusion to entice the reader.

Introduction and Conclusion Ideas. Use a conversation about the food. James Joyces Ulysses? Start with your expectations and end with your actual experience (telling whether it met expectations or overturned them). Talk about popularity or history of the restaurant. Use statistics of people eating fast food more. Discuss the to be a special education teacher, controversy about fast food and critical james joyces ulysses obesity and health. See the why do education teacher essay, chart below for more ideas. How to Connect Introduction and Conclusion. 1. Present the Subject in an Interesting Way. Give the right amount of detail : Be sure to explain clearly what it is and provide enough information for the reader to agree with your judgment. Sometimes movie reviews leave the reader in suspense as to essay the outcome of the story.

You will have to decide what you want to tell. Help readers agree with your evaluation : One reason people like reviews is because they help them decide whether they would like that subject themselves, so make sure to give your reader enough details to decide if they agree. Write a review rather than a summary: Make sure that the summary of the subject is no more than a third of 1920 essay, your paper. The main part of your paper is supposed to be the evaluation, not the summary. It is possible to do the summary separately and critical essay joyces then do the evaluation, or you can summarize as part of your evaluation. Make sure what you are evaluating is clear: It is fleming dissertation often effective to use an introduction which describes the essay, subject or gets the reader involved in essay the action quickly. 2. Make a Clear, Authoritative Judgment (2/3 of paper) Thesis sentence should tell exactly what you think. You might want to foreshadow your body by including the main reasons for your evaluation in that thesis sentence. Essay James Joyces Ulysses? (Ex: The movie XXX is essay of innocence perfect for a college student's study break because of the ulysses, hilarious comedy, intense action, and fantastic visual effects.) Define the amalfi, audience you are addressing and the genre of the subject (in the above example, the audience is college students and the genre is action comedy). Create a three-column-log to help you make notes for your paper. Critical James Joyces Ulysses? Separate your notes into three columns for criteria, evidence, and act of 1920 judgment.

Pick at least three criteria to talk about in your essay. Critical Essay James Ulysses? For example, for a mystery play, it could be three of the following: plot, setting, costumes, acting of main characters, acting of minor characters, the pace of the action, or the unveiling of the the panda thumb, mystery. Be opinionated! Passionate reviews are always more interesting to read. Use vivid nouns and engaging verbs. Have a strong judgment about how this subject is either better or worse than similar subjects. Your judgment can be mixed. For example, you might say the critical essay james joyces ulysses, concert on the mall was a good mix of bands and that the new songs from the spondylo listhesis, main act were energetically played, but that the sound equipment was poorly set up and tended to make it hard to hear the singers.

Order the body paragraphs from least to most important. Back up your opinions with concrete examples and convincing evidence. 3. Argue for Your Judgment. As you state each of your judgments, you need to give reasons to back them up that are specific, interesting, and convincing. For evidence, describe the critical ulysses, subject, quote, use personal anecdotes, or compare and american act of essay contrast with a similar subject. In some cases it is effective to counter-argue, if you disagree with what most people think.

For example, if your subject is very popular and you think it is critical essay james joyces ulysses terrible, you may want to state what most people think and tell why you disagree. This exercise is intended to essay help you prepare to write your paper. Critical Joyces Ulysses? As you answer these questions, you will generate ideas that you can use for your paper. What is the topic (subject) you are going to evaluate? Do a short description of it in essay a list or paragraph. What category is your topic? Be as specific and narrow as possible. Who might be interested in this?

This is your audience for the paper. What does this audience already know? What do they want or expect from this thing? (This can help you develop criteria) What criteria can you use for evaluating your topic? (Think of what is essay james joyces ulysses most important, or what can be either good or bad, or what parts there are of your topic) What did you expect before you experienced your topic? How did your experience either fulfill or reverse your expectations? In your evaluation of your topic, what is good? In your evaluation of your topic, what is not as good?

What is the edward fleming dissertation, best example of something in your topic? (Or what other things can you use to compare your topic with?). How does your topic compare to the best of this sort of thing? If I had to put my evaluation in james joyces ulysses a single sentence, I would say: Look at “How to the panda Write and critical essay ulysses Evaluation Essay” Organization Strategies. Which of these will you use? Explain how you will use it. Introduction/Conclusion ideas: Which of these will work best for you? frame story, scenario, expectations unfulfilled, conversation, vivid scene, statistics and evidence, describe social context or historical period, describe popular trend for the subject, define the genre, personal story, quote from someone (often someone who disagrees with you), analogy, compare and contrast. How will you use this introduction and conclusion idea in your essay? Now write a brief outline of your paper (see hamburger example above). Most of us can tackle a writing project more easily after talking about our ideas.

Instructors may have you work in groups to talk out your ideas. I've even had some students turn on their webcam and answer these questions while videotaping themselves! If your instructor doesn't have you work in a group, you can get together with some friends to amalfi travel answer the following questions and take notes to help you get ideas for your paper. Joyces? Take turns in your group. The main goal is to help one another prepare to write. Prohibition Act Of 1920? Pay special attention to helping each other describe their subject vividly and critical james joyces make their evaluation clear and precise. Also, look for good ways to organize papers. Tell your subject to essay of innocence your group. Critical Essay James Joyces Ulysses? Let the group respond and tell you what they know about it or what they would expect. Amalfi? You write down their answers. Explain your subject.

Have your group ask questions (someone else can record for you if you want). Explain your criteria for judging it (#5 in pre-writing). Have the group respond. Do these seem like the best criteria? Any other suggestions? Tell your group your one-sentence evaluation (this is your thesis). Critical Essay Joyces Ulysses? Get suggestions for of innocence, how to make is more effective. Look at the different “Organization Suggestions” on essay james joyces, the “Basic Features of an Evaluation Paper.” What type of organization would work best for this paper? Try to prohibition act of 1920 write a simple outline.

100 Expository Essay Topic Ideas, Writing Tips, and Sample Essays. by Virginia Kearney 22. 100 Easy Argumentative Essay Topic Ideas with Research Links and critical james Sample Essays. by Virginia Kearney 32. How to Write Cause and Effect Essays. by Virginia Kearney 5. 50 Critical Analysis Paper Topics.

by Virginia Kearney 4. 100 Cause and Effect Essay Topics. by Virginia Kearney 37. Easy Words to Use as Sentence Starters to Write Better Essays. by Virginia Kearney 127. Thank you for this its really helped with my college English class. thank you gave a better explanation that my professor. Thanks! This is helpful.

Virginia Kearney 8 months ago from a special education, United States. That is an interesting idea Lili. I've just created a video game character, then I made 3 seperate animations that shows her personality using only visuals, and now I have it evaluate it. I've never written an evaluation before but this helped get me started, wish me luck! Virginia Kearney 13 months ago from critical joyces ulysses, United States. Hi Janelle! I have lots of information on topic ideas and how to coast travel write different types of Freshman English essays. I wrote these over my 24 years of teaching and critical essay james joyces ulysses publish them here to help other instructors, especially those who are just starting out.

Many students find my essays on their own but I welcome instructors using links to my material, but please do not post the information to your own website or print out my information. Thank you for this. I am teaching a Freshman Comp class in college, and I'll use some of this material to teach an evaluation essay of some kind. I will be writing my essay on the gender inequality. I am trying to evaluate a hotel. Evaluating a TED talks presentation/speech. Lily Galindo 2 years ago. Reviewing a technological device - the essay on loss of innocence, Kindle Keyboard 3G. :)

askformore lm 2 years ago. Thank you for james joyces, a very interesting and useful hub. Thumbs up! Arif 4 years ago from Bangladesh. wow!! amazing really. I should develop my hub just like you :) FilipinoHeart 4 years ago. Thank you for this very accessible and useful information. Why Do I Want To Be Teacher Essay? Cheers! :) Virginia Kearney 5 years ago from United States. Thanks DVKR--I think this is one of the easier essays to write because we are all familiar with the review.

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