How HIPAA Violations Affect the Medical Billing Process Essay

When you hear HIV you always think of Aids are they the same or is there a difference. HIPAA Privacy Rule: HIPAA is a federal law that: †¢Protects the patients’ privacy with their medical records and other health information provided to health plans, hospital, doctors and all other health care providers. †¢Allows the patient access to their medical records. †¢It gives the patient rights to how their personal information is used and exposed. HIPAA has proven to be very successful in stopping discrimination against the people diagnosed with HIV and Aids by preventing anyone from knowing about their HIV and Aids status. In the year 2000 laboratories and doctors are required by law to report to their State Health Department all cases of HIV and Aids. They are reported to better measure the HIV and Aids epidemic, and how it is changing and to create programs for HIV and Aids prevention and offer medical which best serve affected people and their communities. All this information is protected by confidentiality laws. Under this law identifying information regarding who has HIV and Aids can only be used to help the State Health Department track the epidemic and for partner notification this information cannot be shared with immigration and naturalization Service (INS), police, welfare agencies, landlords, employers and insurance companies. The National Centers for Disease Control and Prevention issues guidelines influencing states to collect and report the data on HIV and Aids so they can track the epidemic on a national basis. The state health department will then remove all the personal information (name, address, etc.) from your test results and send the information to the U.S. Centers for Disease Control and Prevention (CDC). Over the next several years HIV and Aids data will become the basis for funding formulas which will allocate federal money for care & treatment under The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act.  This is the largest federally funded program in the United States for people living with HIV and AIDS. This act reaches hundreds of thousands of people every year with medical care, drugs, and support services. The program requires that health departments receiving money from the Ryan White program show â€Å"good faith† efforts to notify the marriage partners of a patient with HIV and AIDS. (www.Aids.gov) HIV (Human Immunodeficiency Virus) is a virus that attacks the T-cells in the immune system. This illness changes their immune system making people very vulnerable to diseases and infections. This condition worsens as it progresses corresponding to research the origins to this disease dates back to the late 19th or early 20th century in Western Central Africa. In 2008 worldwide there were †¢33.4 million People living with HIV and AIDS. †¢2.7 new HIV infections †¢2 million deaths from AIDS The disease was identified in the 1980s, and there is now known cure, but treatments and medicine can slow the course of the disease. The newest drug combination drug therapy can cost up to $20,000 in U.S. dollars a year. HIV is found in body fluids like semen and vaginal fluids, blood and breast mild. And can be passed through blood-to-blood and also sexual contact. Women can pass this to their babies through pregnancy, childbirth, and through breast milk. AIDS is (acquired immune deficiency syndrome or immunodeficiency syndrome). AIDS is the disease caused by the HIV virus AIDS is the syndrome that appear in the advance stages of HIV infection, AIDS is a medical condition derived from HIV. HIV and AIDS are the same AIDS is the outdated name and HIV is the correct name. There are three recognized ethical principles that apply to clinical and research ethics: †¢Respect refers to respecting the decisions of autonomous people and protecting the ones who lack decision making capacity and therefore are not autonomous and imposes a positive obligation to treat people with respect by keeping this information confident and keeping promises. †¢Beneficence imposes a positive obligation of the best interest of the patient. †¢Justice requires people to be treated fairly and often requires that benefits and burdens to be distributed fairly within society. Privacy is critical  when it comes to HIV and AIDS, because of the sensitivity of HIV related information most patients don’t want to share this private and personal aspect of their life because it involves their sexual behavior or substance abuse. This information can lead to stigmatization this can cause patients to worry about their privacy being protected, and they may be hesitant to see a doctor or remain in the care of a physician. It is vital to have health care providers express that they are committed to securing patient privacy. The law gives certain protection to or conditions. Electronic systems need to be able to identify and manage this data appropriately. HIV and AIDS and other sexually transmitted diseases are a whole different category with special privacy concerns. When releasing HIV and AIDS records for other purposes it is necessary to identify testing and treatment for these conditions through the use of red flags or warning messages. The electronic system simplifies exclusion or segregation of HIV test results to protect against release without patients proper consent from the patient. Preferably a system will also flag treatment of HIV and Aids when producing copies of records. EHR systems must provide mechanisms that enable facilities that extra layer of protection for this information required under 42 CFR, Part 2 requires patient consent for disclosures of protected health information even for the purpose of treatment this consent must be in writing. When a health care provider providers care to an HIV and AIDS patient they seem to be walking and ethical tightrope even when they are aware of protocol about disclosing HIV status simple assumptions and carelessness can lead to devastating consequences for the patient and also legal ramifications. There are some things a health care worker can do on their own to protect private information while at work. †¢Turn off your computer when you walk away or not in use. †¢Set your computer with passwords to get access to confidential files. †¢Use a system that will trace who accesses confidential informatio n. †¢Become familiar with the law train employees in proper disclosure protocol. †¢Never discusses a patients HIV and AIDS status. Social ramifications exist if HIV and AIDS information is announced improperly. If a patients friends discover he or she has HIV and AIDS they won’t want to be around them due to the fear of catching the disease people  will start to gossip spreading this private information destructing the life of the infected person. They will undoubtedly be treated differently. He or she could have difficulty finding employment if the employer finds out about the disease because of inappropriate disclosure of medical information. If a person is living with HIV and Aids you are protected against discrimination under Section 504 of the Rehabilitation act of 1973 and Title II of the Americans with Disabilities Act of 1990 (ADA). Under these laws, discrimination means that you are not allowed to participate in a service that is offered to others or you are denied a benefit, because of your HIV disease. ( http://aids.gov/hiv-aids-basics/just-diagnosed-with-hiv-aids/your-legal-rights/civil-rights/index.html ) HIV and AIDS in the workplace gets larger each year, because it affects people between ages 25 – 44 and they make up 50% of our 121% million workers. There are laws to protect people with HIV and AIDS in the workplace. †¢Americans with Disabilities act of 1990 (ADA) does not allow employment discrimination because of disability and covers businesses with 15 or more employees. †¢Occupational Safety and Health Administration (OSHA). Federal and state governments work with more than 100 million working men and women and 6.5 million employers. †¢The Family Medical Leave Act of 1993 (FMLA) this act to the private-sector of employers of 50 or more employees and within a 75 mile radius of their worksite. A person is entitled to a total of 12 weeks of job protected unpaid leave in a 12 month period. †¢The Health Insurance Portability and Accountability Act of 1996 (HIPAA). Addresses obstacles to healthcare you can face if you are HIV and AIDs positive. Protecting you discriminatory treatment from your insurance company, and also protects your privacy rights. †¢The Consolidated Omnibus Budget Reconciliation act of 1986 (COBRA). This law allows employees the option to keep their health insurance at their own expense after getting laid off, fired from a job. Allowing them to purchase health insurance for a period up to 36 months. HIV and AIDS not only hurt people with the disease but also their families and families. According to the International Labor Organization believes that by the year 2020 HIV and AIDS will lower the workforce by 24 million people. This will cost the workforce higher costs of medical insurance as well as work absences related to health, hiring and costs of retraining.

Gates of Fire Essays

Gates of Fire Essays Gates of Fire Essay Gates of Fire Essay That detail in this book is what makes it great. After reading this book I believe that the Sparta has breaded the toughest soldiers in history, not Just physically but most of all mentally with their mastering of fear. Steven Pricelesss fictional idea of philological is a big part in the book. Philological is the science of Fear. Though this concept was made up by Predefines he strongly believes that there was some type of science on fear in Sparta. Spartan soldiers learn to master philological, when they enter the gauge. Gauge Is a real term that served many roles, gauge Is a training, an initiation, a test of will, courage and strength that al Spartan have to go Into at a very young age. In this, Spartan encouraged obedience and conformity In the gauge. A Spartan city state comes before any mans own personal Interest. A Spartan polls also played a large part In this book adding to the reason why Sparta has developed the greatest soldiers. The story is told by Exe a captive of Xeroxes; and squire to Dinkies. Exe is not a born Spartan but fixes himself to be one. Dinkies is a war veteran and very reliable source in the book. : Exe is found with deadly wounds in battle and captured to tell Xeroxes, king of the Persians about Spartan life. Xeroxes saw first hand 300 Spartan fight to their deaths and was very interest in what drives them to do so. You get your first taste of the actual Spartan gauge when Exe reminisces on a memory of Sparta when boys where punished in the gauge camps by being whipped with sticks. A good time for a whipping would be getting caught for steeling. The key word In this Is caught, a Spartan boy going through gauge was expected to steal there were hardly fed and the only way to survive was to steel. Getting caught was unacceptable. Whippings where given by two drill instructors who just recently got out of gauge, they administered the beatings. The beatings worked like this the boys whose turn it was grasped a horizontal iron bar secured to the bases of two trees(the bar had been worn smooth by decades, some said centuries, of the ritual) (Predefines 38). There was a boy by the name of Trained, also know as Tripod because no one could take him down in his age group in wrestling. Tripod was whipped to his death. Most young Spartan held on until they were knocked on conscious or could no longer take the whippings. The book says Tripod kept taking and taking it. The flesh of his back had been torn through In a dozen places; you could see tissue and fascia, rib cage, ND muscle and even the spine. He would not go down. (Predefines 38). Tripods comrades and even the drill Instructor quietly urged the boy to fall. Tripod had made up his mind to die. The drill Instructors whipped Tripod rapidly and very hard to knock him down and preserve his life. Unfortunately, Tripod died. There was no time to morn, later on Tanat rater noon ten rural AT Dealings continued way. The strongest, the toughest of all soldiers. I Nils Is ten Spartan Every young Spartan going through gauge has a mentor. A mentor may say things that a father cannot; a boy can confess to his mentor that which would bring shame o reveal to his father. (Progressed 40). Dinkies is the mentor of Alexandria. Alexandria is not as physically fit as the other boys, he has asthma his greatest talent is singing but his goal is to be a Spartan warrior he is at a large disadvantage and his chance of ever taking the battlefield does not look too good. After Tripods death Dinkies asked Alexandria how he felt about the event. This is a perfect example of how young minds where molded to be so strong. The conversation between them consist of these words: (Did you observe today in the manner of the eeriness (drill instructors) delivering he beating any sign or indication of malice? The boy answered no. Would you characterize their demeanor as barbarous? Did they take pleasure in dealing agony to Tripod? No. Was their intention to crush his will or break his spirit? What was their intention? To harden his mind against pain. (Predefines 40). To harden his mind against pain, this is coming from a boy that is only twelve years old. They also talk about how the flesh does not belong to them, it belongs to the gods, their children, fathers and mothers. This shows how dedicated a Spartan soldier was to their city-state. Dinkies respected Tripod but found him to be stupid he said What he displayed today contained more of recklessness than true courage, Andrei. He cost the city his life, which could have been spent more fruitfully in battle. (Predefines 41). A Spartan life did not belong to him but to Sparta. Due to the help of Dinkies and the Spartan drive that Alexandria had he eventually made it through his Asthma problem and became a Spartan soldier. Spartan soldiers carry up to 80 pounds of armor, the most important is the shield. To show how important the shield was to a Spartan soldier Predefines has an incident here Alexandria has his shield sitting open on the ground, a veteran soldier and Olympian sees this and makes a fool out of Alexandria in front of everyone. Alexandria leaves his shield sitting face down and Polygene sees this and scolds him loudly in front of the whole platoon. Polynesia says, What is this I see in the dirt before me? he roared. It must be a chamber pot, with its bowl peeking up so daintily. (Predefines 79,80). Alexandria says no it is not a chamber pot but Polynesia finds this impossible. Polygene makes Alexandria urinate in his shield. The shield had en patched over and over by his father and grandfather but none of that mattered. He was so dehydrated that there was not much pee entering the shield so Polynesia ordered the other boys to assist him and also pee in Alexandrine shield. Dinkies watch ed from a far but could say nothing, for Polynesia was right in what he was doing. Discipline was a very important to Spartan soldiers. Steven Predefines used some of his personal experiences in the book. There is time where Alexandria shouts This is my shield. I bear it before me into battle, But it is not mine alone. It protects my brother on my left. It protects my city. I will never let my brother out of its shadow Nor my city out of its shelter. I will die with my shield before me Facing the enemy. (Predefines 85). Predefines says in an interview that this part of the book; was a fictional invention based upon my own experience in the US Marine Corps, where Marines recite, This is my rifle. There are many others like, but this one is mine, etc. (Lee). Predefines does a great Job in exemplifying how important the shield was to a Spartan soldier. There where many crazy agonizing training activities, though they seemed ridiculous and UN reasonable it made much sense due to the way Spartan fought in war. When in battle Spartan soldiers form a Phalanx. A Phalanx was a battle formation that consisted of 8 or 16 rows or soldiers. When given the word each soldier would drive there shields into the back of the soldier in front making a wall that could not be broken. Each man protected the man on his left and right, discipline was very important there could be no holes. Young Spartan soldiers had a drill called Tree Bucking. Tree Bucking consisted of forming this Phalanx and pushing a tree until they could make it fall. For hours until the son came up they would push and strain vomiting and shutting themselves, of course the tree would not all. Tree Bucking was a torturing drill but it was great for simulating what would be needed to be done when opposing soldiers that rammed themselves into their shields. The next day with out any sleep they would continue on to other drills. I fully understand why Xeroxes desired so avidly to know about the Spartan warrior. The difference between Persian and Spartan value where very different, you could tell by the way their soldiers fought in battle. The Persian army consisted of slaves and soldiers that where conquered in war. The Spartan army consisted of citizens who believed their lives belonged to Sparta not themselves. Spartan fight for their city- state in which they love. Persians fight for Xeroxes because their only alternative is death, they have no love for him.

Best Places For Internship To Make Awesome Career by BestEssay.Education

Best Places For Internship To Make Awesome Career Best Places For Internship To Make Awesome Career Making the Right Choice At Start As an intern, you are never seen to be a threat to the established order of things within a department or organization. It gives you a unique opportunity to observe, suggest, and even implement ideas that might take months of meetings, and many hours of presentation time to explain, in the normal course of events, simply because of the temporary nature of your tenure. Most successful careers require a degree of politics and guile, and this is probably the only chance you will ever get to explore different tactics and methods without upsetting too many people along the way. It also gives you the opportunity to see, live, the way other people address these issues in the workplace. As an intern, you usually have huge flexibility to flit between departments, and the different parts of an organization, and because of that, you can speak to people that you would not normally meet in the normal course of your duties. Students internships cover a multitude of situations and are a great opportunity to pick the brains of everyone from the warehouseman, through to the chief executive; students employment covers a multitude of situations. Great Options For Early Career There are a huge number of student internship opportunities available; and to give you an idea of the scope and scale of these opportunities we have listed some below, along with some notes on each. Before we forget; here is a list of internship programs 2016  which you may find useful after reading this article. As you can imagine, the competition for places on internships is fierce; your resume and cover letter have to be spot-on. For this reason if you are not confident that you can put together a compelling and convincing case, it may be worth considering cover letter writing help to get your point across and to secure that elusive interview. Resume editing is another approach you may need to consider, just to get the final polish into your application. One of the other things that you need to consider is that many of the applicants will come from similar backgrounds, similar colleges, and have similar approaches to gaining that place on the internship program, as you. In this situation, thinking outside the box, taking up advanced learning techniques  is an incredibly powerful way of looking at the whole idea of gaining an internship placement. Investigate some of these ideas if you want to give yourself an edge. Let's take a look at a few Internship programs, from varying industries, in more detail: KPCB Design and Engineering offer a Product Fellows Program, which enables students to spend a whole year at a Silicon Valley startup and see the action from the ground floor. On the program, they meet with other design students and engineering gurus, and there is a three-month summer program focused just on design and engineering. Incidentally, they also run a new year-long program which is focused solely on product management. The Boston Consulting Group The chances are that if you have ever read a financial newspaper, magazine or publication, you will have heard of The Boston Consulting Group, even though you may not have any idea what it is that they do. They are, in fact, one of the world's leading management consulting firms; with a staff of over 10,000, working in 45 countries. They offer a summer placement for over 100 students, for between 6 to 12 weeks. The idea behind the program is that it enables students to get to know the business and the staff, and work on projects whilst assuming the same responsibilities as those of the permanent staff in order to give them a proper insight into what business strategy and management consultancy involve. Kohl's Stores operate an 8-week program in which students can have a realistic experience of retail management by exposure to managing a team, and running a department. This practice is followed by a full debriefing via a store walk with district managers and concentrates on business analysis, motivation, and leadership skills. Areas of participation include human resources, purchasing, logistics, marketing, finance, e-commerce, IT programming and IT business analysis, technical design, textiles design, product development, and buying. In addition to this corporate program, there are distribution center courses, which are a 10-week program, and a contact center program, also of 10 weeks, which are designed to give insights into the â€Å"backroom† operations of Kohl’s structure. MossAdams  Is one of the largest accountancy firms in America, with 27 offices around the country, and with a presence in more than a hundred other countries. It offers internships via the Moss Adams Foundation â€Å"Campus† program. These internships are part of the tax and assurance groups and are an 8 to 10-week program, which simulates the assignments and tasks you are likely to encounter as a staff accountant in your first year. There is also a state and local tax services internship that covers subjects such as law and compliance requirements and involves keeping the clients up to date with changes in legislation, Nexus analysis and planning, as well as undertaking refund audits and tax credit calculations. 3M has connections in over 70 countries, and works in fields as diverse as transportation, office products, safety, and health care. It is responsible for many household products such as Post-Its and Velcro. Internships are available in the domains of marketing, finance, sales, HR, engineering, research and development, IT. Internships are usually of 6 to 12 weeks duration full-time comprising 3M's corporate student programs. These programs are designed to help 3M to find the most promising students and to allow the students themselves to appraise 3M and see if it is a suitable employer for them. Two-thirds of the intern intake are based in the headquarters in St. Paul, Minnesota. Comcast/NBCUniversal are a massive media, film, and telecommunications company. They offer a number of internships based on their financial functions. These can be located at a number of posts including Atlanta GA, Denver CO, Englewood NJ, Los Angeles CA, Miami FL, and New York NY. The Internship allows the students to see the way in which financial viability and risk assessment apply to everything from television programming through to the network cell coverage of a telecommunications system. So; there are half-a-dozen examples of internships which are currently available and many more can be found, together with reviews and rankings, more details and information on pay packages and housing allowances, travel arrangements, and so on. Just enter your criteria and the software will pull up whatever is available. We hope this has been a helpful insight into some of the aspects of internship and gaining a place on some of the more prestigious internship programs. Being on an internship is one of the most fantastic experiences of your career. It is something that you will never be able to repeat, and as well as giving you immense satisfaction, will be something that you will always look back upon fondly in the latter stages of your career. Getting the best out of your internship starts with getting the right course in the first place. Making sure that you have the best resume that you can possibly create, and an exemplary cover letter to accompany it, will be the best foundation possible for achieving this goal. Good luck!

What exactly makes a good counsellor Essay Example | Topics and Well Written Essays - 1000 words

What exactly makes a good counsellor - Essay Example All a counselor does is dealing and communicating with human beings in need of help and guidance. Therefore, a good counselor should be a compassionate human, a gentle friend and a sympathetic listener, before every other thing. The role of counseling today is evidently on the rise in every walk of life, whether it is work, health, family, personal, social or individual lives of human beings.This paper provides an investigation into the core traits or characteristics that conjure up, in the truest sense, the picture of a good counselor.For this purpose, the paper provides a brief exploration of the term 'counseling' to illustrate what the role of counsellor actually entails and then proceeds to the crux of the discussion, i.e., an evaluation of the essential features that make a good counselor in any field.Counselling, fundamentally is a term used to refer to the collaboration of a person with other people to help them easily cope with the problems encountered in life and guide them to act decisively and hopefully towards their goals. As Burks and Stefflre (1979, p14) define it,"Counseling denotes a professional relationship between a trained counsellor and a client. This relationship is usually person-to-person designed to help clients to understand and clarify their views of their life space, and to learn to reach their self-determined goals through meaningful, well-informed choices and through resolution of problems of an emotional or interpersonal nature". Hence, the authors' words mentioned above comprehensively pen down the complete picture of a counsellor's role and responsibility in effectuating significance and instigating substance into one's life. The main purpose of the counselling profession revolves around the word 'help', i.e., whatever the counsellor does is meant only to help, assist or guide a person or client to bring about change in his life in a successful or at least in a satisfied and confident fashion. Man-tak Yuen (1993, p30) depict that, "in counselling, the client is helped to increase self-consciousness, develop positive self-concept, commit in relationships, achieve in tasks, and strive for meanings in life". What Makes A Good Counsellor At the essence of this paper is the exploration of the aspects crucial for the development of a good counsellor. Observed efficaciously, there appears to be a bundle of attributes that the researchers (e.g. Man-tak Yuen (1993), Combs, Richard and Richard (1976), and Peavy (1997) etc.) point out to be essential in building a good counsellor. What actually is pre-eminent in becoming a good counsellor is a cluster of human, social and professional values instigated into a single personality. These specific qualities or features, as they may be referred to, are important in developing the personality of the counsellor to the extent that he can be able to guide others in an efficient and responsible manner. Some of these dimensions have been specified by Man-tak Yuen (1993, p32) as "positive self-concept, belief in human dignity and potentiality, acuity, and counsellors' capacities to orientate towards goal and communicate respect, empathy, genuineness and concreteness are essential personal qualities of an effective counsellor". All these qualities are, in essence, personal and human qualities that are imperative for a counsellor for the reason that if he lacks these traits for himself, there will remain less probability that he inspires these attributes into other human beings. In order to help clients invigorate effective personal qualities into their lives, the counsellor needs to experience these values primarily. People are different in their backgrounds, approaches, thoughts, feelings, attitudes and responses. To know how to communicate and help different kind of people, a good counsellor should be ready to learn to dig out the perceptions of people he comes across. Combs, Richard and Richard (1976) (as cited in Man-tak Yuen, 1993, p30) explain this as, "when we know how people see themselves, much of their behaviours become clear to us, and often we can predict with great accuracy what they are likely to do next".

Reflective evaluation Essay Example | Topics and Well Written Essays - 500 words

Reflective evaluation - Essay Example There are quite a number of occasions when I wanted to tell more to drive a point across, but the time allotment is not enough to allow me to do that. Another problem that rose from this is knowing what to include or omit in the presentation slides. I had to use other means of presenting data. For this particular report, I used tables extensively to give the results of my literature review and interview. However, pictures, charts and graphs are also commonly used in compressing many messages in a smaller space. However, it is better to have a lot to omit than having less to include. As I look back to how I prepared for and delivered this presentation, I now realize that it is better to come overprepared. It gives me added boost of confidence in the delivery of the report, as well as in answering questions from the members of the audience. Whenever presentations are to be given, research is vital. Acquiring sufficient knowledge is required to be able to discuss the points adequately. However, sufficiency of information does not only depend on quantity, but also on their quality. This means that the information should come from reliable sources, which are experts in the field in question. In this particular presentation, I felt that I have researched many and various journal articles to sufficiently support the points that I want to drive at.

Multimedia assignment Example | Topics and Well Written Essays - 250 words

Multimedia - Assignment Example Adobe Soundbooth is audio editing software. The user can create and edit multiple tasks in the program to edit an audio track. The software was not very popular due to its complex interface and usability. The software releases were stopped in 2011 and Adobe Audition has replaced it. Adobe Flash is animation software. User can use this software to animate text, still images and graphics designed on other software programs. Adobe Flash is commonly used in web advertisement, games etc. Autodesk Maya is platform to create animated 3D videos. It can also be used to create powerful animation, modeling and simulated videos. Companies are using Maya to create animated films, simulated videos for schools and other professional environment and games etc. 1. Interactive and static multimedia objects have also revolutionized the Anatomy. Tools discussed above are widely used to create effective educational demos and animated videos to show how there anatomy can be used and employed.

Political System of Pakistan

Political System of Pakistan INTRODUCTION The current system of government in Pakistan is a mixed, â€Å"hybrid† form of government with elements from the parliamentary as well as the presidential systems. The country initially had a parliamentary form of government, it shifted to a presidential one with the 1962 constitution but later reverted back to a parliamentary one according to the current 1973 constitution. However, the various amendments and modifications to the constitutional provisions carried out by political leaders over the years have left a democratic, parliamentary government only in paper. The question that this paper, thus, attempts to answer is that, is a pure parliamentary form of government suitable for Pakistan? To find a proper conclusion to the aforementioned question, the essay will explore the shortfalls of the current system and compare the two forms of government i.e. Parliamentary and Presidential, in order to suggest the better suited government structures of the two. In order to do this India, with its similarities to Pakistan in terms of shared history and culture, is taken as an example for Pakistan along with instances of the two types of democratic government systems prevalent in other countries. While the arguments for Parliamentary and Presidential forms of governments may draw inspiration from their practical application in India and elsewhere but these examples will be implied and not necessarily always mentioned explicitly. RESEARCH METHODOLOGY The research for this paper comprised primarily of review of works by established professionals and academics in the field. Most of the research was limited to consultation of print and online sources for access to published material on the relevant topic. The starting point of analysis was with examination of the text containing reviews of the current system of government structure in Pakistan, its flaws and the eventual inefficiencies it has led to. Various journal articles and books were consulted for a variety of perspectives on the debate regarding the suitable system of government for Pakistan. Along with consultation of material for analysis of government structure of various countries, especially India and the South Asian region in particular, online journals were looked upon for comparative perspectives on the suitable government structure and their merits and demerits. Although the research is limited to a select few academics and professionals in the field, it allows for a sample of the general prevalent views on the issue since both sides of the debate have been looked at. LITERATURE REVIEW A large majority of literature on the topic is either about the shortfalls of the current mixed government of Pakistan or it highlights how the presidential system of government is better suited for the country. What is needed, however, is a detailed comparison of the two systems and not just analysis of any one of the systems with regards to Pakistan. Material by foreign academics and professionals looks at the Pakistani political system in comparison to their own and focuses on the inadequacies of the Pakistani system. The following reviewed literature comprises of a small sample of previously conducted study and analyses on the subject under discussion. Khalid Sayeed (1967), in his book ‘The Political System of Pakistan, explained the chronological progression of events leading up to the constitution of 1962 and the provisions it made regarding the system of governance to be put in practice in Pakistan. Regarding the 1962 constitution, the author (Sayeed, 1967) was of the view that the constitution severely curtailed the powers of the parliament and reduced the country to a distorted version of a presidential government. The author provided a favorable opinion about the parliamentary form of government, provided that it is actually in its truly democratic form (Sayeed, 1967, pp. 83). Although the author has given his opinion with support through illustrative historical examples but the author has failed to mention, explicitly, the merits or demerits of either of the systems of government and his clear choice of the either of the two. The authors arguments seemed to reflect a leaning towards the parliamentary system but he does not clearly highlight his choice, leaving the audience a little ambiguous about his perspective. In the book entitled ‘Government of Pakistan, Parmatma Sharan (1975) gave an outsiders opinion regarding the system of government present in Pakistan with comparison to their home country, Indias government system. The author has sounded alarms regarding the high centralization of the government in Pakistan throughout the years ever since its independence. The author has said that this should be countered since a weaker leadership can, and has shown in actuality, the perils of a weak decision-making power in times of need (Sharan, 1975, pp. 150). Ahmed Shuja Pasha (1995), in his account of the scenario of the Pakistani politics, was of the view that people themselves are largely responsible for choosing the ‘wrong leaders as their democratic representatives. Pasha (1995, pp. 281-287) believed that the inefficiencies present in the political system of Pakistan are largely due to the fact that people associate democracy with one particular person who takes advantage of the situation and manipulates their powerful position for their own gains. Pashas (1995) views were a little biased as he does not consider the constant shuffling of the regime as much of a problem for the lack of people getting accustomed to the workings of a democracy. The authors views were favorable for the military as he finds the military having the most disciplined set up during the times it came into power in the country (Pasha, 1995, pp. 189-190). In an attempt to contextualize the latest Musharraf-led military coup in Pakistan, Sohail Mahmood (2001) tried to consider the factors that have led to the demise of true democracy in the country. He was of the view that regardless of the fact that the country is under parliamentary or presidential regime, the country has never truly been a democratic country because of the highly centralized nature of governance (Mahmood, 2001, pp. 7). The author also discussed the current semi-parliamentary system of Pakistan in comparison with a more presidential system like governance. He analyzed the merits and demerits of both (Mahmood, 2001, pp.128-129). Although the author presented a fairly balanced view about the situation, he merely referenced historical political situations as chronological facts without his opinions being clear regarding them. The autho,r Udaya N. Shukla, in his essay â€Å"Parliamentary Control over Government Policies in India† (1990) looked at the parliamentary system as a British legacy. The shortcomings in this system experienced in South Asia (by India as well as Pakistan) are attributed to the centralization and the lack of proper literate population to understand the exact nuts and bolts of a parliamentary government (Shukla, 1990). The author should consider that this leads to the political elite to manipulate the situation and also he should outline the kind of political elite that could benefit by the ignorance of the population regarding the system. This is important because it allows the audience to contextualize the problems that plague the current parliamentary form of government. Furthermore, it is not possible to make an absolute, decisive conclusion on the issue since access to every study and detailed research has not been possible and limited numbers of past discourses have been examined for the current analysis. ANALYSIS Pakistan, according to its constitution, is a ‘federal republic (Constitution of Pakistan 1973, Article 1(1)). This means that Pakistan is a country where several autonomous states have come together under a federation, the states being the self-governing provinces and the federal capital, Islamabad, being the centralizing federal authority. Being a republic, Pakistani government is a government where majority of the power vests among the larger body of citizens and where there is a head of state but that is not a monarch, the head of state is democratically elected, directly or indirectly (Merriam-Webster, 2011). The Constitution of Pakistan calls for a democratically elected government where the legislative authority is vested in the Parliament and the executive is led by the President (Constitution of Pakistan 1973, Objectives Resolution). The origins of the sort of power division proposed by the 1973 Constitution can be found in the ‘Separation of Powers doctrine proposed by Montesquieu (Anon. web). The Montesquieu doctrine called for division of the powers to govern a country with three proper divisions i.e. Legislature, Executive and Judiciary. Checks and Balances on all three of them by each other were proposed to ensure that every government instrument carried upon its tasks without infringing upon other institutions. However, the system of mixed government at present in Pakistan where the President, in paper is ceremonial, but in reality is a political affiliate of a particular party and where the Prime Minister is not only the leader of the Legislative body but also the head o f the Council of Ministers which is the Executive body, is not properly following the ‘Separation of Powers. Chaudhry Muhammad Ali, the fourth Prime Minister of Pakistan, has even been quoted calling the 1965 government one that is â€Å"a government of the President, by the President and for the President† (Sayeed, 1967, pp. 105), there is a similar situation at present as well. This is a problem for the country since the population has not even been accustomed to the concept of a proper parliamentary democracy that was introduced initially, now the highly distorted form of government is the product of and also leads to further irresponsible decision-making by the countrys leadership, centralization of all important government policy matters and hegemony of the few. These inefficiencies have also been reflected in the political parties of Pakistan and their working. Being a heterogeneous society, Pakistan, like other developing countries with people from a diverse background, for instance India, Pakistan also needs the participation of a larger number of people in the political life in order to break the shackles of domination that the political elite are keeping an overwhelming majority bound in (Kohli, 1994, pp. 90). The form of government and the design of party politics prevalent at present in the country is a major road block towards a liberal democratic Pakistan where all adults are actually empowered and educated enough to voice their opinions. Party politics is dominated by a handful of feudal families which share the government between them. This leads to a centralized system of decision making in the country regarding national and international matters which does not necessarily effectively reflect the majoritys opinion and keeps the ascendancy of the few (Kohli, 1994; Sayeed, 1967). Pakistan has also been suffering from bad governance owing to high centralization of the command (Sharan, 1975; Sayeed, 1977; Mahmood, 2001). This centralization of the decision making further conforms to Atul Kohlis (1994) comments regarding the increased hegemony of the richer, more dominant political elite. With increased concentration of powers not only does one person or office become uncontrollably powerful but there is an increased chance of the irresponsible and corrupt usage of that power (Mahmood, 2001). In Pakistans case if the Prime Minister or the President is leading the Legislative body as well as the Executive they themselves are the ones making any new laws and regulations and ensuring their adherence by the general public, this becomes a case similar to the British Monarchy where the crown is above the law (De, 1991, pp. 246). A situation like this leads to chaos when that particular person does not remain in their position anymore and since there has been no power sharing and none of the other institutions have contributed to the decision making process so nobody is ready to completely assume responsibility automatically upon the vacation of the office. Ahmed S. Pasha (1995) also sounded off similar comments when he mentioned that the population associated democracy with one person and the exit of that person caused chaos and disruption in the functioning of the government. In order to clear up the mess of the mixed system and completely evolve into a more efficient form of governance it is necessary to understand both the systems of government Parliamentary and Presidential. The Parliamentary form of government has been labeled by most as a direct descendent of Monarchy. While a monarch comes into power by a dynastic succession, the head of state in a parliamentary form of government is democratically elected through the concept of universal suffrage (Philip. 2007, pp. 42). The existence of political parties is crucial for a parliamentary form of government. For a true parliamentary democracy, S.C. Stokes (1999, pp.263) said that political parties are an essential component and there is no removing them. However, the present party system does not seem capable enough to accommodate the essence of a liberal democracy where any number of people from any background can represent their group. Thus, for establishing an effective liberal parliamentary democracy political parties need to be truly democratic themselves (Mahmood, 2001). This measure may also effectively solve the issue of centralization of power in the hands of a few since with a democratic setup of the parties more people from diverse backgrounds can participate in the party politics. Another feature of the parliamentary system is that the division of powers is often blurred; this again alludes to the Monarchical roots of the parliamentary system of government. However, lack of strong division of power does not mean lack of power sharing. Even in a parliamentary system there can be more decentralized decision making with powers vested in various echelons of the government. This can be seen in United Kingdom where although the final decision approving authority is with the executive the Crown, the decision-making power is highly differentiated with the House of Commons and the House of Lords being involved in the legislative process. On the other hand, the Presidential system of government is based strictly on the doctrine of ‘Separation of Powers and the Head of the State the President, is elected directly by the population along with the core legislative body (Philip. 2007. pp. 39). Both the systems have their own merits and demerits but for a heterogeneous society like Pakistan where strong ethic affiliations play a central role in the populations trust in their representative, a parliamentary system is rather more effective because the direct election of the Head of State in Pakistan is definitely not a suitable option as larger population areas are more likely to have their candidates elected to the office every time. Moreover, as Ahmed Shuja Pasha (1995) argued that most of Pakistans problems of electing the ‘wrong candidate are associated with the lack of awareness regarding the best candidate by the general voters. The Presidential system calls for the election of one particular person and implementation of such a system in Pakistan would not change the status quo of re-election of the same feudal leaders. In a true form of Parliamentary system where political parties are truly democratic themselves, this would allow for parties to choose better candidates for election and helping the largely illiterate Pakistani population in electing deserving representatives. Accountability of a ‘non-deserving candidates election will be, in such a system, done once that person has been elected to the Parliament. The lack of capability of such a person would soon be exposed in a truly parliamentary system and this would lead to damaging of the political partys image so they would be wary of choos ing those who are not capable. Another favorable argument for a parliamentary government system is that it allows for electing the government once, unlike a presidential system where the governments are to be elected in two steps; once the congress and then the president (Mehta, 1994; Mahmood, 2001; Philip, 2007). This may lead to instances, in a presidential system, where the president is of a different political ideology than the majority of the congress. In such a situation passing legislation would be a torturously slow task. While Sohail Mahmood (2001) was of the view that slowing down legislation is the goal for a country like Pakistan, in fact a quicker paced legislative process would be required for the country once it adopts the true democratic form of Parliamentary government. This quicker paced legislative process would be favored because this way reforms and legislation favored by the public can be enacted quickly which would be very slow if a Presidential system is adopted.. One point that defendants of the Presidential system make is that it brings the leaders closer to the people and this way the population can decide the best person they feel that can govern them (Philip, 2007, pp.45). However, in Pakistan this is actually a disadvantage since charismatic leadership is often overshadowed by the feudal hegemony maintained by the ruling elite. A pure parliamentary system can at least allow more people to compete alongside the ruling elite and may be they even give them an opportunity to be a part of the government. CONCLUSION The question of the form of government is extremely important for Pakistan because the form of government intended by the constitution is a parliamentary form of democracy (Constitution of Pakistan 1973, Preamble). This already establishes that all administrative and political aspects of governance will be dealt with according to the general provisions of a parliamentary democratic government. An important aspect to be discussed here is that parliamentary democracy itself is the ideal form because of a long history of the success rate of a parliamentary democracy as compared to a presidential one. JosÃÆ' © Cheibub and Fernando Limongi (2002, pp. 152) have reported that most forms of parliamentary democracies have survived over a longer period of time unlike a presidential form which has fallen prey to a dictators hands numerous times. Although in the current system even the president is part of one of those families, in the long term once a true liberal democratic regime has been established in the country the hegemony of the few might be effectively destroyed and the president will work as merely a ceremonial head of state, as can be seen in India. Regulation of political parties is also important and legislation to enforce certain measures, like in-party elections, should be introduced. Whatever the final outcome may be, it is quite welcome that the current government has at least intended to move away from the present mixed system to a more parliamentary form of government. The incumbent Prime Minister of Pakistan has been reported to have resolved to make sure necessary steps are taken to start the process of this transition (Daily Times, 2008; VOA News, 2010). It is suggested to the current government that decentralization of decision-making and clean-up process within the political parties be taken as the first steps to start the journey towards a pure parliamentary democracy for Pakistan.