Monday, December 30, 2019

What Does Commander in Chief Really Mean

The U.S. Constitution declares the President of the United States to be the â€Å"Commander in Chief† of the U.S. military. However, the Constitution also gives U.S. Congress the exclusive power to declare war. Given this apparent constitutional contradiction, what are the practical military powers of the Commander in Chief? The concept of a political ruler serving as the ultimate commander of the armed forces dates to the Emperors of the Roman Kingdom, Roman Republic, and Roman Empire, who held imperium—command and regal—powers. In English usage, the term may have first been applied to King Charles I of England in 1639.   Article II Section 2 of the Constitution—Commander in Chief Clause—states that â€Å"[t]he President shall be Commander in Chief of the Army and Navy of the United States, and of the Militia of the several States, when called into the actual Service of the United States.† But, Article I, Section 8 of the Constitution gives Congress the sole power, To declare War, grant Letters of Marque and Reprisal, and make Rules concerning Captures on Land and Water; †¦Ã¢â‚¬  The question, which comes up almost every time the grim need arises, is how much if any military force can the president unleash in the absence of an official declaration of war by Congress? Constitutional scholars and lawyers differ on the answer. Some say the Commander in Chief Clause gives the president expansive, almost unlimited power to deploy the military. Others say the Founders gave the president the Commander in Chief title only to establish and preserve civilian control over the military, rather than give the president additional powers outside a congressional declaration of war. The War Powers Resolution of 1973 On March 8, 1965, the 9th U.S. Marine Expeditionary Brigade became the first U.S. combat troops deployed to the Vietnam War. For the next eight years, Presidents Johnson, Kennedy, and Nixon continued to send U.S. troops to Southeast Asia without congressional approval or official declaration of war. In 1973, Congress finally responded by passing the War Powers Resolution as an attempt to stop what congressional leaders saw as an erosion of Congress’s constitutional ability to play a key role in military use of force decisions. The War Powers Resolution requires presidents to notify Congress of their commitment combat troops within 48 hours. In addition, it requires presidents to withdraw all troops after 60 days unless Congress passes a resolution declaring war or granting an extension of the troop deployment. The War on Terror and the Commander in Chief The 2001 terrorist attacks and the ensuing War on Terror brought new complications to the division of war-making powers between Congress and the Commander in Chief. The sudden presence of multiple threats posed by poorly defined groups often driven by religious ideology rather than allegiance to specific foreign governments created the need to respond faster than allowed by the regular legislative processes of Congress.   President George W. Bush, with the agreement of his cabinet and military Joint Chiefs of Staff determined that the 9-11 attacks had been funded and undertaken by the al Qaeda terrorist network. Further, the Bush administration determined that the Taliban, acting under the control of the government of Afghanistan, was allowing al Qaeda to house and train its fighters in Afghanistan. In response, President Bush unilaterally sent U.S. military forces to invade Afghanistan to fight al Qaeda and the Taliban. Just one week after the terrorist attacks – on September  18, 2001 – Congress passed and President Bush signed the Authorization for Use of Military Force Against Terrorists Act (AUMF). As a classic example of â€Å"other† ways of changing the Constitution, the AUMF, while not declaring war, expanded the president’s constitutional military powers as Commander in Chief. As the U.S. Supreme Court explained in the Korean War-related case of Youngstown Sheet Tube Co. v. Sawyer, the president’s power as Commander in Chief increases whenever Congress clearly expresses its intent to support the actions of the Commander in Chief. In the case of the overall war on terror, the AUMF expressed Congress’s intent to support future actions taken by the president. Enter Guantanamo Bay, GITMO During the U.S. invasions of Afghanistan and Iraq, the U.S. military â€Å"detained† captured Taliban and al Qaeda fighters at the U.S. Naval base located at Guantanamo Bay, Cuba, popularly known as GITMO. Believing that GITMO – as a military base – was outside the jurisdiction of the U.S. federal courts, the Bush Administration and the military held the detainees there for years without formally charging them with a crime or allowing them to pursue writs of habeas corpus demanding hearings before a judge. Ultimately, it would be up to the U.S. Supreme Court to decide whether or not denying the GITMO detainees certain legal protections guaranteed by the U.S. Constitution overstepped the powers of the Commander in Chief. GITMO in the Supreme Court Three Supreme Court decisions related to the rights of the GITMO detainees more clearly defined the military powers of the president as Commander in Chief. In the 2004 case of Rasul v. Bush, the Supreme Court ruled that U.S. federal district courts had the authority to hear petitions for habeas corpus filed by aliens detained within any  territory over which the United States exercises â€Å"plenary and exclusive jurisdiction,† including the GITMO detainees. The Court further ordered the district courts to hear any habeas corpus petitions filed by the detainees. The Bush Administration responded to Rasul v. Bush by ordering that petitions for habeas corpus from the GITMO detainees be heard only by military justice system tribunals, rather than by civilian federal courts. But in the 2006 case of Hamdan v. Rumsfeld, the Supreme Court ruled that President Bush lacked constitutional authority under the Commander in Chief Clause to order the detainees tried in military tribunals. In addition, the Supreme Court ruled that the Authorization for Use of Military Force Against Terrorists Act (AUMF) did not expand presidential powers as Commander in Chief. Congress, however, countered by passing the Detainee Treatment Act of 2005, which stated that â€Å"no court, court, justice, or judge shall have jurisdiction to hear or consider† petitions for writs of habeas corpus filed by alien detainees at GITMO. Finally, in the 2008 case of Boumediene v. Bush, the Supreme Court ruled 5-4 that the constitutionally guaranteed right of habeas corpus review applied to the GITMO detainees, as well as to any person designated as an â€Å"enemy combatant† held there. As of August 2015, only 61 mainly high-risk detainees remained at GITMO, down from a high of about 700 at the height of the wars in Afghanistan and Iraq, and almost 242 when President Obama took office in 2009.  Ã‚   Sources and Further Reference Dawson, Joseph G. ed (1993). â€Å".†Commanders in Chief: Presidential Leadership in Modern Wars University Press of Kansas. Moten, Matthew (2014). â€Å"Presidents and Their Generals: An American History of Command in War.† Belknap Press. ISBN 9780674058149.Fisher, Louis. â€Å".†Domestic Commander in Chief: Early Checks by Other Branches Library of Congress

Sunday, December 22, 2019

Amoretti Sonnets - 897 Words

Edmund Spenser wrote two poems, â€Å"Happy ye Leaves when as Those Lilly Hands†, â€Å"Lyke as the Culuer one the Bared Bough†, and many others, for his wife Elizabeth Boyle. He created Amoretti more like a diary of when they first met, up until the day Elizabeth died (we believe). Spenser wrote his sonnets in the rhyme scheme, Spenserian: ABAB BCBC CDCD EE, and it is commonly used in all of his writings. Additionally, the other eighty seven sonnets that are in Amoretti, sonnet I (one) and sonnet LXXXIX (eighty nine) portray the key elements; furthermore, the two of the Spenser’s poems illustrate corresponding and / or dissimilarity to one another by using different aspects: situation, speaker, and tone. Spenser wrote the situation for sonnet†¦show more content†¦Secondly, he also describes her to be a pretty angle and when she looks at him or acknowledges him, he is in â€Å"my [him] heavens blis† (1. 12): â€Å"When ur behold that Angles blessed looke, / My soules long lacked foode† (1.11-12). Not only does sonnet I talk about how he loves this woman, but also, he explains how his life is so gloomy when she left. Spenser conveyed the man’s feeling to a female dove, morning for the loss of her mate: â€Å"Culuer on the bared bough, / sits morning for the absent of her mate† (2. 1-2). The man relates to the dove by expressing how he morns the â€Å"absence of my [his] love† (2. 6) and â€Å"seek with my playnts to match that mournful dove† (2. 8). Although, the speaker in both sonnets reveal how much he cares for the women. Many tones are used to help the readers or audience understand the author’s feelings and emotions towards the piece, as well as Spenser. In sonnet I (one), the tone is shown to be sentimental to the lady through the speaker. The man in the poem is putting his heart in the woman’s hands, to either hold it and cherish it or stomp on it and break it: â€Å"shall handle you and hold in loves soft bands, / Lyke captives trembling at the victors sight† (1. 3-4). He also goes on about how he gives her these things to please her and that’s all he cares about: â€Å"Leaves, lines, rhymes, seeke her to please alone, / Whom if ur please, I care for other none† (1. 13-14). However, the second sonnet depressing, by the loss of the lovely maiden. HeShow MoreRelated Sonnet 64 of Spencers Amoretti Essay798 Words   |  4 PagesSonnet 64 of Spencers Amoretti      Ã‚  Ã‚  Ã‚   Poets, in general, are fond of symbolism and figures of speech.   Instead of wallowing in the concrete and the obvious, it has always been the purpose of the poet to give ... to aery nothing a local habitation and a name.   The writers of love poetry are especially fond of imagery, metaphors, and similar devices, comparing their loved ones to such and such an animal or cosmic event.      Ã‚  Ã‚  Ã‚  Ã‚   It is therefore of no surprise that 16th centuryRead MorePoetry1461 Words   |  6 PagesAnalysis of Sonnet 75 (Amoretti) by Edmund Spenser Sonnet 75 is taken from Edmund Spenser’s poem Amoretti which was published in 1595. The poem has been fragmented into 89 short sonnets that combined make up the whole of the poem. The name Amoretti itself means â€Å"little notes† or â€Å"little cupids.† This poem is said to have been written on Spenser’s love affair and eventual marriage to Elizabeth Boyle, his second wife. Sonnet 75 centers on the immortality of spiritual love and the temporality of physicalRead MorePerspectives of Love in Thomas Wyatts They Flee From Me, and Edmund Spencers Amoretti1100 Words   |  5 Pagesfavor of men. Two interesting portrayals of love are in the sonnet â€Å"They Flee From Me† by Thomas Wyatt and collection of sonnets â€Å"Amoretti† by Edmund Spencer. In these poems, love is described mostly in two opposite ways. While â€Å"They Flee From Me† portrays men as the victim to women and their deviousness, â€Å"Amoretti† takes an opposing turn from how most poetry of that time wrote about love by celebrating it in a positive and joyful way. â€Å"Amoretti† was a change and very different from most writings aboutRead MoreElizabethan Poetry Essay582 Words   |  3 PagesA Miscellany of Uncertain Authors commonly known as Tottels Miscellany. Sir Thomas Wyatt (1503 - 42) and Henry Howard, Earl of Surrey (1517-47) made valuable contributions to this anthology. Wyatt transplanted the sonnet form from Italy to England.Both Wyatt and Surrey wrote sonnets based on the Petrarchan model, the form which immortalized by Shakespeare and Milton. They brought the theme romantic personal love in poetry to Britain. Surrey translated the Aeneid of Virgil into English. EdmondRead MoreSonnet994 Words   |  4 Pagesï » ¿The Spenserian Sonnet  was named for Edmund Spenser 1552-1599, a 16th century English Poet. The Spenserian Sonnet inherited the tradition of the declamatory couplet of  Wyatt / Surrey  although Spenser used Sicilian quatrains to develop a metaphor, conflict, idea or question logically, with the declamatory couplet resolving it. Beyond the prerequisite for all  sonnets, the defining features of the Spenserian Sonnet are: a quatorzain made up of 3 Sicilian quatrains (4 lines alternating rhyme) andRead MoreCompare and Contrast the Ways Philip Sidneys Astrophil and Stella and Miltons Comus explore Gender and Sexuality.948 Words   |  4 Pagessexuality in a new light. Sexuality and desire Philip Sidney: Astrophil and Stella (c. 1591) Sidneys Astrophil and Stella, a compilation of 108 sonnets and 11 songs, describes a desire of a poet for his muse, inspired by Petrarch. It is a variation of his rhyme, and a motive Petrarch exploited: the poets love and want for a woman. 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Saturday, December 14, 2019

Healthcare Reform Free Essays

Healthcare Reform Calls for Enormous Payment Restructure for Health Care Providers and Facilities Healthcare reform has been a topic of great interest and a highly debated public issue for the past several years. Opinions are split on the reasons behind growing health care costs and methods to bring healthcare spending back in line. However, a consensus has formed surrounding the conviction that drastic changes must be implemented within our healthcare system. We will write a custom essay sample on Healthcare Reform or any similar topic only for you Order Now Some of these changes include a complete restructure of the payment system for health care providers, health care facilities and insurance companies in effort to control the rising costs of health care within the United States. The rising costs of health care within the United States have long been a concern among economists. According to the Organisation for Economic Cooperation and Development (OECD), a forum in which the economic data of multiple countries is analyzed and compared, total United States spending on health care between 2000 and 2009 increased an average of 4. % per year. While this growth rate has been reduced to 2. 7% between 2009 and 2010, health care spending in the United States still equates to 17. 6% of the gross national product (GDP). This is significantly higher than the OECD 2010 health care percent of GDP average of 9. 5% (OECD Health Data 2012). These statistics demonstrate that health-related spending compared to other industrial countries and within the United States in outpacing spending on other goods and services. Rising health care costs are making health care less affordable for individuals, families, and businesses. These higher costs have a significant effect on government budgets at both the federal and state levels as well. Victor Fuchs, an emeritus professor of economics and health research and policy at Stanford University asserts, â€Å"approximately 50 percent of all the health care spending is now government spending. At the state and local level it is crowding out education, crowding out maintenance and repair of bridges and roads. At the federal level we have a huge deficit financed by borrowing from abroad. We are financing a huge deficit in Medicare and Medicaid by selling bonds, mostly to China. (Kolata) In terms of actual dollars, the United States health spending has nearly doubled in the past ten years. Rising from a reported $1. 3 trillion dollars in 1999 to $2. 5 trillion dollars in 2009, growing $96 billion dollars from 2008 to 2009 alone (Auerbach, and Kellermann 1630-1636). The United States cannot sustain the continued growth rate of health spending. â€Å"In 2007, the no npartisan Congressional Budget Office projected that if health care spending in the United States stays on its current course, it will constitute half of the nation’s GDP by 2082† (Health Affairs, Auerbach Kellermann). Fortunately small changes in the annual per capital growth rates can produce considerable long-term effects. By reducing annual growth in per capita spending 1. 1%, a cumulative savings of $1. 42 trillion is projected for Medicare (Fisher, Bynum, and Skinner 849-855). Similarly, the United States health per capita, which is calculated by dividing the total health care expenditures by the total insured population, totaled $8,233 USD in 2010. This means the US health per capita is $4,965 USD higher than the OECD average of $3,268 USD or roughly two-and-a-half times more (OECD Health Data 2012). The graphs below show the trending on both US health per capita and health as a percentage of the GDP for the past thirty years compared to similar industrialized countries. In 1980, the United States appeared to be in line with comparative nations but in the subsequent years we have deviated from the group and are clearly surpassing our peers in health care expense. If the United States was once in line with comparative industrial nations what variables have led to the extreme gaps that can be seen today? What are the possible explanations for the excessive US costs? Pinpointing the exact causes for higher costs within the United States health care systems is challenging. Several factors are likely to impact the costs of health care across the United States. The most often stated reason is the aging of the US population. â€Å"The percentage of the American population age 65 or over is 12. now and is projected to rise to about 21 by 2050. † (Reinhardt, Health Care Costs Part V). It is generally accepted that as individuals age they require additional health services due to new complications or chronic conditions. While this may be true, an aging population cannot be the only rationale for higher spending. â€Å"In a number of other industrialized countries — notably in Japan, Germany, Italy and Sweden — the elderly already represent close to 20 percent of the population, a level the United States will not reach ntil about 2040†(Reinhardt, Health Care Costs Part V). The disparity in US health care spending consequently cannot be the rationale if the countries of Japan and Italy, whose health expenditure as a percent of the GDP and health per capita are below the OECD average, are comprised of a greater amount of elderly consumers the United States. Further research has shown that the aging of a population alone added only an approximate half percentage point to the per capita health spending annual rate in industrial societies (Reinhardt, Health Care Costs Part III). Another potential reason for higher health care spending in the United States is greater access to medical advances in both technology and pharmaceuticals. The availability and accessibility of computed tomographic (CT) scans and magnetic resonance imaging (MRI) imaging across industrial nations is measured by the OECD. â€Å"There were 40. 7 CT scanners per million population in 2011, a number that is almost double the OECD average of 22. 6. And there were 31. 6 MRIs per million population, two-and-a-half times the OECD average of 12. 5† (OECD). The availability alone, however, does not seem to be a driver of increased health care costs. Regional variations of health spending within the United States show an increase of technology utilization in higher spending regions due mainly to medical discretionary of physicians. The research of Drs. Sutherland, Fisher, and Skinner show patients in the highest spending regions â€Å"undergo more magnetic resonance imaging (MRI) procedures (21. 9 vs. 16. 6 per 100 beneficiaries) and computed tomographic (CT) scans (61. 4 vs. 46. 9 per 100 beneficiaries). To this end, controlling cost will require physicians’ assistance in eliminating excessive procedures and their leadership to help educate the public as to the appropriate usage of such procedures. â€Å"If the entire country were brought to the spending level of the lowest quintile, the savings would be about $750 per capita: $225 billion or 21% of the gap† (Hixen, Forbes) The United States also exhibits higher costs for medications. â€Å"The United States tends to be an early adopter of newly launched drugs, which are patent protected and sold at higher prices† (McKinsey Company). The increased availability of these new drugs hastens the wide spread usage and these higher priced prescriptions quickly become some of the most preferred medications among US consumers. Whereas the lack of availability in comparative nations maintains lower prescription drug costs by the increased utilization of generic medications as a substitute to new formulas. To support the conclusions that medication is truly a higher cost within the United States, McKinsey Global institute compared usage of medications in addition to cost. According to their findings, usage of prescription drugs is approximately 20 percent lower in US patients than in other nations. Therefore, medications are priced higher in the United States and thus contribute to the higher spending in the United States (McKinsey Company). Physician and Specialist costs have also been identified as potential factors in the elevated costs of United States health care spending. The McKinsey analysis of OECD comparative countries shows, â€Å"physician compensation is, on average, 4 times GDP per capita for specialist and 3. 2 times for generalists. In the United States, these figures rise to 6. 6 and 4. 2 respectively. † Therefore, it should come as no surprise that on a per capita basis annual spending within the United States is approximately five times higher than peer countries, reported at $1,600 versus $310 per capita, or a difference of $1,290 per capita, which equates to $390 billion dollars nationally (Hixen, Forbes). The United States also has a disproportionate amount of specialist compared to other countries. In the majority of industrial countries the ratio of specialists to primary care physicians is one-to-one. The United States currently contains a two-to-one ratio of specialists to primary care physicians. The effect to spending is compounded since US specialists get paid more per hour and their spending is typically already higher due to more exotic interventions (Kolata). â€Å"Although payments to primary care physicians were greater in the United States than elsewhere, the differential was smaller than would be expected given the costliness of the overall US health care system†(Laugesen, and Glied 1647-1656). Therefore it is more likely that higher physician compensation is not due to higher education costs or greater skill levels, instead physicians are paid more per service in the United States than in comparative industrial countries. Overall, higher prices can be linked to higher US health spending. Public and private payers paid higher fees (27 percent more for public and 70 percent more for private) to US primary care physicians for office visits and much higher fees to specialists than comparable fees paid to physicians in other industrial countries (Laugesen, and Glied 1647-1656). A final potential contributor to the higher health expenditures are the higher administrative costs of the unique United States health care system. â€Å"The United States spent $412 per capita on health care administration and insurance in 2003 –nearly six times as much as the OECD average† (McKinsey Company). The combination of the various private and public health options and numerous regulations across the nation increase the complexities of administering healthcare thus raising the costs to do so. (McKinsey Company). The reduction of administrative costs will be a challenge in the current state of the United States health care system however; the opportunity exists and can be addressed during health care reform initiatives. With so many potential reasons it is clear that no single factor is either a cause or magic solution for reform initiatives. Some would argue that perhaps the rising cost of health care within the United States is justified by higher quality and efficiency in the system. Unfortunately this is not the case. A recently released report from the Commonwealth Fund compares the health systems of six other industrialized countries across five areas: quality, efficiency, access to care, equity and the ability to lead long, healthy, productive lives. The United States ranked a dismal last in overall performance compared to the other six industrialized countries suggesting that not only are the costs of health care out of line in the United States but the services provided at these higher costs are of a lower value (â€Å"Eurek Alert†). The table below highlights the findings of the Commonwealth study. In the area of quality the United States received their highest ranking of 4th in the specific categories of effective care and patient-centric care. In the remaining categories of safety, coordinated care, access, efficiency, equity, and life quality the United States was within the bottom three if not the last. US patients with chronic conditions reported a higher rate of receiving an incorrect dose of medication decreasing the safety rankings. Delays in obtaining abnormal test results and 13% higher level of reported avoidable emergency room visits contributed to the poor ratings of coordinated care and efficiency. US patients also overwhelmingly reported difficulty affording the health care they need. Many patients became non-compliant with medication or follow-up care or avoided necessary care altogether due to costs. The 7th place ranking of the United States of healthy lives is associated with the high rate of infant mortalities and potentially preventable deaths before the age of 75 (â€Å"Eurek Alert†). The United States, as an industrial nation, should have higher increases in life expectancy to match the rate of health care spending. The graph to the right compares total expenditure on health per capita in USD to the average life expectancy at birth. The US life expectancy in 2010 was 78. 7 years, which is one full year below the OECD average life expectancy of 79. 8 years. Other industrial nations, such as Japan, Italy and Spain, report at least half of the amount of US expenditures on health per capita and have life expectancies which exceed 82 years. This is not to say the life expectancy at birth has not been increasing in the US. In fact the OECD reports â€Å"In the United States, life expectancy at birth increased by almost 9 years between 1960 and 2010, but this is less than the increase of over 15 years in Japan and over 11 years on average in OECD countries. † Upon review of these figures, the necessity for controlling the rising costs of health care in the United States becomes abundantly clear. Health care reform is a necessity. Reformers have suggested a complete reversal in the structure and approach to the delivery of health care within the United States. The current method of reactive individual care will need to be displaced by the â€Å"triple aim,† a three tiered simultaneous goal of health care reform to lower costs, improve care and promote better health across the population. Improving the quality while simultaneously lowering the costs of the complex health care system of the United States will require a multi-level approach. â€Å"The alternative approach to controlling costs is to support a healthcare system in which individual decisions of both the provider and patient are much better aligned with value† (McClellan 69-92). The objectives to reduce per capita costs of health care, improve the general health of the population, and expand the experience of patient care seem intuitive yet at the same time challenging to achieve. Triple aim components are not independent of one another, instead they are tenuously linked. An adjustment to one component can have either a positive or negative effect on the other components. Reducing the use of specialists, expensive testing, and new medication usage can improve the goals of cost reduction and general health, but might produce a long-term negative effect on the individual experience by limiting technological advances. A health system capable of continual improvement on all three aims, under whatever constraints policy creates, looks quite different from one designed for the first aim only. The balanced pursuit of the Triple Aim is not congruent with the current business models of any but a tiny number of U. S. health care organizations† (Berwick, Nolan, a nd Whittington 759-769). A key feature of this new philosophy is the focus on the complete health of a subgroup or â€Å"population. † Population management anticipates and shape patterns of care rather than reacting to the acute needs at the individual patient level. Only when the population is specified does it become, in principle, possible to know about its experiences of care, its health status, and the per capita costs of caring for it†(Berwick, Nolan, and Whittington 759-769). Capturing and tracking this population data overtime to assist physicians with proactive and preventative treatment plans will require research, development and investment. It is important to note a population cannot exclude individual members or subgroups. To achieve the triple aim, all citizen must have access to the same level of service. Another fundamental element in achieving the triple aim is the integrator. An integrator is an entity, whether it consists of a hospital with an affiliated physician group, a large primary care group, or a creative insurer, that accepts responsibility for all three components for a specific population (Berwick, Nolan, and Whittington 759-769). An effective integrator will bridge the gaps of the multi-faceted health care system and coordinate behavior among health service suppliers to work as a system for the defined population. To achieve these goals the integrator will need to be a single organization with the mission â€Å"to change the ‘more-is-better’ culture through transparency, systematic education, communication, and shared decision making with patients and communities, rather than by restricting access, shifting costs, or erecting administrative hurdles to care† (Berwick, Nolan, and Whittington 759-769). Health care will be challenged to expand beyond the four walls of the health care facility and deliver creative and comprehensive care to patients in their daily lives. Many members of the population, especially those with chronic illnesses, will need someone who can work with them to establish a plan for their ongoing care, guide them through the technological jungle of acute care, advocate for them, and interpret† (Berwick, Nolan, and Whittington 759-769). New methods to provide service are emerging as technology advances. Health care providers are beginning to use e-mai l, telephone, teleconference and virtual media to deliver services and potentially reduce the high rates of specialist referrals or visits. However, this expanded level of care requires a greater time commitment on the part of the primary care physician and his or her care team- time which is currently not incentivized or reimbursed. â€Å"Eliminating unnecessary care therefore requires reorganizing the delivery system to ensure that providers aren’t penalized for providing what is often the better alternative for their patients† (Sutherland, Fisher, and Jonathan 1227-1230). â€Å"The broken financing system of the present mirrors the fragmented care system† (Berwick, Nolan, and Whittington 759-769). Current payment to United States health care facilities and providers are based on a system which encourages utilization of health care services regardless of necessity. Since 1996, the United States health system has operated under a fee-for-service payment method. Under this payment structure, a provider or facility typically receives a set fee for a particular service, such as a routine physician office visit or an inpatient stay at a hospital. These fees are characteristically paid through a combination of patient and insurer, either public or private. Each year these set fees are reviewed and adjusted according to volumes of service types. Typically there is minimal reduction in fees, despite advances in efficiency by means of technology, because the review board is partially comprised of physicians. Many analysts believe this value scale is highly distorted and no longer reflects relative costs (Ginsburg 1977-1983). Hence, fee-for-service drives the volume based productivity of United States physicians, specialists and health care facilities. The Fee-for-service format creates incentives to see more patients than other formats would – especially since subjective clinical judgment guides treatment intervals and consultations in most cases. Not surprisingly, then, do physicians in the United States see, on average, 1. 6 times more patients than do physicians in other countries† (McKinsey Company). The fee-for service model of payment has two additional drawbacks. With the objective to service as many patients as possi ble in the shortest amount of time frame physicians are not encouraged to educate patients on the importance of preventative measures and unnecessary procedures. Hospitals lose money when they improve care in ways that reduce admissions, and they lose market share when they don’t keep pace in the local medical arms race. In this race there are no financial rewards for collaboration, coordination, or conservative practice. † (Fisher, Bynum ; Skinner). The co-ownership of many outpatient facilities such as ambulatory surgery centers (ASC), diagnostic imaging centers (DIC), and diagnostic testing and procedure laboratories by United States physicians also impedes the success of the fee-for-service payment model in cost containment. With ownership, physicians receive additional profits for consultations and procedures referred to these facilities. These alignments directly conflicts with the need to reduce unnecessary services (McKinsey ; Company). To achieve the triple aim, new payment methods will have to be devised. The concern is that continued dependence on fee-for-service payments, which reward high utilization and promotes variable expense for different subpopulations, threatens the necessary practice transformation and the expressed goals of delivery system reform. The practices that are rewarded are the practices that are implemented. To create the desired behavioral changes new financing and competitive dynamics are required (Berwick, Nolan, and Whittington 759-769). â€Å"Transitioning from a fee-for-service payment system, with its emphasis on volume, to a more value-driven payment model that encourages better health care at lower cost will require realignment of financial incentives† (Goroll, and Schoenbaum 577-578). The economic objective of provider payment reforms is to give healthcare providers as a group an incentive to offer the right care for each patient—care that is well-coordinated and efficient for each individual, which means both giving difficult cases the extra resources required while conserving resources when they would not be well-used† (McClellan 69-92). Payment reform needs to be staged-in and coordinated with the implementation of practice reform, permitting time for the required changes to occur in practice culture, care delivery, and information systems. Over the course of recent health care reform initiatives, several new methods are quickly being devised, tested and realized (Goroll, and Schoenbaum 577-578). Following in the footsteps of peer industrial nations, the United States has begun to explore supplementary methods of health service payment by incorporating elements of quality-related bonuses, incentive payment, bundling similar services, and shared savings programs thereby fostering culpability for overall costs and quality of care. â€Å"Pay for Reporting† is one of these new payment methods. In the pay for reporting model additional payments are tied to the ability to provide information related to quality of care measurements. The goal is to obtain long-term data on both health outcomes and associated costs. Presently Medicare offers pay for reporting to both hospitals and physicians who disclose a set of specialty specific quality measures related to the use of evidence-based processes of care. â€Å"Such payments have had a substantial effect: virtually all U. S. hospitals now participate in Medicare quality reporting, and as a result, more healthcare performance measures are becoming available† (McClellan 69-92). There is also some evidence that providing information to the public inherently leads to quality improvements. Increased knowledge of meaningful data is essential to revising the United States health care system. â€Å"Consequently, incentives or requirements to report on quality are a prerequisite for all of the reforms that follow† (McClellan 69-92). A second reimbursement model that has recently been implemented in the United States health care system by a handful of insurance plans is the â€Å"pay for performance† model. Payments in the pay for performance model are issued upon improvement of predetermined quality metrics. In 2003, Medicare instituted a hospital pay for performance program in which reimbursement is tied to performance within a set of 33 clinical measures, including the administration of aspirin to heart attack patients and assessing the oxygen levels of pneumonia patients. The program is linked to significant quality improvements and appears to reduce the costly complications associated with the chronic conditions. However, overall cost savings are hard to detect. Some analyst report â€Å"trend comparisons with hospitals that reported on quality without a pay-for-performance program showed that most of this effect was associated with underlying time trends and not pay-for-performance per se† (McClellan 69-92). In the practice setting of the United States health care system pay for performance also occurs in the form of â€Å"medical homes. † The objective is to better manage care for chronic diseases and prevent costly complications. Physicians are financially rewarded for spending more time with high risk patients. Studies are split in their findings regarding the impact physician pay for performance methods have on the total quality and cost of patient care (McClellan 69-92). Health information technology is also widely incented by pay for performance methods through the 2009 economic stimulus program of â€Å"meaningful use. † Along the lines of pay for reporting an increased knowledge of meaningful data is essential to revising the United States health care system. Meaningful use† combines the two methods by first rewarding the ability to report on quality measures through a shared information system with the ability to track the patient population and secondly providing addition payment for the achievement in attaining certain clinical criteria (McClellan 69-92). Concerted efforts are underway to combine payments across multiple providers and settings in a broader manner that will go beyond prov iding incentives for performance. Bundled payments provide a means in achieving this objective. Bundled Payments are not a new concept within the fee-for-service payment method. Recently efforts have been taken to expand and include quality metrics within these bundled payments. â€Å"For example, in the case of diabetes, some quality measures might include how well-controlled a patient’s blood sugar was, the rate of hospitalization of patients with potentially preventable diabetic complications, and patients’ assessment of their overall experience with care† (McClellan 69-92). Historically such measurements have not been included in the traditional, provider or facility specific episode-based bundled payments. The enlargement and broadening of â€Å"bundles† for payment across multiple providers is extremely challenging due to the constant evolving of health knowledge and the growing crossover between chronic disease complications. Nevertheless, the opportunities for improving quality while lowering costs could be substantial. â€Å"Whether these reductions in intensity and costs within the bundles resulted in lower overall spending growth is less clear, but their impact on costs within the ‘silo’ of bundled care and their potential for lowering overall costs is unquestionably a key reason for their more widespread use†(McClellan 69-92). The most drastic proposed change to the current payment system in United States health care is through capitated payments and shared savings. The intricacies of outlining specific bundles of care for various chronic conditions can be avoided by bundling payment for all health care services together. A launching point for this proposal stems from health maintenance organizations (HMO) and preferred provider organizations (PPO) in which an insurance plan organizes a large network of services and regulates the usage and cost with capitated payments. The members within the insurance plan therefore become the population requiring managed and coordinated care for which fixed payments are provided on a service level basis. In some instances the providers share the financial risk for overall patient costs, not just the services provided, and split the cost savings with the HMO or PPO. â€Å"In recent years, Medicare has similarly tried out reforms that enable providers to ‘share savings’ that are achieved in overall per-capita spending. These developments are leading to what has come to be called â€Å"accountable care organizations† (McClellan 69-92). An accountable care organization (ACO) is comprised of a network of health care providers that share responsibility and are held accountable for the overall costs and quality for an identifiable population of at minimum 5000 Medicare patients. â€Å"The ACO would bring together the different component parts of care for the patient – primary care, specialist, hospitals, home health care, etc. – and ensure that all of the ‘parts work well together†Ã¢â‚¬â„¢(Gold). Under an ACO patients would have access with coordination to an entire health care package. Within the current United States health care system, patients shop around for care which is disjointed by the lack of communication between providers. Unlike HMOs patients would not be limited to services within the ACO, instead it would be the responsibility of the ACO to coordinate with any resources utilized outside of the network (Gold). The Medicare ACO Shared Savings Program launched in April of 2012 with regulations for participation within the program surround the core concepts to achieve better care for individuals, better health for populations and lower expenditures for Medicare, in other words the Triple Aim. Two payment options are available for shared savings. ACOs can either assume a smaller share of upside gain with no risk of loss for the first two years of operation, transitioning to full risk in the third year, or ACOs can incur full responsibility for patient service cost at inception thereby receiving a higher percentage of shared savings or risk (Berwick 1-4). â€Å"Provider payment reform is a work in progress. As the capacity to measure health are processes and outcomes continues to expand rapidly, in conjunction with at least some growing confidence that we are measuring the right things, the linkages between provider payments and measured quality are likely to strengthen† (McClellan 69-92). Most likely a combination of the aforementioned payment reform methods will surface as the structure and focus of the United States health care systems shifts towards the triple aim goals. Integrated health care delivery systems that are responsible for populations cannot flourish unless payment systems encourage their development and laws and regulations support their growth. A joint effort will be required on the part of physicians, specialists, insurance companies, employers, government and the individual patient to influence any effective reform initiatives. If all the stakeholders can agree on the triple aim vision of a United States health care system, the development of professionally led, integrated systems can be achieved. Work Cited â€Å"Accounting for the Cost of Health Care in the United States. † McKinsey Global Institute. McKinsey ; Company, Jan 2007. Web. 11 Sep 2012. Auerbach, David, and Arthur Kellermann. â€Å"A Decade Of Health Care Cost Growth Has Wiped Out Real Income Gains For An Average US Family. † Health Affairs. 30. 9 (2011): 1630-1636. Print. Berwick, Donald. â€Å"Launching Accountable Care Organizations – The Proposed Rule for Medicare Shared Savings Programs. † New England Journal of Medicine. 10. 1056 (2011): 1-4. Web. 5 Sep. 2012. Berwick, Donald, Thomas Nolan, and John Whittington. â€Å"The Triple Aim: Care, Health, And Cost. † Health Affairs. 27. 3 (2008): 759-769. Print. Fisher, Elliott, Julie Bynum, and Jonathan Skinner. â€Å"Slowing the Growth of Health Care Costs – Lessons from Regional Variation. † New England Journal of Medicine. 360. 9 (2009): 849-855. Print. Ginsburg, Paul. â€Å"Fee-For-Service Will Remain A Feature Of Major Payment Reforms, Requiring More Changes In Medicare Physician Payment. † Health Affairs. 31. 9 (2012): 1977-1983. Print. Gold, Jenny. â€Å"ACO is the hottest three-letter word in health care. † Kaiser Health News. Kaiser Family Foundation, 21 Oct 2011. Web. 1 Sep 2012. Goroll, Allan, and Stephen Schoenbaum. â€Å"Payment Reform for Primary Care Within the Accountable Care Organization. † Journal American Medical Association. 308. 6 (2012): 577-578. Web. 2 Sep. 2012. Kolata, Gina. â€Å"Knotty Challenges in Health Care Costs. † New York Times 05 Mar 2012, Web. 11 Sep. 2012. Laugesen, Miriam, and Sherry Glied. â€Å"Higher Fees Paid to US Physicians Drive Higher Spending For Physician Services Compared to Other Countries. † Health Affairs. 30. 9 (2011): 1647-1656. Print. McClellan, Mark. Reforming Payments to Healthcare Providers: The Key to Slowing Healthcare Cost Growth While Improving Quality?. † Journal of Economic Prespectives. 25. 2 (Spring 2011): 69-92. Print. â€Å"OECD Health Data 2012. † How Does the United States Compare. Organization for Economic Cooperation and Development, June 2012. Web. 1 Sep 2012. Reinhardt, Uwe. â€Å"Why does U. S. Health Care Cost so Much? (Part III: An Aging Population Isnâ€⠄¢t the Reason). † Economix: Explaining the Science of Everyday Life. The New York Times, 05 Dec 2008. Web. Web. 2 Sep. 2012. Reinhardt, Uwe. â€Å"Why does U. S. Health Care Cost so Much? (Part V: Can Americans Afford Medicare? ). † Economix: Explaining the Science of Everyday Life. The New York Times, 05 Dec 2008. Web. 2 Sep. 2012. Sutherland, Jason, Elliott Fisher, and Skinner Jonathan. â€Å"Getting Past Denial – The High Cost of Health Care in the United States. † New England Journal of Medicine. 361. 13 (2009): 1227-1230. Print. â€Å"US Ranks Last among 7 countries on health system performance. † Eurek Alert Organization. Commonwealth Fund, 23 June 2010. Web. 1 Sep 2012. How to cite Healthcare Reform, Essay examples Healthcare Reform Free Essays Healthcare Reform By Kim LeFave Healthcare is one of the hottest political topics in the news. It affects every man, woman, and child. I’m sure most if not all of you have caught something on this topic. We will write a custom essay sample on Healthcare Reform or any similar topic only for you Order Now As I researched this topic on the internet I was surprised to learn some of the statistics on healthcare in America. Even though our nation is faced with recession and more than 8% of Americans are unemployed I still assumed the rest of the 92% of working Americans had some kind of healthcare insurance. I was alarmed to learn that 15% of Americans have no coverage. This is roughly 47 million Americans. To me it is obvious that healthcare reform is necessary. We are still one of the richest countries in the world. Why are so many without any healthcare insurance? Those of you who work full-time, how many of you pay a certain amount out of your weekly check for healthcare insurance? It seems to go up higher than the cost of living each year. Do you have adequate coverage? Most Americans are not happy with the out of pocket expenses they have to pay in addition to paying high premiums. Do you have a co-pay every time you see a doctor? Do you have to pay a portion for drug coverage? These costs can add up. When was the last time you saw a doctor? Do you avoid doctors unless you are absolutely sick? The reason I am bombarding you with these questions is to get you to think about what healthcare reform might mean to you. What is it you want out of your healthcare insurance provider? Most of us might say lower out of pocket expenses, like low or no co-payments for doctor’s visits, or low or no co-payments for needed drugs, or even no money taken out of our paychecks to pay for that health insurance. Wouldn’t that be nice? Do you realize that most developed countries have universal healthcare systems, which means whether or not you are employed you are covered for your healthcare needs. After watching a PBS program about universal healthcare in other countries I was very surprised that our country was not trying to do some of the same things that these other countries were doing. Take for instance Japan, under their universal health care system MRI’s are about two hundred and fifty dollars, and in America it is about two thousand dollars. No doctor in Japan is getting rich quick, but people are able to afford healthcare more easily. It is much of the same in other countries that have universal healthcare systems. Okay let’s get back to what is now going on in this country. Basically the Healthcare Reform Bill under President Obama’s administration is a very small step in actual healthcare reform compared to what other countries have done. I’m sure most of you have heard that under the new reform bill insurance companies cannot deny coverage if you have a preexisting condition. Also it limits sky high premiums because of gender and age. It will also prevent insurance companies from dropping coverage when people are sick and need it the most. It will eliminate extra charges for preventative care like mammograms, flu shots, and diabetes tests to improve health and save money. It is supposed to protect medicare for seniors by extending new protections for medicare beneficiaries. It will also eliminate the â€Å"donut-hole† gap in coverage for prescription drugs. If you don’t have insurance this new reform bill will create a new insurance marketplace called the Exchange. This will allow people without insurance and small businesses to compare plans and buy insurance at competitive prices. It will also provide new tax credits to help people to buy insurance. It will give tax credits to small businesses and give affordable options for covering employees. It will offer a public health insurance option to provide the uninsured and those who can’t find affordable coverage with a real choice. It will offer new, low-cost coverage through a national â€Å"high risk† pool to protect people with preexisting conditions from financial ruin until the new Exchange is created. Hopefully this can all be achieved as proposed. It is not supposed to add to the national deficit and is paid upfront from the immediate savings from the initial healthcare reform. If savings are not realized essentially cuts will be required by the President to ensure that the plan does not add to the deficit. In addition these reforms will begin to rein in health care costs and align incentives for hospitals, physicians, and others to improve quality. It will create an independent commission of doctors and medical experts to identify waste, fraud and abuse in the health care system. It will order immediate medical malpractice reform projects that could help doctors focus on putting their patients first, instead of practicing on defensive medicine. To do this the Secretary of Health and Human Services is instructed by the President to award medical malpractice demonstration grants to states funded by the Agency for Healthcare Research and Quality. Also large employers with more than fifty employees who can afford to buy insurance so everyone of their employees share in the responsibility of reform will be required. Their will be a â€Å"hardship exemption† for those who cannot afford the premiums. Okay so there it is the basics of the new Healthcare Reform Bill proposed by President Obama and his administration. To me this is just a minute scratching of the surface for healthcare reform in this country. I suppose you have to start somewhere. Not every American will be happy with the proposed changes. To me it should be done more on a trial basis, but let’s get real try it before you buy it in this country is virtually unheard of especially when it come to healthcare. I’m sure we will learn as we go and that it will be an honest effort to avoid high cost health insurance. What bothers me the most is that many things that make the healthcare too costly are not being addressed. What about the cost of a doctor’s visit, or the cost of a procedure, or the cost of your drugs? Will it go down? This reform bill hardly explains if this will happen. I think because of the newly created Exchange, healthcare insurance may go down a bit, but only time will tell if by the year 2013 when the exchange is fully active if it will affect the cost of the quality of healthcare as a whole. I read a blog online that made me question what is in the future for Americans when it comes to healthcare. How are people who can’t afford healthcare now supposed to afford healthcare when this new reform bill goes through? The blog questioned the validity of our government taking over another area where they have continuously failed in other areas. The point was that the Medicare / Medicaid system is already nearing bankruptcy as well as the U. S. Postal Service. It questioned how all this was going to be paid for by suggesting that the only real way to get the money is more taxes. Does that offer Americans a choice or is this being forced on us? These are very important points and even tougher questions that any American would be concerned about. Another blog for the healthcare reform bill suggests that there are many areas that the government has handled well, for instance; fire departments, police departments, waste water management, military, and coastguard. Although most of us think of some of these on a local level they are all federally funded. The strongest point was that this healthcare reform bill will reduce administrative costs from 20-30% to 2-3%. This would also reduce the profit that big time insurance companies and their biggest investors would make. My sister-in-law had that laser surgery on her eyes. When she researched cost she found that she could go to Canada and pay far less for the same procedure. She paid about three thousand dollars compared to the hefty price tag of seven thousand dollars here in the States. Many people have gone to Canada to receive cheaper procedures and cheaper drug prices. To me this is the real issue in this country. Yes, the insurance is expensive, but if you think about it procedures are even more expensive. If the cost of procedures and drugs go down along with the cost of insurance then this would make more sense to me. I think it will be at least another 5-10 years before we see this happen in this country. I think this bill will force some insurance companies to either go bankrupt or lose a tremendous amount of money. How will they compete with the less expensive insurances? Will it be just what happened to our banks? I see lots of merging insurance companies in our future. I hate to be clique but I think only time will tell how this will work out for all our citizens, our government and our insurance companies. How to cite Healthcare Reform, Papers

Friday, December 6, 2019

Cell Phone Speech free essay sample

To start it, Ill tell you about the common function of cell phone, after that Ill tell about theadvantages and disadvantages, and then its bad and good effect for university student. Finally, Illgive my own perspective in the end of my speech. First, Ill talk about the function of cell phones. Im sure that all of you have known that the functionof cell phone is for communication. As we know that nowadays most of people in this world,especially teenagers, cant live without cell phones. It is shown by data fromPew Research CentersInternet American Life Project (Lenhart, Ling, Campbell, Purcell, 2010)that 75% of 12? 17-year-olds own cell phones. Cell phone is different with telephone. If a telephone just used for calling, acell phone can be used for calling and texting. In this era, cell phones texting has become a basiccommunication between people, especially for teens. We will write a custom essay sample on Cell Phone Speech or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page More over, for teens who still given money bytheir parents will choose texting than calling, because the fact is texting is cheaper than calling. Thisday, there are many types of cell phones, and most of that new brand cell phones are completedwith internet connection. So, we can not just texting and calling, but we can emailing, surfing, orsharing something through internet in cell phone. Next, every gadget in this world exactly has advantages and disadvantages. Now, Ill tell you aboutthe advantages and disadvantages of cell phones. Because we are Medical Faculty students, so Illtell the advantages of cell phones that related to health. Do you know that cell phone can help us totake care our healthy? Ya, cell phone can do it. We can communicate with a nutrition advisor orsearching about healthy life style with cell phone. I have an experience about it. Yesterday, I was sick,and with cell phone I can call my sister, so she can bought me some medicines. And everyday, mymom always remembering me to drink my medicine, so I can be health again like now. Beside theadvantages, cell phones also has disadvantages. Related to health, cell phones can make eye strainbecause of lack of sleep. Cell phone also can disturb mental health, for example someone can bebullying through cell phone texting and that can make mental be down. The last thing I wanna tell to all of you is the effect of cell phone for us as university student. Im surethat everyone in here have your own cell phone, right? Im also sure that your cell phone give someeffects that change your behavior. One of that effect is dishonesty. Center on Media and ChildHealth in 2007states that The Pew Internet American Life Project found that 39% of cell usersages 18-29 say they are not always truthful about where they are when they are on the phone. Iagree with that statement because sometimes I do that too, especially if I am on the phone withsomeone who I hate. Ill lie to her/him because I hate them. Yeah something like that. But rememberone important thing : Dont ever lie to your parent! Maybe next time all of you will find and feel theother effect from cell phone by your self. Now, I wanna end my speech here. One sentence from me,a thing will be a good thing if the person who wear that thing is good. So, let be a good person tomake all the things better.

Thursday, November 28, 2019

Adventures Of Huck Finn By Mark Twain Essays (504 words)

Adventures Of Huck Finn By Mark Twain The conflict between society and the individual is a theme portrayed throughout Twain's Huckleberry Finn. Huck was not raised in accord with the accepted ways of civilization. He practically raises himself, relying on instinct to guide him through life. As portrayed several times in the novel, Huck chooses to follow his innate sense of right, yet he does not realize that his own instincts are more moral than those of society. From the very beginning of Huck's story, Huck clearly states that he did not want to conform to society; "The Widow Douglas she took me for her son, and allowed she would civilize me . . . I got into my old rags and my sugar hogshead again, and was free and satisfied." When Pap returns for Huck, and the matter of custody is brought before the court, the reader is forced to see the corruption of society. The judge rules that Huck belongs to Pap, and forces him to obey an obviously evil and unfit man. One who drinks profusely and beats his son. Later, when Huck makes it look as though he has been killed, we see how civilization is more concerned over finding Huck's dead body than rescuing his live one from Pap. This is a society that is more concerned about a dead body than it is in the welfare of living people. The theme becomes even more evident once Huck and Jim set out, down the Mississippi. Huck enjoys his adventures on the raft. He prefers the freedom of the wilderness to the restrictions of society. Also, Huck's acceptance of Jim is a total defiance of society. Ironically, Huck believes he is committing a sin by going against society and protecting Jim. He does not realize that his own instincts are more morally correct than those of society'. In chapter sixteen, we see, perhaps, the most inhumane action of society. Huck meets some men looking for runaway slaves, and so he fabricates a story about his father on the raft with smallpox. The men fear catching this disease and instead of rescuing him, they give him money and advise him not to let it be known of his father's sickness when seeking help. These men are not hesitant to hunt slaves, yet they refuse to help a sick man. This is contrasted to Huck's guilt felt for protecting Jim when he actually did a morally just action. Huck's acceptance of his love for Jim is shown in chapter thirty-one. Huck writes a letter to Miss Watson to return Jim, yet he ends up ripping the letter and wishes to free Jim. " 'All right, then, I'll go to hell'- and he tore it up." Here, we see that Huck concludes that he is evil, and that society has been right all along. The ending is perhaps most disappointing because it seems as though through all the situations that it seemed he was growing up and accepting his innate ideas of right, he hasn't grown at all. When he is reunited with Tom, he once again thinks of Jim as property. Huck functions as a much nobler person when he is not confined by the hypocrisies of civilization.

Monday, November 25, 2019

Free Essays on Crime In Society

Crime in most people’s minds would probably be viewed as the index crimes. Murder, rape, arson, robbery, and aggravated assault, all of which are index crimes are probably what most people think of when crime is mentioned. This paper however, is not on crime, it is on criminal behavior. The focus of this analysis is actually on white-collar and corporate crime. Crime that many times are overlooked. Why is white-collar crime many times overlooked? It is overlooked because the people that commit these types of crime are not exactly your everyday criminals. They are not your average poor, so called white trash and low-life people. They are not the people who you would expect to be criminals. They are actually in fact your everyday working class and middle class people. As I mentioned before, white- collar crime involves not people who are usually poor but people who are much better off in life. These people who are typically successful and have families and are the people who you would never even picture as being criminals. They are people who could never even be categorized as a criminal but are because white-collar crime and corporate crimes are in fact what they are, a crime. White- collar crime occurs in banks and corporations and often involves important figures in a community, like I said the people you would never expect. As for corporate crime, it does not involve just one individual, but many people, often an entire company or corporation, once again crime in the suites, not in the streets. So, what is white-collar crime and corporate crime? Now that I have introduced the topic I will go into detail as to what both of these topics actually are and I will examine more closely and look at what social forces play major roles in these crimes in the paragraphs to come. White-collar crime refers to illegal activities committed by people during the course of their employment or regular business activities. Crimes such as, fraud, which ... Free Essays on Crime In Society Free Essays on Crime In Society Crime in most people’s minds would probably be viewed as the index crimes. Murder, rape, arson, robbery, and aggravated assault, all of which are index crimes are probably what most people think of when crime is mentioned. This paper however, is not on crime, it is on criminal behavior. The focus of this analysis is actually on white-collar and corporate crime. Crime that many times are overlooked. Why is white-collar crime many times overlooked? It is overlooked because the people that commit these types of crime are not exactly your everyday criminals. They are not your average poor, so called white trash and low-life people. They are not the people who you would expect to be criminals. They are actually in fact your everyday working class and middle class people. As I mentioned before, white- collar crime involves not people who are usually poor but people who are much better off in life. These people who are typically successful and have families and are the people who you would never even picture as being criminals. They are people who could never even be categorized as a criminal but are because white-collar crime and corporate crimes are in fact what they are, a crime. White- collar crime occurs in banks and corporations and often involves important figures in a community, like I said the people you would never expect. As for corporate crime, it does not involve just one individual, but many people, often an entire company or corporation, once again crime in the suites, not in the streets. So, what is white-collar crime and corporate crime? Now that I have introduced the topic I will go into detail as to what both of these topics actually are and I will examine more closely and look at what social forces play major roles in these crimes in the paragraphs to come. White-collar crime refers to illegal activities committed by people during the course of their employment or regular business activities. Crimes such as, fraud, which ...

Thursday, November 21, 2019

Fallacies Analysis Assignment Example | Topics and Well Written Essays - 1250 words

Fallacies Analysis - Assignment Example This is a type of question that is intended to make the opponent look unavoidably bad and uncomfortable. It can be found in political campaigns aimed at the citizens’ noble feelings: e.g. do you favor voting for a party that will legalize drugs, promote gay marriages and diminishes importance of religious spirituality justifying it with democratic aspirations? In this fallacy, the premises supporting the conclusion imply that the conclusion is true. For example, one can say that the United States is the best country to live in the world because there are no other countries better than the U.S. Drawing conclusions based on the available evidence, we often suppress both available and unavailable evidence that might make the conclusion more consistent. A common instance is insisting that America is an inherently Christian nation relying on the fact that ‘in God, we trust’ is inscribed in money. However, this conclusion is inconsistent due to a suppressed evidence: this inscription was added in the middle of the 20th century because of the fear of communism. Lack of proportion is over- or underestimation of actions, arguments, and outcomes used to convince people. An instance of this fallacy can be seen in downplaying important arguments for the sake of less significant ones. For example, a mother can be worried about the risk her child faces at school, i.e. risk of a mass school shooting; but she ignores the significance of the risk the child faces going to the school by bus daily.

Wednesday, November 20, 2019

The pianist of willesden lane Movie Review Example | Topics and Well Written Essays - 750 words - 2

The pianist of willesden lane - Movie Review Example Different themes have been used to show the fear and what was going through the woman’s head during the holocaust. In life, no one is supposed to go through what the woman in the play went through. We should all try to accommodate each other’s believes and respect them (Hurwitt). The play tells a great story. It incorporates narration of the story with music that fuses well to set the mood and illustrate the exact feelings and the situation at the time. The result of this is the heart responding in kind with the theme. When the play was featured in the theater, everyone sheds a tear. The director has tried to fuse all the tales told in the story with a song. Director Hershey Felder who adapted the book and came up with the play uses music and costumes trying to reenact the mood of the writer while writing the book. These tails are deep and can appeal to any human being. The use of stage lights to further set the required mood for the play. The music only comprises of a piano. This is because in the book the author tells the tails using songs that she played on her keyboard. It gives the play a more intricate meaning because music appeals to the emotions (Hurwitt). The director of the play adds visuals to the play to further intensify the mood that he intends to portray. Since some of the visuals are a bit graphic, the director tries to blend them with the emotional music that accompanies them. The director divides the play in three parts. The first part sets up the conditions that were experienced in 1938 during the holocaust. The intention of this is to bring the attention of the audience to the mood of the play. The music that opens the play is deep and conveys a sad mood. The second part takes the play to a new high. The music and visual introduce a new dimension to the play. They bring out the emotions at the time of the holocaust. It goes deeper in bringing out the mood of the author of at the time of the holocaust (Hurwitt). Being that the p lay is centered on the story narrated by the author of the book, it was important to convey her thoughts and emotions at the time. The last part does exactly that. It brings the play to a fervent resolution. The music at this time is deep and very emotional. The visuals are intense and the play reaches its climax. The response from the audience is amazing. Everyone is full of emotion. The third part makes a passionate appeal to the emotion and humane part to never repeat the issues shown by the play. To illustrate further the theme of the play, the director uses archival photos, newsreels and file videos projected to large old golden picture frames hanging in the middle of the theater stage. The theater stage is painted midnight blue. The contrast in the colors brings out the theme of the medieval ages. The play does not portray comfort of the actor. The actor has to assume the voices of men, women and children written in the book (Hurwitt). The play comes alive in different ways. T he use of the piano music creates a more emotional attachment. The use of visuals in the play lets you tell how the situation was at the time expressed. The actors bring out the physical actions that are expressed in the play. With this, the director tells the story as it is in the book it was adopted. When I watched the play, I felt touched. I understood what the director's intentions were when he created the play. The emotional attachment to the songs and visuals in the play is strong. I think the play was a success in educating us about the holocaust and how it

Monday, November 18, 2019

Homeland Security Research Products Paper Example | Topics and Well Written Essays - 1000 words - 1

Homeland Security Products - Research Paper Example Understanding the radicalization process is crucial in developing effective counter-strategies. This is because potential terrorists begin and progress through radicalization processes. Successful counter strategies can only be achieved if the security structures identify the point where radicalization begins. The second report is that of the Department of Homeland Security titled Right-wing Extremism: Current economic and political climate fueling resurgence in radicalization and recruitment (U.S Department of Homeland Security, 2009). The report provides an assessment of the threat posed by homegrown extremism from right-wing groups. The report is an intelligence assessment that helps in facilitating a better understanding of the emergence of violent radicalization in the United States. The report lacks credible evidence that the right-wing terrorists are planning any acts of violence. However, it bases its argument on the speculation that the extremists may be training more recruits owing to the fear related to several emergent issues i.e. the economic downturn and the election of the first African American president. To address the research question in detail, the report has focused on discussing issues such as the prevailing political and economic environment, exploitation of the econ omic downturn, the presidential election, illegal immigration, and the legislative initial drivers among others. This report addresses the homegrown threat that terrorism activities pose in developed nations, for example, the United States. The study discusses the radicalization factor that promotes terrorism activities. The research is successful in the use of case studies to explain the formation and advancement of the intentions that lead to terrorism. Use of case studies amounts to qualitative research. The case studies provided existing data and information on terrorism for the report.  

Friday, November 15, 2019

Factors of Affecting Online Game Satisfaction

Factors of Affecting Online Game Satisfaction CHAPTER ONE INTRODUCTION 1.1 Introduction Online gaming is one of the most popular entertainments among the citizen in this world no matter what ages they are. Due to the advancement in the technologies, it has brought lots of growth in this industry since early of 2000s. This growth has been developed online game market into the core of the world cultural industry (Sang, Yung, Jae, and Kyoung, 2004). Hsu and Lu (2003) stated that online game service has been a highly profitable e-commerce application in recent years and its market value has increasing markedly as well as number of player growth at the same time. Now a day, most of the household will owned at least one personal computer (PC) or a laptop and some even more than that due to the cheaper cost to have a computer. Consequently, the demand for computer has been grown rapidly throughout this recent year. The accessibility of internet also is easier with each passing year and the cheaper price to have broadband internet connectivity (Bizymoms.com). Generally, online game service can be categorized as business-to-consumer or B2C in e-commerce and it is also one the videogame and interactive entertainment industry. A strategic market research and consulting firm which focuses on the interactive entertainment and the emerging video game, online game, interactive entertainment and portable game markets namely, DFC Intelligence has made its forecast for worldwide videogame and interactive entertainment industry each year since year 1995. According to DFC Intelligence forecast on year 2008, the worldwide videogame and interactive entertainment industry revenue to reach USD 57 billion in 2009 with no signs of slowing due to the slumping economies and expensive hardware (Androvich, 2008). The rapid growth in videogame and interactive entertainment industry has been attracted lots of entrepreneur who would like to enter this profitable industry. Based on the report of DFC, PC was the top platform for games in 2007, with online game revenue alone eclipsing USD 7 billion on year 2006 and not including retail sales. The DFC also stated the total PC game revenue is expected to reach USD 19 billion by year 2013 (Androvich, 2008). In Malaysia, there were 15 million subscriber of internet and it was 62.8% out of the total population in 2008 (Internet World Stats, 2008). It was more than half of the citizens of Malaysia have used the internet and this has brought a great opportunity to the entrepreneur who would like to join this industry to be one of the online game service providers to share the profit since the number of internet users was increasing each year. It did not showed that the number of the online game subscribers but there is a business opportunity for the entrepreneur to start-up their business through online. Table 1.1: Internet Usage and Population Growth of Malaysia Year No. of Users Total Population % 2000 3, 700, 000 24, 645, 600 15.0% 2005 10, 040, 000 26, 500, 699 37.9% 2006 11, 016, 000 28, 294, 120 38.9% 2007 13, 528, 200 28, 294, 120 47.8% 2008 15, 868, 000 25, 274, 133 62.8% (Source: http://www.internetworldstats.com/asia/my.htm [2009, November 1]) A study showed that customer satisfaction is the immediate factor affecting the consumer retains loyalty (Cronin, Brady, and Hult, 2000). Most of the studies showed that higher levels of customer satisfaction will lead to customer loyalty. â€Å"A minor change in satisfaction could lead to a substantial change in loyalty increment† (Bowen and Chen, 2001). However, most of these studies were in offline environment. Wind and Rangasamy (2001) found that online environments offer more opportunities for interactive and personalized marketing. Eventually, these opportunities may influences customer satisfaction and customer loyalty in the online environment if compared to the traditional market or offline environment (Shankar, Smith, and Rangaswamy, 2003). The main purpose of this study is to identify the factors affects the customer satisfaction towards online game services and which could lead to customer loyalty. It is including the service quality, transaction cost, experience value, and technology acceptance factor. These four antecedents of online game service satisfaction and loyalty will test associations based on the model that has been constructs. 1.2 Background of the Research In this century, computer might be a need for a person if compared to the olden days where there was a limited growth in technologies. Now, computer seems like a tool which can do everything for you such as searching information, payment, shopping, and so on. This powerful electrical appliance has gain a well response from the citizen of the world. It has many functions can perform through computer and one of the most popular functions of computer is gaming. In the earlier 2000s, most of the games were played offline since the limited internet connectivity and expensive prices to have an internet connectivity. However, this situation has changed due to the technologies advancements and the industry has achieved economic of scale. To more understand what online games is, it is a must to brief its history. The very first online gaming activities were introduced in the late of 1960s and early of 1970s. Later, they started gain more popularity within 1970s to 1980s when dial-up Bulletin Boards became popular and the users started playing online game over them. Clyde and Thomas (2008) stated that the development of arcade game in the 1970s, and video and computer games in the 1980s; digital games have become an influential part of popular culture. The bulletin boards provided a multi-user platform which allowed few users to play at the same time. Now, it has been transformed to MMORPG (Massively Multi-Player Online Role-Playing Games) which is popular all around the world presently (Bizymoms.com). At one time, games were used for educational purpose rather than entertainment (Clyde and Thomas, 2008). However, due to the changed in the perception of game role and the culture, it becomes an entertainment but there is still has some of the game designers and educators used it as educational purposed such as learning typing skills and so on. In the year of 1990s, due to the growth of internet technologies of Flash and Java, it has led to the increasing usage of the internet and the millions of new websites mushrooming across the World Wide Web. When enter to the millennium year, technological giants such as Sony, Microsoft and Ninetendo came out with advanced gaming consoles has changed the features of online gaming completely (Bizymoms.com). The people all around can play a same game with each other virtually at the same time. Currently, online gaming industry is growing each year and it has a great expansion in future. The online game service is one of the most competitive industries among the entire industries. The new and the existing online game service provider are delivering their best services to gain more market share to sustain its organization. To penetrate the market, the firm must meet the customer expectation which may lead to customer satisfaction. Eventually, it may bring customer loyalty. 1.3 Research Problem Customer is the one who contribute the profit to the firm because they are the one who are using the product or services. However, consumers are becoming wisely now a day when they would like to use certain product or services. They will tend to purchase the product only if the product can meet their expectation which might lead to satisfaction. To meet the customer expectation, it is a biggest challenge for the firm. Other than that, the growth of the online game has brought some a major problem to the service provider which is how to retain the existing online game users and will not shifting to other service provider or loyalty to the current provider (Yang, Wu, Wang, 2009). In order to survive in this competitive industry, many practitioners and academicians in this field have focused on how to improve online services to attract potential buyers as well as the current customers (Jun, Yang, and Kim, 2004). There are some of the factors to achieve customer satisfaction. However, the key factors especially in online game services which are able to make the customer satisfied with the products and services still under study or unknown (Dick, Wellnitz, and Wolf, 2005). If the key factors have been determined, the provider might be able to gain the competitive advantages which trying to meet the customer expectation. This research is emphasizing the customer satisfaction and loyalty in online game service. Specifically, it is trying to identify the key factors affects online satisfaction and online loyalty in order to guide the online game service provider to improve their service quality to garb more potential customers and retain the existing one. 1.4 Research Objectives The objectives were formed based on the research problem and there are formulated to achieve the main goal of this study which is to examine the factors of affecting the online game satisfaction and loyalty. To determine service quality has a positive impact towards online game satisfaction. To determine transaction costs has a positive impact towards online game satisfaction. To determine technology acceptance factor has a positive impact towards online game satisfaction. To determine experience value has a positive impact towards online game satisfaction. To determine online game satisfaction would have a positive impact on online game loyalty. To determine service quality, transaction cost, technology acceptance factors, and experience value will affect online game satisfaction and eventually online game loyalty. 1.5 Justification of the Study This study is significant for several reasons. First, it can identify the gaps between customer expectation and perception about online game service provider in order to guide them to provide better services. â€Å"It is commonly known that there is a positive relationship between customer loyalty and profitability† (Bowen and Chen, 2001). It is correct once the customer is loyal to the company because they will visit the firm after a purchase and some even recommend to their friends. In the online environment, the online satisfaction also grabs much attention from all of the researchers because to meet a customer expectation is the toughest challenges to the company. Also, it brings the profitability and the survival of the company. Online game service provider should concern about the medium which may influenced the online game satisfaction and online game loyalty. The importance of the study is to keep the online game service improvement in order to achieve the customer satisfaction from time to time. In online environment, the customer can easily compared the alternative than offline customer especially products and service (Shankar et al., 2003). As in online environment, the user is free to search the information to the product that they demand. As well as online game, there is large amount of online game service provider. Therefore, the user can easily compared the features of the game and service quality that provided by the firm. Once the factor has a positive impact on online satisfaction has been determined, the service provider is able to strengthen their weaknesses in order to sustain its market share. Besides, the study is providing guidelines for the service provider to develop their future or long-term plan. The importance of the online game satisfaction will give a direction to the service provider to plan for their future such as strategic plan. It also helps the company to gain competitive advantages in this industry. Commonly, most of the studies regarding to customer satisfaction and loyalty were did for offline environment and only limited for online environment. However, consumers still have some same characteristics in making decision when they would like to purchase a product. As the study has identified the factors affect the customer satisfaction and loyalty, the firms are able to fulfill the users need and wants. This action is trying to meet the customer satisfaction and eventually customer loyalty. Once the customer become loyal, the company may survive in this competitive market. On the other hand, it is also will benefit the user to gain a better service from the online game service provider once they have responded to what they are percept towards the online game service provider that they currently subscribed. Also, the service provider is able to understand what kind of service quality that the users perceived and expected. It will leads to a win-win situation if both of the parties could perform what they are request and give. 1.6 Definition of Important Terms There are some important terms in this study: Online satisfaction, online loyalty, service quality, technology acceptance factors, transaction cost, and experiences value. Online Game Satisfaction Online game satisfaction is customer satisfaction towards online game service. Oliver (1980) defines customer satisfaction as customers evaluation of a product or service with regard to their needs and expectations. It is just in virtual environment perspectives. Online Game Loyalty Online game loyalty is customer loyalty towards online game service. It can be defined as â€Å"a deeply held commitment to rebuy or repatronize a preferred product or service consistently in the future, thereby causing repetitive same-brand or same brand-set purchasing, despite situational influences and marketing efforts having the potential to cause switching behaviuor† (Oliver, 1997). Service Quality Parasuraman, et al., (1988) defined service quality as â€Å"a global judgement, or attitude, relating to the superiority of the service†, â€Å"and explicated it as involving evaluations of the outcomes (i.e., what customer actually receives from services) and process of service act (i.e., the manner in which service is delivered)† (Jain, and Gupta, 2004) Technology Acceptance Factors It is also known as technology acceptance model (TAM). Davis (1989) proposed TAM to explain and predict user acceptance of information systems (IS) or information technology (IT). In short, it is explaining â€Å"intention to use a technology† (Schepers and Wetzels, 2007). Transaction Cost It is a theory â€Å"seeks to explain why firms exist and how firm boundaries were determined† (Watjatrakul, 2005). Experience Value It refers to â€Å"shopping efficiency and making good product performance and functionality† (Wu and Liang, 2009). Wu and Liang (2009) added â€Å"its perceptions are based on interaction involving either direct usage or distant appreciation of goods or services†. MMORPG (Massively Multi-Player Online Role-Playing Games) It is known as a virtual environment where it allows multiple geographically distributed users interact with each other at the same time (Papargyris and Poulymenakou, 2005). Besides, it is â€Å"offering an alternative channel for players to communicate, share experiences, socialize, and eventually from virtual communities† (Chee, Zaphiris, and Mahmood, 2007) Online Game Service It is a service provider who provides a server for the online game user to get into the network to interact with each other by playing games. 1.7 Organization of the Report This study will be constructed into five different chapters and there are: Chapter 1 is presenting the introduction and a brief overview of the study. The problems of the study, objectives of the study, significance of the study, and the chapter outline of the research are stated in this chapter. Chapter 2 provides an extensive review of international journals, reports, and articles from online and offline resources. Besides, all the reviews in this chapter are related to the problem of the research that will guide to construct the conceptual foundation and hypothesis of the study. Chapter 3 is describing the methods used in conducting this study in detail. Besides, it also presents the development of the research framework which proposed the relationship between dependent variables and independent variables. Next, the methodology applied is provided, sampling procedures, hypothesis development, data analysis and measurement. Chapter 4 presents the findings and data analysis of the research. It analyses and discussed the data collected in the research using the research instrument which has been developed in chapter 3. The hypothesis will be tested and it is also presents the results of statistical analysis used in this study (t-test, ANOVA, and etc.). Chapter 5 is presenting the conclusion and recommendation. There is also discussion of the studys implications, recommendations, limitations and suggestion for the future research. CHAPTER 2 LITERATURE REVIEW 2.1 Introduction Chapter 1 has discussed and highlighted the important issues which related online game service satisfaction and loyalty. All of these issues that mentioned in the chapter 1 are playing an important role for online game service industry in order to understand the expectation of the user and eventually grab more market share. As a result, to more understanding these issues, an examination of literature on related study were carried out. Generally, literature review provides the theoretical basis for the development of the research framework of this study, which will be discuss in the next chapter Chapter 3. This chapter consists of the following subject areas: (1) Definition of key terms; (2) online game satisfaction; (3) online game loyalty; (4) the factors might affect online satisfaction and loyalty; and (5) summary of literature review. 2.2 Definition of Key Terms 2.2.1 Online Game Service As technologies have became more advance, people have more rely on the technologies and they even expect technology will do all the things for us. Now, most of the people are prefer online rather than offline when they would like to purchase or acknowledge a transaction. In the olden day around 1980 where the technology has a limited growth, people can only play games in offline environment such as TV and handheld game console (Nintendo). In the late 1980s computer game was invented and started popular. Currently, computer games have been transformed into MMORPG (Massively Multi-Player Online Role-Playing Games) which is popular all around the world (Bizymoms.com). Besides, the multi-player online role-playing games also known as Net games (Lo, Wang, and Fang, 2005). Generally, net game can be divided into three which is web games, network games, and online games. The below is the definition of this three types of net games. Table 2.1 Types of Net Games Types Definition Players Web games Games which use a website as an interface. Players must register to play. Network games Games which allow multiple players to use their own PCs to interact via Local Area Networks (LANs) or the internet. Also, many of these closely resemble PC games. Players must purchase and install game software. However, it does not require any fees beyond those for internet connections. Online games Games where require players to connect to the service provider and log in to a server. Player must subscribe to the service provider and select a role to interact with other virtual roles. Source: Lo, 2008 Online game is requiring player to log in to a server in order to play the games. It is means that the players must have internet connection to connect with the service provider. After the player subscribe to the games, the user has to select a role to interact with the rest of the subscribers. The special characteristic of online game is the user can continue to play their role after they have log out for few days. The player can keep continue playing where they have stopped when they have log out last time with the experiences and assets are remain. Online game user must install a client program for internet connection and online game providers to attend the online game (Lo, 2008). This program is inexpensive and sometimes even free. However, there are some need additional fees are paid to the Internet Service Provider (ISP) (Lo, 2008). Commonly, the charges of online game is based on the time where the player spent to playing games and usually it is prepaid which pay before they play the games. Due to the technology advancement and the cheaper price for paying the internet connectivity, consumers are more easily to connect to the internet and playing online game. This golden business opportunity has been attracted lots of firms entered to this industry. Online game service is the company which provides a server for the players in order to play game with others. The company main activities is improve the performance of the online game also maintenance of the server to avoid any shut-down or system down of the server. There are some features have attracted lots of people subscribe to online game and the number of players is keep increasing each day. The online games allow the player to build the role based on their preference, beliefs, goal, or other factors and most of the time the players play it in a team (Klang, 2004). The features in the online games has play an important role in order to gain more subscriber and also some other factors. 2.3 Online Game Loyalty In general, loyalty can be defined as faithful. However, in terms of customer loyalty, it is hard to define (Bowen ad Chen, 2001). Dennis (2003) stated that loyalty is the feeling where a customer has about a brand. This could be explained as the customer has a positive perception about the brand and this brand will always come in the first of the mind of this particular consumer if compared to the other firms which have offer the same service or product. Edvarson, Johnson, Gustafsson and Strandvik (2000) define loyalty as a customers intention to repurchase from the same firm again. On the other hand, loyalty can be measured in three distinctive approaches and there are behavioural measurements, attitudinal measurements, and composite measurements (Bowen and Chen, 2001). Behavioural measurements can be defined as consistent, repetitious purchase behaviuor as an indicator of loyalty. For example, if the customer is often and repeat visit the same firm and purchase the product from the firm can be said as loyalty under the behavioural measurement. Next, attitudinal measurements can be defined as used attitudinal data to reflect the emotional and psychological attachment inherent in loyalty. Lets put it in a situation where a consumer holds a favourable attitude toward an online game service provider, but it is not necessary that consumer will subscribe o this service provider. It might be expensive to the consumer but the consumer will recommend it to others since he holds a favourable attitude towards the service provider (Toh, Hu, and Withiam, 1993). Composite approach is the combination of the first two dimensions and measure loyalty by customers products preferences, propensity of brand-switching, frequency of purchase, recency of purchase and total amount of purchase (Pritchard and Howard, 1997). This approach is valuable tool to understand customer loyalty in several fields such as retailing, upscale hotels and airlines (Pritchard and Howard, 1997). Many of the researchers and also in common think that loyalty is generating positive and measurable financial results (Dennis, 2003). In short, there is a positive relationship between loyalty and profit (Bowen and Chen, 2001). When a company is able to retain 5 percent more of its customers, consequently, profits will increase 25 percent to 125 percent (Reichheld and Sasser, 1990). The impact of loyalty has played an important role for the profit of the company. Based on the reasons mentioned above, online game loyalty (customer loyalty) is the independent variable for this study. On the past studies showed that online customer loyalty is result from customer satisfaction with the e-commerce channel. Also, the online satisfaction has the positive impact on online loyalty is the proved in the context of electronic commerce (Anderson and Srinivasan, 2003; Rodgers, Negash, and Suk, 2005. As proposed by Yang et al. (2009), online loyalty is the final result of their study. For this study, online loyalty is defined as a customers favaourable attitude and commitment towards online game service provider that results in sustaining in the same service provider which based on the study of Yang et al. (2009). Hence, this study is proposing online loyalty as the dependent variable. 2.4 Online Game Satisfaction Satisfaction is the â€Å"overall customer attitude towards a service provider† (Levesque and McDougall, 1996). Oliver (1980) defined customer satisfaction as customers evaluations of a product or service based on their needs and expectations. In the other way, it is an emotional customer anticipates and what they receive (Zineldin, 2000). Customer satisfaction could be the big challenges for all the firms and to satisfy the customer expectation is not an easy job because customers are human being who has a complex mind. As a human being, we have different characteristics and different expectation. Some people might expect a basic service from the service provider but some might expect a high service from the service provider. When people would like to defined something which involve human attitude, it is hard to find a common or universal definition. Gerpott, Rams, and Schindler (2001) proposed satisfaction is based on the customers estimated experience of the extent when the service provider is able to fulfill customers expectations. There are some benefits of customer satisfaction and the major benefits of customer satisfaction is stay loyal longer (Zineldin, 2000; Hansemark and Albinsson, 2004). Besides, Hansemark and Albinsson (2004) stated that satisfied customer are relatively less price sensitive, tend to purchase additional products, and they are relatively hard influenced by the competitors. They proposed many company view customer satisfaction as the crucial to a companys survival and must be satisfied those customer all the time as the company has been promised them. In general, much research no matter in offline environment or online environment, customer satisfaction is not really a new concept and lots of research efforts have been made to understand its antecedents and consequences (Bai, Law, and Wen, 2008). To assess a firms productivity and its marketing performance, the measures of perceived quality, satisfaction and loyalty was being used (Cortina, Elorz, and Villanueva, 2004). Besides, the great number of study of customer satisfaction is because its potential influence on consumer behavioral intention and customer retention (Cronin, Brady, Hult, 2000; Yang et al., 2009). A study of online retailing stated that satisfied customer tend to have higher usage of service and have stronger repurchase intention (Kim, Jin, and Swiney, 2008). Also, this particular customer will often recommend the product or service to their friends than those who are not satisfied (Zeithaml, Berry, and Parasuraman, 1996; Kim et al., 2008). Anderson and Srinivasan (2003) have investigated the impact of satisfaction on loyalty in the context of e-commerce. They concluded that online satisfaction has an impact on online loyalty. However, they also stated that the relationship is just moderated both by consumers individual factors and firms business factors. However, the relationship between online satisfaction and online loyalty also has been found in numerous studies (Yang et al., 2009; Kim et al., 2008; Anderson and Srinivasan, 2003; Rodgers et al., 2005). Hence, this study is going to propose online satisfaction might have a positive effect on online loyalty. 2.4.1 Online game satisfaction as a mediator Online game satisfaction will be the mediator between the online game loyalty and its determinants which are service quality, transaction cost, technology acceptance factor, and experience value. As proposed by Yang et al., 2009, service quality, transaction cost, and experience value will influence on online game satisfaction. However, this study is going to propose another antecedent which is technology acceptance factors which based on the studies of Lin and Sun, 2009; Hsu and Lu, 2003. In this model, online game satisfaction is a function of the four antecedents operating in a situation and helps to explain the influence of the antecedents on online game loyalty. As prior mentioned that online satisfaction has an impact on online loyalty, but, there are some factors might influence online satisfaction before it comes to online loyalty. To achieve the online satisfaction, the online game service providers have to meet the expectation of the consumer in some of the aspects as the four antecedents. Yang et al., 2009 stated that rare research examines the moderating effects of customer satisfaction in an integrated loyalty model and less formally tests that online game satisfaction in the online game service environment. Therefore, in this study, it proposes online game satisfaction as the mediator between the four antecedents and online game loyalty. The below table is to shows that the selected empirical research on determinants of customer satisfaction and loyalty (online). Table 2.2: Selected empirical research on determinants of customer satisfaction and loyalty (online) Independent Variables Key References Context Service Quality (SERVQUAL) Yang et al., (2009) Lin and Sun (2009) Lee and Lin (2005) Santos (2003) Online Game Service Online Shopping Online Shopping e-Service Quality Technology Acceptance Factors Lin and Sun (2009) Hsu and Lu (2003) Online Shopping Online Game Transaction Cost Yang et al., (2009) Liang and Huang (1998) Online Game Service Electronic M Factors of Affecting Online Game Satisfaction Factors of Affecting Online Game Satisfaction CHAPTER ONE INTRODUCTION 1.1 Introduction Online gaming is one of the most popular entertainments among the citizen in this world no matter what ages they are. Due to the advancement in the technologies, it has brought lots of growth in this industry since early of 2000s. This growth has been developed online game market into the core of the world cultural industry (Sang, Yung, Jae, and Kyoung, 2004). Hsu and Lu (2003) stated that online game service has been a highly profitable e-commerce application in recent years and its market value has increasing markedly as well as number of player growth at the same time. Now a day, most of the household will owned at least one personal computer (PC) or a laptop and some even more than that due to the cheaper cost to have a computer. Consequently, the demand for computer has been grown rapidly throughout this recent year. The accessibility of internet also is easier with each passing year and the cheaper price to have broadband internet connectivity (Bizymoms.com). Generally, online game service can be categorized as business-to-consumer or B2C in e-commerce and it is also one the videogame and interactive entertainment industry. A strategic market research and consulting firm which focuses on the interactive entertainment and the emerging video game, online game, interactive entertainment and portable game markets namely, DFC Intelligence has made its forecast for worldwide videogame and interactive entertainment industry each year since year 1995. According to DFC Intelligence forecast on year 2008, the worldwide videogame and interactive entertainment industry revenue to reach USD 57 billion in 2009 with no signs of slowing due to the slumping economies and expensive hardware (Androvich, 2008). The rapid growth in videogame and interactive entertainment industry has been attracted lots of entrepreneur who would like to enter this profitable industry. Based on the report of DFC, PC was the top platform for games in 2007, with online game revenue alone eclipsing USD 7 billion on year 2006 and not including retail sales. The DFC also stated the total PC game revenue is expected to reach USD 19 billion by year 2013 (Androvich, 2008). In Malaysia, there were 15 million subscriber of internet and it was 62.8% out of the total population in 2008 (Internet World Stats, 2008). It was more than half of the citizens of Malaysia have used the internet and this has brought a great opportunity to the entrepreneur who would like to join this industry to be one of the online game service providers to share the profit since the number of internet users was increasing each year. It did not showed that the number of the online game subscribers but there is a business opportunity for the entrepreneur to start-up their business through online. Table 1.1: Internet Usage and Population Growth of Malaysia Year No. of Users Total Population % 2000 3, 700, 000 24, 645, 600 15.0% 2005 10, 040, 000 26, 500, 699 37.9% 2006 11, 016, 000 28, 294, 120 38.9% 2007 13, 528, 200 28, 294, 120 47.8% 2008 15, 868, 000 25, 274, 133 62.8% (Source: http://www.internetworldstats.com/asia/my.htm [2009, November 1]) A study showed that customer satisfaction is the immediate factor affecting the consumer retains loyalty (Cronin, Brady, and Hult, 2000). Most of the studies showed that higher levels of customer satisfaction will lead to customer loyalty. â€Å"A minor change in satisfaction could lead to a substantial change in loyalty increment† (Bowen and Chen, 2001). However, most of these studies were in offline environment. Wind and Rangasamy (2001) found that online environments offer more opportunities for interactive and personalized marketing. Eventually, these opportunities may influences customer satisfaction and customer loyalty in the online environment if compared to the traditional market or offline environment (Shankar, Smith, and Rangaswamy, 2003). The main purpose of this study is to identify the factors affects the customer satisfaction towards online game services and which could lead to customer loyalty. It is including the service quality, transaction cost, experience value, and technology acceptance factor. These four antecedents of online game service satisfaction and loyalty will test associations based on the model that has been constructs. 1.2 Background of the Research In this century, computer might be a need for a person if compared to the olden days where there was a limited growth in technologies. Now, computer seems like a tool which can do everything for you such as searching information, payment, shopping, and so on. This powerful electrical appliance has gain a well response from the citizen of the world. It has many functions can perform through computer and one of the most popular functions of computer is gaming. In the earlier 2000s, most of the games were played offline since the limited internet connectivity and expensive prices to have an internet connectivity. However, this situation has changed due to the technologies advancements and the industry has achieved economic of scale. To more understand what online games is, it is a must to brief its history. The very first online gaming activities were introduced in the late of 1960s and early of 1970s. Later, they started gain more popularity within 1970s to 1980s when dial-up Bulletin Boards became popular and the users started playing online game over them. Clyde and Thomas (2008) stated that the development of arcade game in the 1970s, and video and computer games in the 1980s; digital games have become an influential part of popular culture. The bulletin boards provided a multi-user platform which allowed few users to play at the same time. Now, it has been transformed to MMORPG (Massively Multi-Player Online Role-Playing Games) which is popular all around the world presently (Bizymoms.com). At one time, games were used for educational purpose rather than entertainment (Clyde and Thomas, 2008). However, due to the changed in the perception of game role and the culture, it becomes an entertainment but there is still has some of the game designers and educators used it as educational purposed such as learning typing skills and so on. In the year of 1990s, due to the growth of internet technologies of Flash and Java, it has led to the increasing usage of the internet and the millions of new websites mushrooming across the World Wide Web. When enter to the millennium year, technological giants such as Sony, Microsoft and Ninetendo came out with advanced gaming consoles has changed the features of online gaming completely (Bizymoms.com). The people all around can play a same game with each other virtually at the same time. Currently, online gaming industry is growing each year and it has a great expansion in future. The online game service is one of the most competitive industries among the entire industries. The new and the existing online game service provider are delivering their best services to gain more market share to sustain its organization. To penetrate the market, the firm must meet the customer expectation which may lead to customer satisfaction. Eventually, it may bring customer loyalty. 1.3 Research Problem Customer is the one who contribute the profit to the firm because they are the one who are using the product or services. However, consumers are becoming wisely now a day when they would like to use certain product or services. They will tend to purchase the product only if the product can meet their expectation which might lead to satisfaction. To meet the customer expectation, it is a biggest challenge for the firm. Other than that, the growth of the online game has brought some a major problem to the service provider which is how to retain the existing online game users and will not shifting to other service provider or loyalty to the current provider (Yang, Wu, Wang, 2009). In order to survive in this competitive industry, many practitioners and academicians in this field have focused on how to improve online services to attract potential buyers as well as the current customers (Jun, Yang, and Kim, 2004). There are some of the factors to achieve customer satisfaction. However, the key factors especially in online game services which are able to make the customer satisfied with the products and services still under study or unknown (Dick, Wellnitz, and Wolf, 2005). If the key factors have been determined, the provider might be able to gain the competitive advantages which trying to meet the customer expectation. This research is emphasizing the customer satisfaction and loyalty in online game service. Specifically, it is trying to identify the key factors affects online satisfaction and online loyalty in order to guide the online game service provider to improve their service quality to garb more potential customers and retain the existing one. 1.4 Research Objectives The objectives were formed based on the research problem and there are formulated to achieve the main goal of this study which is to examine the factors of affecting the online game satisfaction and loyalty. To determine service quality has a positive impact towards online game satisfaction. To determine transaction costs has a positive impact towards online game satisfaction. To determine technology acceptance factor has a positive impact towards online game satisfaction. To determine experience value has a positive impact towards online game satisfaction. To determine online game satisfaction would have a positive impact on online game loyalty. To determine service quality, transaction cost, technology acceptance factors, and experience value will affect online game satisfaction and eventually online game loyalty. 1.5 Justification of the Study This study is significant for several reasons. First, it can identify the gaps between customer expectation and perception about online game service provider in order to guide them to provide better services. â€Å"It is commonly known that there is a positive relationship between customer loyalty and profitability† (Bowen and Chen, 2001). It is correct once the customer is loyal to the company because they will visit the firm after a purchase and some even recommend to their friends. In the online environment, the online satisfaction also grabs much attention from all of the researchers because to meet a customer expectation is the toughest challenges to the company. Also, it brings the profitability and the survival of the company. Online game service provider should concern about the medium which may influenced the online game satisfaction and online game loyalty. The importance of the study is to keep the online game service improvement in order to achieve the customer satisfaction from time to time. In online environment, the customer can easily compared the alternative than offline customer especially products and service (Shankar et al., 2003). As in online environment, the user is free to search the information to the product that they demand. As well as online game, there is large amount of online game service provider. Therefore, the user can easily compared the features of the game and service quality that provided by the firm. Once the factor has a positive impact on online satisfaction has been determined, the service provider is able to strengthen their weaknesses in order to sustain its market share. Besides, the study is providing guidelines for the service provider to develop their future or long-term plan. The importance of the online game satisfaction will give a direction to the service provider to plan for their future such as strategic plan. It also helps the company to gain competitive advantages in this industry. Commonly, most of the studies regarding to customer satisfaction and loyalty were did for offline environment and only limited for online environment. However, consumers still have some same characteristics in making decision when they would like to purchase a product. As the study has identified the factors affect the customer satisfaction and loyalty, the firms are able to fulfill the users need and wants. This action is trying to meet the customer satisfaction and eventually customer loyalty. Once the customer become loyal, the company may survive in this competitive market. On the other hand, it is also will benefit the user to gain a better service from the online game service provider once they have responded to what they are percept towards the online game service provider that they currently subscribed. Also, the service provider is able to understand what kind of service quality that the users perceived and expected. It will leads to a win-win situation if both of the parties could perform what they are request and give. 1.6 Definition of Important Terms There are some important terms in this study: Online satisfaction, online loyalty, service quality, technology acceptance factors, transaction cost, and experiences value. Online Game Satisfaction Online game satisfaction is customer satisfaction towards online game service. Oliver (1980) defines customer satisfaction as customers evaluation of a product or service with regard to their needs and expectations. It is just in virtual environment perspectives. Online Game Loyalty Online game loyalty is customer loyalty towards online game service. It can be defined as â€Å"a deeply held commitment to rebuy or repatronize a preferred product or service consistently in the future, thereby causing repetitive same-brand or same brand-set purchasing, despite situational influences and marketing efforts having the potential to cause switching behaviuor† (Oliver, 1997). Service Quality Parasuraman, et al., (1988) defined service quality as â€Å"a global judgement, or attitude, relating to the superiority of the service†, â€Å"and explicated it as involving evaluations of the outcomes (i.e., what customer actually receives from services) and process of service act (i.e., the manner in which service is delivered)† (Jain, and Gupta, 2004) Technology Acceptance Factors It is also known as technology acceptance model (TAM). Davis (1989) proposed TAM to explain and predict user acceptance of information systems (IS) or information technology (IT). In short, it is explaining â€Å"intention to use a technology† (Schepers and Wetzels, 2007). Transaction Cost It is a theory â€Å"seeks to explain why firms exist and how firm boundaries were determined† (Watjatrakul, 2005). Experience Value It refers to â€Å"shopping efficiency and making good product performance and functionality† (Wu and Liang, 2009). Wu and Liang (2009) added â€Å"its perceptions are based on interaction involving either direct usage or distant appreciation of goods or services†. MMORPG (Massively Multi-Player Online Role-Playing Games) It is known as a virtual environment where it allows multiple geographically distributed users interact with each other at the same time (Papargyris and Poulymenakou, 2005). Besides, it is â€Å"offering an alternative channel for players to communicate, share experiences, socialize, and eventually from virtual communities† (Chee, Zaphiris, and Mahmood, 2007) Online Game Service It is a service provider who provides a server for the online game user to get into the network to interact with each other by playing games. 1.7 Organization of the Report This study will be constructed into five different chapters and there are: Chapter 1 is presenting the introduction and a brief overview of the study. The problems of the study, objectives of the study, significance of the study, and the chapter outline of the research are stated in this chapter. Chapter 2 provides an extensive review of international journals, reports, and articles from online and offline resources. Besides, all the reviews in this chapter are related to the problem of the research that will guide to construct the conceptual foundation and hypothesis of the study. Chapter 3 is describing the methods used in conducting this study in detail. Besides, it also presents the development of the research framework which proposed the relationship between dependent variables and independent variables. Next, the methodology applied is provided, sampling procedures, hypothesis development, data analysis and measurement. Chapter 4 presents the findings and data analysis of the research. It analyses and discussed the data collected in the research using the research instrument which has been developed in chapter 3. The hypothesis will be tested and it is also presents the results of statistical analysis used in this study (t-test, ANOVA, and etc.). Chapter 5 is presenting the conclusion and recommendation. There is also discussion of the studys implications, recommendations, limitations and suggestion for the future research. CHAPTER 2 LITERATURE REVIEW 2.1 Introduction Chapter 1 has discussed and highlighted the important issues which related online game service satisfaction and loyalty. All of these issues that mentioned in the chapter 1 are playing an important role for online game service industry in order to understand the expectation of the user and eventually grab more market share. As a result, to more understanding these issues, an examination of literature on related study were carried out. Generally, literature review provides the theoretical basis for the development of the research framework of this study, which will be discuss in the next chapter Chapter 3. This chapter consists of the following subject areas: (1) Definition of key terms; (2) online game satisfaction; (3) online game loyalty; (4) the factors might affect online satisfaction and loyalty; and (5) summary of literature review. 2.2 Definition of Key Terms 2.2.1 Online Game Service As technologies have became more advance, people have more rely on the technologies and they even expect technology will do all the things for us. Now, most of the people are prefer online rather than offline when they would like to purchase or acknowledge a transaction. In the olden day around 1980 where the technology has a limited growth, people can only play games in offline environment such as TV and handheld game console (Nintendo). In the late 1980s computer game was invented and started popular. Currently, computer games have been transformed into MMORPG (Massively Multi-Player Online Role-Playing Games) which is popular all around the world (Bizymoms.com). Besides, the multi-player online role-playing games also known as Net games (Lo, Wang, and Fang, 2005). Generally, net game can be divided into three which is web games, network games, and online games. The below is the definition of this three types of net games. Table 2.1 Types of Net Games Types Definition Players Web games Games which use a website as an interface. Players must register to play. Network games Games which allow multiple players to use their own PCs to interact via Local Area Networks (LANs) or the internet. Also, many of these closely resemble PC games. Players must purchase and install game software. However, it does not require any fees beyond those for internet connections. Online games Games where require players to connect to the service provider and log in to a server. Player must subscribe to the service provider and select a role to interact with other virtual roles. Source: Lo, 2008 Online game is requiring player to log in to a server in order to play the games. It is means that the players must have internet connection to connect with the service provider. After the player subscribe to the games, the user has to select a role to interact with the rest of the subscribers. The special characteristic of online game is the user can continue to play their role after they have log out for few days. The player can keep continue playing where they have stopped when they have log out last time with the experiences and assets are remain. Online game user must install a client program for internet connection and online game providers to attend the online game (Lo, 2008). This program is inexpensive and sometimes even free. However, there are some need additional fees are paid to the Internet Service Provider (ISP) (Lo, 2008). Commonly, the charges of online game is based on the time where the player spent to playing games and usually it is prepaid which pay before they play the games. Due to the technology advancement and the cheaper price for paying the internet connectivity, consumers are more easily to connect to the internet and playing online game. This golden business opportunity has been attracted lots of firms entered to this industry. Online game service is the company which provides a server for the players in order to play game with others. The company main activities is improve the performance of the online game also maintenance of the server to avoid any shut-down or system down of the server. There are some features have attracted lots of people subscribe to online game and the number of players is keep increasing each day. The online games allow the player to build the role based on their preference, beliefs, goal, or other factors and most of the time the players play it in a team (Klang, 2004). The features in the online games has play an important role in order to gain more subscriber and also some other factors. 2.3 Online Game Loyalty In general, loyalty can be defined as faithful. However, in terms of customer loyalty, it is hard to define (Bowen ad Chen, 2001). Dennis (2003) stated that loyalty is the feeling where a customer has about a brand. This could be explained as the customer has a positive perception about the brand and this brand will always come in the first of the mind of this particular consumer if compared to the other firms which have offer the same service or product. Edvarson, Johnson, Gustafsson and Strandvik (2000) define loyalty as a customers intention to repurchase from the same firm again. On the other hand, loyalty can be measured in three distinctive approaches and there are behavioural measurements, attitudinal measurements, and composite measurements (Bowen and Chen, 2001). Behavioural measurements can be defined as consistent, repetitious purchase behaviuor as an indicator of loyalty. For example, if the customer is often and repeat visit the same firm and purchase the product from the firm can be said as loyalty under the behavioural measurement. Next, attitudinal measurements can be defined as used attitudinal data to reflect the emotional and psychological attachment inherent in loyalty. Lets put it in a situation where a consumer holds a favourable attitude toward an online game service provider, but it is not necessary that consumer will subscribe o this service provider. It might be expensive to the consumer but the consumer will recommend it to others since he holds a favourable attitude towards the service provider (Toh, Hu, and Withiam, 1993). Composite approach is the combination of the first two dimensions and measure loyalty by customers products preferences, propensity of brand-switching, frequency of purchase, recency of purchase and total amount of purchase (Pritchard and Howard, 1997). This approach is valuable tool to understand customer loyalty in several fields such as retailing, upscale hotels and airlines (Pritchard and Howard, 1997). Many of the researchers and also in common think that loyalty is generating positive and measurable financial results (Dennis, 2003). In short, there is a positive relationship between loyalty and profit (Bowen and Chen, 2001). When a company is able to retain 5 percent more of its customers, consequently, profits will increase 25 percent to 125 percent (Reichheld and Sasser, 1990). The impact of loyalty has played an important role for the profit of the company. Based on the reasons mentioned above, online game loyalty (customer loyalty) is the independent variable for this study. On the past studies showed that online customer loyalty is result from customer satisfaction with the e-commerce channel. Also, the online satisfaction has the positive impact on online loyalty is the proved in the context of electronic commerce (Anderson and Srinivasan, 2003; Rodgers, Negash, and Suk, 2005. As proposed by Yang et al. (2009), online loyalty is the final result of their study. For this study, online loyalty is defined as a customers favaourable attitude and commitment towards online game service provider that results in sustaining in the same service provider which based on the study of Yang et al. (2009). Hence, this study is proposing online loyalty as the dependent variable. 2.4 Online Game Satisfaction Satisfaction is the â€Å"overall customer attitude towards a service provider† (Levesque and McDougall, 1996). Oliver (1980) defined customer satisfaction as customers evaluations of a product or service based on their needs and expectations. In the other way, it is an emotional customer anticipates and what they receive (Zineldin, 2000). Customer satisfaction could be the big challenges for all the firms and to satisfy the customer expectation is not an easy job because customers are human being who has a complex mind. As a human being, we have different characteristics and different expectation. Some people might expect a basic service from the service provider but some might expect a high service from the service provider. When people would like to defined something which involve human attitude, it is hard to find a common or universal definition. Gerpott, Rams, and Schindler (2001) proposed satisfaction is based on the customers estimated experience of the extent when the service provider is able to fulfill customers expectations. There are some benefits of customer satisfaction and the major benefits of customer satisfaction is stay loyal longer (Zineldin, 2000; Hansemark and Albinsson, 2004). Besides, Hansemark and Albinsson (2004) stated that satisfied customer are relatively less price sensitive, tend to purchase additional products, and they are relatively hard influenced by the competitors. They proposed many company view customer satisfaction as the crucial to a companys survival and must be satisfied those customer all the time as the company has been promised them. In general, much research no matter in offline environment or online environment, customer satisfaction is not really a new concept and lots of research efforts have been made to understand its antecedents and consequences (Bai, Law, and Wen, 2008). To assess a firms productivity and its marketing performance, the measures of perceived quality, satisfaction and loyalty was being used (Cortina, Elorz, and Villanueva, 2004). Besides, the great number of study of customer satisfaction is because its potential influence on consumer behavioral intention and customer retention (Cronin, Brady, Hult, 2000; Yang et al., 2009). A study of online retailing stated that satisfied customer tend to have higher usage of service and have stronger repurchase intention (Kim, Jin, and Swiney, 2008). Also, this particular customer will often recommend the product or service to their friends than those who are not satisfied (Zeithaml, Berry, and Parasuraman, 1996; Kim et al., 2008). Anderson and Srinivasan (2003) have investigated the impact of satisfaction on loyalty in the context of e-commerce. They concluded that online satisfaction has an impact on online loyalty. However, they also stated that the relationship is just moderated both by consumers individual factors and firms business factors. However, the relationship between online satisfaction and online loyalty also has been found in numerous studies (Yang et al., 2009; Kim et al., 2008; Anderson and Srinivasan, 2003; Rodgers et al., 2005). Hence, this study is going to propose online satisfaction might have a positive effect on online loyalty. 2.4.1 Online game satisfaction as a mediator Online game satisfaction will be the mediator between the online game loyalty and its determinants which are service quality, transaction cost, technology acceptance factor, and experience value. As proposed by Yang et al., 2009, service quality, transaction cost, and experience value will influence on online game satisfaction. However, this study is going to propose another antecedent which is technology acceptance factors which based on the studies of Lin and Sun, 2009; Hsu and Lu, 2003. In this model, online game satisfaction is a function of the four antecedents operating in a situation and helps to explain the influence of the antecedents on online game loyalty. As prior mentioned that online satisfaction has an impact on online loyalty, but, there are some factors might influence online satisfaction before it comes to online loyalty. To achieve the online satisfaction, the online game service providers have to meet the expectation of the consumer in some of the aspects as the four antecedents. Yang et al., 2009 stated that rare research examines the moderating effects of customer satisfaction in an integrated loyalty model and less formally tests that online game satisfaction in the online game service environment. Therefore, in this study, it proposes online game satisfaction as the mediator between the four antecedents and online game loyalty. The below table is to shows that the selected empirical research on determinants of customer satisfaction and loyalty (online). Table 2.2: Selected empirical research on determinants of customer satisfaction and loyalty (online) Independent Variables Key References Context Service Quality (SERVQUAL) Yang et al., (2009) Lin and Sun (2009) Lee and Lin (2005) Santos (2003) Online Game Service Online Shopping Online Shopping e-Service Quality Technology Acceptance Factors Lin and Sun (2009) Hsu and Lu (2003) Online Shopping Online Game Transaction Cost Yang et al., (2009) Liang and Huang (1998) Online Game Service Electronic M