China’s Energy Security Plan

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For an economy that is growing as fast as China, the need fro energy is always paramount. China’s fast-paced economic growth has rendered the nation tot be highly in need of reliable energy sources. Currently, coal-produced energy is the main source for Chain, making up to 70% of the country’s energy need. This is convenient for China because it is the world’s highest producer of cola. However, give the fact that coal is not a renewable source of energy, there is a need to make sure the country has secured its energy for future purposes. At the same time, coal is not environmentally sustainable as it leads to massive damage to the environment. China also has high levels of oil reserves that it has not exploited use, in the hope to use this as a sour of energy in case of an energy crisis. It imports its oil from different countries around the world. The recent addition of hydroelectric power to the power grid has helped in making sure that the countries energy future si secured, both in terms of energy availability and also its sustainability. China should explore this more and add more dams such as the three gorges dam as well as expand its solar and wind energy. This will not only increase its energy sources, but will also increase the environmental sustainability of its energy.


China is not only the worlds largest country by population, it is also the worlds fastest growing economy. Despite the fact that the per capita consumption of energy is much lower than in developed countries such as United States of America, France, United Kingdom, Germany and Canada, the national power consumption in China is much higher than for any of these countries. For instance, despite the fact that the per capita energy consumption in China is 1806.8 kilograms of oil equivalent (kgoe) compared to that is Canada which is a whopping 7379.6 kgoe, the national consumption of energy for China is still uses more than that of Canada. This is because China has a population that is more than ten times that of Canada, or any other developed nation. China’s energy sector is not the most efficient, however. For example, it still depends on coal-fired electricity production (World China Para 2). Despite China having many oil and gas reserves, it has not been able to explore this. China is the largest world consumer of coal-powered electricity and the words second largest exporter of coal. Its energy is over 70 percent dependent on coal. However, in the recent years, the country has tried t diversify its energy production to renewable sources, and this has been possible through investing in large hydroelectric power stations, such as the seven gorges dam. Regardless of this, the major source of energy in China, both for domestic and industrial uses still comes from coal. China is both an exporter and importer of energy. Its main energy exports are from cola and its main imports is oil and gas.

China’s Total Current Energy Needs

China is one of the highest producers of electricity in the world. It produces 5,583 Mtoe (Million Tonnes of Oil Equivalent) of electricity per year, by 2015. The United States of America which produces 4,330 Mtoe is the second largest producer and consumer (Year Book Para 2). However, china’s energy consumption is lower than this and therefore has a surplus of energy than tit exports to other countries. For instance, while its power production of over 5,000 Mtoe, its consumption is only 3,034.

China’s Energy Mix

The energy mix in china continues changing due to several factors such as government policy and the fact that the country is among from traditional non-renewable spruces to the modern renewable sources such as hydroelectric. The three gorges dam as a great improvement in reshaping the power grid for china. However, the country’s energy mix remains the same as it has in the last over fifty years.

Coal – 66%

Hydrochloric power -08%

Nuclear energy -1 %

Other renewable -1%

Oil -20 %

The above figures are for 2014. Of course, there has been a few changed as the county’s energy mix continues to change over time. It is good to note that china imports most of its oil for energy production. This means that the 20% making up its total energy mix is dependent on imports (Lam Para 7). With regard to china’s energy exports, it is also good to note that it mostly exports raw energy and not ready to use energy. Fro instance, with regard to exporting, china exports raw cola as opposed to electricity produced using coal.

Where China’s Energy Is Obtained

As indicated, the main source of energy for china is coal-generated electricity. This serves both the industrial needs as well as the domestic needs, especially in cities. Most people who live in rural areas in chain do not use electricity because they are not connected to the power grid. While the largest source of energy in china is coal-generated electricity, the country also uses a significant amount of energy from the oil and gas. It only produces 4% of the total oil and gas that it consumes.  China consumers a whole 8% of the total oil produced in the world and imports it from over ten countries. Its main oil imports come from Angola, but also imports from countries as far as Brazil and Venezuela.

Energy imports versus exports

China spends 833.3bn Yuan ($128 billion in US dollars) for import of energy and earns (Statista Line 8 Table 1). While the main energy import from china is coals, this is not sustainable because of a number of issues. First, it is necessary to note that china and the rest of the world is moving from coal as a source of energy due to its massive negative impact on the environment. As a result, while china is the largest exporter of coal, these imports will continue to decline over the next few decades. In fact, the decline can already be felt in china today. The value in the Chinese currency had also affected the coal imports and exports between China and the rest of the world. For instance, the devaluing  the Yuan can meant that china was better off importing coal than when exporting it (McFarlane Para 5). China has an opportunity to export oil, but due to China’s strategic petroleum reserve policy, it has not exploited its oil reserves which are in billions of barrels.  The country continues to stand with  this measure for its one energy security in the future.

Projections/ China’s Energy production and consumption future

As already identified, china’s main source of energy in the current time is electricity produced from burning of coal. In 2014, it accounted for over 65% of china’s energy. It is estimated that in 2016, the total contribution of coal to Chinese energy production stands at over 70%. Oil is the second highest source of energy for china. It is good to note that even oil, just like coal, it not only non-renewable, it is also environmentally unsustainable. As a result, it is necessary to assume that in the future, coal will not be the main source of energy for china. Neither will gas and oil.

One of the major pointers that indicate that the current energy mix in china will have to change is the massive investment in hydroelectricity power plants as well as the solar and wind energy. Currently, despite the fact that china depends mostly on coal as a source of energy, China is the global leader for wind energy and solar power installations. As this trend continues, china will continue reshaping its energy mix to align itself with the current environmental needs for sustainable and renewable energy. Currently, china has the highest per capita carbon and greenhouse gas emission, despite the fact that it has the some of the lowest per capita energy consumption. The main reason for this discrepancy is the fact that most of China’s energy is used in the industrial sector and not in the domestic sector. This means that the energy consumption in China cover not only the over 1.2 billion people who live in China, but also billions of other people who live outside china but use products manufactured in china. To turn this high levels of carbon and greenhouse gas emissions, china will have to reshape its energy. In the future, the main energy source for china will be hydroelectric energy.

China had a very crucial opportunity to clean up its energy as it has massive natural resources such as rivers that can be used for hydroelectricity production. Currently, even in the consideration of the three gorges dam hydroelectric power plant, China only uses a fraction of its total capacity for hydroelectricity production.  The three gorges dam can be seen as the pioneer project that has shown the potential for China to utilize the available natural resources to create new energy for its domestic as well as industrial use. In the next twenty years, projects such as the seven gorges dam will transform the energy mix in china.

Solar and wind energy will also enter the grid and become significant contributors to the national power and energy grid in china. While the solar energy in China is not a big promise due to the fact that China does not have a lot of natural resources to support solar energy production, the wind energy resources in chain are abundant enough. It is however necessary to note that china has been reserving its oil resources and this will mean that when it chooses to use these oil reserves, the contribution of oil and natural gas to the Chinese energy mix will go up. As of now, oil and natural gas only contributes about 20% of the Chinese energy needs.

China imports most of this oil and natural gas from other counties and only produces a very small percentage at home. The idea is to make sure that in the future, if their is energy crisis, the nation will have the capacity to provide its big industrial sector with energy to continue running the economy. China also has a high capacity for geothermal power production that has not yet been property exploited. Although the geothermal capacity is not high enough to because the major source of energy in china, it is big enough to provide an alternative for other non-renewable and environment unfriendly energy sources such as oil and gas. The Yangbajain Geothermal Field is a good example and provides a good opportunity

Recommendations regarding future energy security

China has one way to go in order to achieve a proper energy security in the future. First, it needs to be able to utilise the natural resource such as dams, wind and solar. Although the nations has been doing this for some times now, it needs to do more, especially with regard to its hydrometric power.  For instance, china’s installed hydropower capacity is 280 GW while its hydropower generation  is 1,064.34 TWh. In this regard, the best energy mix for china in the future to make sure that the county has energy security for its future will be as follows;


Hydroelectricity will be of big advantage for china’s energy source for three major reasons. First, as the hydroelectricity power grid increases, the overall cost of electricity production will increase and this will save the country a lot in fiscal terms. Secondly, as the world moves towards clean and sustainable energy, the cost of producing unclean and unsustainable energy will go far. Getting away from coal as the major source of energy will therefore be a big many saver for china. At the same time, there is the issue of job creation. Developing hydroelectricity will help the country to produce productive job opportunities for many Chinese who are jobless. This will have reverberating positive impacts to the economy.

The second source of energy fro china in the future should be geothermal energy. Like hydroelectricity, it is renewable and has very little environmental impact compared to other sources such as coal and oil. Given the fact that china had many opportunities for the growth of the power, it will be necessary to make sure that these resources are well utilized to make sure that the country can move away from its current energy mix which is mainly dominate by non renewable and environmentally unsustainable sources. Other renewable sources of energy should form a composite contribution to china’s energy mix.

It is also necessary to note that coal is not likely to disappear very fast and will continue to be a major part of he energy mix in china. However, this does not mean that it has to remain the major contributor of energy in the country. China should look to reduce its contribution as much as possible and replace this gap with renewable sources such as hydroelectricity as well as geothermal and wind. In the next 20 to 50 years, china’s energy mix should be as follows;

Coal – 20%

Hydroelectric power -50%

Geothermal -10%

Other renewable sources (wind, biomass, and solar) -15%

Oil -5 %

The above energy mix will have not only economic advantages for china, but also no economic benefits such as improved national heath due to less pollution. It will also give the nations an added advantage in that it will have most of its energy sources being renewable, meaning that it will not have to worry about running out of energy. For instance, even though climate changes can shift the capacity of most of its hydroelectric power plants, this will not be as serious as having its coal reserves being depleted and therefore leading to an energy crisis. Laghoth china has lots of oil and natural gas reserves, they are also easy to deplete and cannot promise a good future with regard to energy security, not to emotion that they are also harmful to the environment. The need to phase of nuclear energy is also high and china should replace it with the other non-risk energy sources such as wind and hydro power.

Break down estimate to realize the recommendations

To be able to realise the above recommendations, china will need massive investments in trsm of dollars. It is necessary to note that these investments cannot be done in one or two years but eed to be implemented over a period of several decades. China has been investing heavily in energy security, but it needs to invest even more.

Hydrochloric power

To increase its hydroelectric power production to the point  of making it to be the nation’s lardiest source of energy, china will have to invest massively in fiscal terms. It needs to invest in over 20 more large-scale hydropower projects in the next 20 to 50 years. Construction of large-scale hydropower can also for over ten years, and this means that it will need to carry out most of these projects concurrently. For example, the construction of he seven gorges dam took 18 years and cost US$27.6 billion. China will need to construct over 20 dams of these nature size and production capacity in order for the country to be assured to energy security the future. In this regard, the total cost for hydropower will be around US$552 billion in the next 30 to 50 years.


China will need to be able to implement more geothermal power plants, not only as a way of security its energy, but also as a way to clean its energy. As a result, it will need to be able to invest a lot in the geothermal sector. It will need a minimum of 30 more geothermal power plants in the next 20 to 50 years.

Estimated cost for geothermal development can be based on the Yangbajain Geothermal Power Station in Tibet which cost 1.9 million U.S. dollars and has a capacity of 25,181 kW. To build another 20 of this, it will cost 38 million US dollars in the next 30- 50 years.

Other renewable sources (wind, biomass, and solar)

China will also need to invest a lot of money in other renewable sources of energy sot ht it can exploit them and have a way to make sure that it not only has energy security but also that it has energy cleanliness. These other sources of clean energy such as wind, solar and biomass do not necessarily provide a way to become the main sources of energy, but when exploited affectively, they can provide a composite source of energy that will make a bog part of china’s energy mix. In this regard, china needs to gear up its investments in this are in order to make sure that there is a way to achieve positive outcomes with its energy. To maximally exploit these small but important sources of energy, the country will need to invest at least 50 million of American dollars.

It is good not note that these figures are not adjusted for implementation and changes in currency over the next fifty years when the project will have to be carried out. However, they give and estimate that is worthy of consideration for china as it seeks to not only clean up its energy mix, but to also achieve energy security in the future and this avoid an energy crisis for its fast growing industry. It is also necessary to note that apart from the government, the private sector is also involved in the development of power. As a result, the burden does not rest entirely on the government as a source of capital to make these recommendation be achieved.

What the government need to do is to ensure that it has put in place the right incentives that will encourage private developers to be involved in the development of new and sustainable energy power plants. However, the government would be careful to note that energy security is not just about the availability of the energy, but also the cost. For example, even when there is enough energy but the cost is too high, this will still lead to energy insecurity and crisis. This is why the Chinese government should be careful in involving the private sector in the development of energy resources because these private firms are profit inspired which means that they can hike the prices of energy with every opportunity they get to maximize their profits.

Breakeven point from these investments

As identified, these investments will not be carried out in one batch but will be implemented one by one. In this case, determining the break-even point for all these projects would not be feasible. However, it is feasible to argue that most of them will break even within ten years after the completion of the project.


China’s economy is growing at a very high rate, which means that the need for energy is also growing at an alarming rate. Two main concerns about china’s energy is the fact that over 70%, which is not good given the fact that this is a non-renewable, source of energy as well as harmful to the environment. China however has massive opportunities in that it has many large rivers which can be used for generating hydroelectric power. However, developing hydroelectric power plants is an expensive endeavour that costs a lot of money ad takes up to decades before any power come from them. China should have a fifty-year plan on increasing its hydroelectric power production. It should also consider exploring other clean and renewable energy sources such as biomass, solar and wind energy.












Works Cited

Haijiang Wang. China’s oil policy and its impact.  Energy Policy, 23, 7, 1995, pp. 627-635.

Lam, Pun-Lee. Energy in China: Development and Prospects. 12 February 2015. 2015 March 2016 <;.

McFarlane, Sarah. Yuan devaluation could trigger coal exports by world’s biggest buyer. 13 August 2015. 09 March 2016 <;.

Statista. Statistics and facts about Imports to China. 05 May 2015. 08 March 2016 <;.

World China. World China. 25 May 2015. 09 March 2016 <;.

Year Book. Global Energy Statistical Yearbook 2015. 20 March 2014. 09 March 2016 <;.



Hypothesis Testing of Program Effectiveness of Police as a Crime Reduction Program

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Police officers have a role to protect civilian. They carry out the government’s mandate to protect the lives and property of people from wrong doers. While it is clear that police officers help in curbing crime, one issue is with regard to how increasing the number of officers, or the ratio of officers to civilians affects the levels of crime. In the following study, 300 participants, 150 from each region, will be used as a way to determine the effectiveness of increasing the number of police officers in curbing crime.

Research Question

Can increasing the number of policy reduce the level of crime?

Are there other factors, other than the ratio of police to civilian that affect the effectiveness of police officers as a way to curb crime?


The effectiveness of increasing the number of police to curb crime is dependent on several factors that must work together. Just having a higher number of police officers within a community does not necessarily increase their effectiveness in reducing crime.



This will look at the number and frrequncy of patrols and how they affect the levelsof crime in a neighborhood.

Rapid response to reported crime

This will look at how the rapines of police response when there has been a reported crime affects the possibility of future crime happening in the same location of neighborhood.

Proactive and Reactive Arrests

This variable will look at the ways in which police arrests of criminals and suspects affects the level of crime.

Statement of the Problem

The continuous increase in the level of crime in many neighbourhoods has led to many recommendations on how crime can be cured. One mainstream argument is that by increasing the number of police officer in order to increase their ration to civilian increases their effectiveness in curbing crime. However, this argument can be contended by some in that just adding the number of police officers may not necessarily affect the way in which crime develops. Adding more officers to the police office costs both the local and national government a lot of money. As a result, it is necessary to identify with assurance whether the addition of more officers affects the effectiveness of police officers in curbing crime. If this is not done effectively, there would be a chance that the additional cost of would be termed as ineffective use of public funds.

Population of Study

The study will use a population of 300 people who will be interviewed in different regions. The first region will be one with a lower number of police officers and higher number of civilians while the second one will have a higher number of officer and less civilians. Each regions will be represented by at least 150 people with an aim of comparing the two regions. To make sure that the population of the two regions have been represented properly, a random sampling method will be used in order to select the participants.  However, those who will happen not be residents of the regions, or who have moved in recently, will be excluded from the study.

Data Collection Methods

Data collection will be done using both interviews and questionnaires. The participants will be asked about their encounters will crime in order to determine how often a person from any of the two regions is likely to be affected by crime. During data analysis, this will be adjusted for other factors in order to get the picture that is closest to the reality. For instance, some regions may have lower crimes not necessarily because they have more police officers but because they do not have a culture of crime among the community members. Other factors such as seasonal or one time hikes in crime will also be considered.

Significance of the Research

As established, crime is a serious concern among many people in many communities. It affects people by either injuring them, leading to loss of life and even property. The government has a responsibility of protecting people in order to make sure that not one is harmed. One of the major ways in which the government does this is by providing policy offices who are certified and trained to policy neighbourhoods and any other public areas such as city streets. The pressure from different quarters for the government to increase the number of officers as a way to reduce, curb, and even eliminate crime is high. However, there is no clear evidence that doing so will reduce crime or have any positive effect on levels of crime.

Program Effectiveness of Police as a Crime Reduction Program

High crime rates have been one of the main challenges facing various communities. It places their lives as well as their valuable properties at risk. This has forced communities to develop programs aimed at either reducing or eliminating crime within the community setup. A mix of prevention programs and social policy has often been proposed within various communities as a relevant measure of the reduction of crime. The implementation of such programs faces several challenges, which often hinder their success in a community setting. Crime rates can be analyzed statistically in relation to the type of crime prevention program that is being employed in the specific community. Review of various literature indicates multiple crime management programs that have been employed in various communities depending geographical location and political standings (Sherman, 2009). Such programs have played an important role in the reduction of crime. However, they have been unable to achieve the expected goals due to various factors that are related either to the process of implementing the program or existing perception among community members. This paper aims to explore various literature reviews on policing as a crime prevention institution, outlining limitations that have possibly hindered its success in specific community setups.

Independent Variables

Several communities in various parts of the world believe that a large number of police results in a significant reduction in crime rates (Sherman, 2009). Public officials and the citizens believe that crime can be curbed effectively by increasing the number of police officers. However, empirical analysis indicates that the population of police officers does not explicitly address security. Lawrence Sherman (2009) indicates that a large population of police will only make a minimal contribution to the prevention of crime, especially in highly influential social structures such as labor markets and the family. The effectiveness of additional police in crime prevention depends on several variables such as their total focus towards the various objectives intended to oversee a crime prevention scheme. The supposedly ideal number of police should be posted in places where crime is highly concentrated within the right time limit.

Policing as a crime management strategy depends on the achievement of other related objectives. In the U.S. and several other parts of the world, policing is only accepted as a crime reduction tool if the police force effectively meets certain standards. First, a community is supposed to have a certain number of police that depends on the population of that community. Their effectiveness also depends on their level of response (McElvain, Kposowa, & Gray, 2013).

Rapid Response

They are expected to be able to arrive at the crime scene in the shortest time possible. Their ability to reach the crime scene in time and hold the criminals accountable helps to discourage other people from involving in criminal acts; thus, a reduction in crime rates. The rapid response program ensures that the police are able to reduce the harm felt from criminal acts. Moreover, the police are able to deter possible punishment by the public through the response-related arrests (McElvain et al, 2013). Rapid response greatly helps the police force to obtain immediate evidence that can be effectively used to prosecute offenders. It is apparently clear that employment of an adequate number of police officers is one of the ways where the rapid response can be made possible within a policing unit. Initial studies indicate that a reduction in the time taken to respond to criminal acts results to the arrest of a large percentage of criminals. This serves to deter those who may intend to engage in criminal acts and eventually influence a reduction in criminal activities in the community. In the U.S., the rapid response program resulted in initiation of 9-1-1 systems that speed the contact between the police equipped with radio and the victims of crime resulting in a reduction of response time, leading to deterred crime by adding to the likelihood of arrest (The John Howard Society of Alberta, 1995).

A test of the hypothesis based on 265 Los Angeles police responses to calls by citizens and further confirmed by a study of Seattle indicated that the possibility of a police arrest was increased with consequent decrease in time taken to travel to the crime scene (Schultz & Tabanico, 2007). However, statistical evidence also shows that a reduction in the response time is not an assurance for a reduction in crime. Its impact in crime prevention is otherwise minimal.

Random Patrols

Additionally, the police are expected to take random patrols. The more random the patrol, the more the people will begin to perceive the police as omnipresent (Sherman, 2009). This tactic serves to deter those who intend to commit crime and escape unnoticed. This has significantly aided in reducing crime, especially in public places. This objective is only achievable if a security location has a sufficient number of police officers. However, testing of this hypothesis proves a hard task. For instance, an experiment by Kansas City Preventive Patrol Committee found no differences in statistical results after varying the extent of patrol within one year (United States Department of Justice, 2011). The police force has also been able to implement directed patrols that aim at ‘hot spots,’ which are noted for the presence of high criminal activity. They have also been able to carry out patrols at specific times of the day when criminal acts are known to be at the peak.

Proactive and Reactive Arrests

Moreover, the police have also been able to carry out proactive and reactive arrests. However, the existing evidence on proactive and reactive arrests is unconvincing. The test results are generally negative especially for juveniles (Sousa, 2001). They are also considerably contradictory for certain groups such as unemployed, employed, and domestic assailants. The public perceives that the more the police are able to arrest suspects in response to observed or reported offenses the higher the probability that crime rates will reduce. On the other hand, general deterrence significantly contributes to the evident inappropriateness of reactive arrest as a crime management tool. Statistics indicate that the reactive arrest is only effective in areas with less than 1000 people above the estimated tipping point (Sherman, 2009). On an individual level, studies indicate that same reasons that led to the arrest of juveniles can only serve to increase repeated offending. In this case, arrests prove an ineffective strategy in managing crime. Additionally, Sherman found out that the higher the legalistic is the process of arresting and prosecuting juvenile the more is it able to cause an increase in recidivism in a community setup.

The effectiveness of the police force as a crime management strategy also depends on the relationship between the community and the police (Cohen & Felson, 1979). The police force has the duty to maintain a good relationship with the citizens if they are to obtain certain critical security information held by the community. Poor relationships deter interactions, which regardless of the number of police and efforts put in place, may result in the ineffectiveness of the unit and persistence of high crime rates. A better quality and high quantity of interactions between the citizens and the police imply a possible reduction in crime rates in such a setting. The police need to be able to identify the accurate causes of the existing patterns of crime if they will be able to reduce the rates of crime. The community will need to have confidence in the police force. This defines the police legitimacy in their place of work. Studies indicate that the police establish a greater, legitimate presence to win the confidence of the citizens. A legitimate police institution fosters obedience within a community setup that is critical for effective police service.

Neighborhood Watch Program

On the other hand, some communities use Neighborhood Watch crime prevention programs, which involve the coming together of the residents of a specific setting in a small group in order to manage crucial information concerning crime in their area. This program has had both advantages and limitations (United States Department of Justice, 2011). The program entails sharing information on prevention of crime as well as organizing crime reporting and community surveillance. The program aimed at making everybody in society to be responsible for his or her security and that of others. A specific crime prevention or law enforcement officer organizes each block or group that forms a critical part of the program. Each block is authorized to hold its secret small security meeting. These programs take into consideration the fact that criminal acts may influence isolation and fear within a society. Therefore, it aims at promoting social cohesion and social contact within a community setup. Arguably, the breakdown of the historical informal social control processes that decide the social order may influence fear among community members (Schultz & Tabanico, 2007).

Dependent Variables

The police as a crime prevention technique are faced with several challenges, which make it an unreliable program within the context of Community Crime Management. This has forced various communities to incorporate many programs in the bid to curb criminal acts effectively. The police independently create a risk that becomes a challenge in managing crime. The police are often fond of what the rest of the source regard as bad manners (McElvain et al., 2013). The police are often considered less respectful by some subsets of society, which diminishes their legitimacy and contributes to the loss of confidence in the police unit. This further creates a poor relationship between the police and the citizens, crippling interactions between the two groups. In this context, it will be relatively hard for the police to obtain critical security information. Scientific evidence supports that less respectful are the police towards the citizens and the suspects, the fewer citizens will be ready to obey the law.

There is great need to change the police style and increasing focus on the police effectiveness if a community is to realize a change in crime rates in the face of a significant number of police officers. Legitimization of the police ‘substance’ as well as their style in the public eye, especially the juveniles who are highly exposed to arrest risks, appears one of the effective, long-term strategies that should be considered by any society that intends to use the police as a crime prevention program (Bratton & Malinowski, 2008).

The policing program has experienced both success and failure in different security angles. For instance, there is no consistent crime reduction in drug crackdowns. This is mostly due to the susceptibility of the police to the various influences; there has been no strong reduction of crime after and during a crime crackdown. Research indicates disparities on police handling of drug crackdowns (Sherman, 2009). For example, a randomized experiment that entailed raids of crack houses indicated a significant reduction of crime on the block. However, another research on open-air raids indicated a significant reduction in crime. At this point, police are an effective entity that can be utilized in crime management but can only be effective if certain factors are considered.

The tactics employed by the police force can also determine their success in crime reduction. For instance, there exists supportive evidence on hypothesis of arrests as a result of the Broken Windows-Zero Tolerance program (Sherman, 2009). Studies indicate that a police focused on street incidences can plausibly reduce crime. However, this depends on the strategy employed. Some tactics are controversial and rather serve to increase crime rates rather than reducing. A Newark test from 1982 indicated some tactics employed by the police force as unconstitutional and should be eliminated in the bid to foster an improvement in the effectiveness of the police unit. These include the police ordering off the teenage male, often loitering on street corners, on the basis that they are obstructing traffic. Such instructions often provoke these teenagers and may end up committing a crime. On the other hand, poor community-police relations have often been characterized by field interrogations, which questionably is considered by various police units in the U.S. and Europe as a favorite crime prevention strategy. Importantly, studies by NIJ Oakland City Center and San Diego suggest that there exist better ways of controlling public behavior in a manner that supports police legitimacy (Cialdini, Reno & Kallgren, 1990). The police service needs to incorporate such strategies that support standard community-police relationships.

The Zero Tolerance strategy raises many questions regarding its possible negative implications especially on those arrested for minor offenses (Sherman, 2009). Therefore, the police force as a crime prevention scheme will need to implement its tactics and measures to establish an effective crime management approach. Studies indicate that though massive arrests may serve to reduce significantly crime in the short-term they may, on the other hand, serve to spark serious crime issues in the long run. Police arrests have also had substantial negative effects on the labor market participation. Additionally, police arrests because of minor offenses have played a role in permanently lowering police legitimacy both for those who have been arrested and for their network of friends and family. Therefore, police arrests have a relatively insignificant contribution to the eventual crime reduction in a community.

In addition, studies show that rapid police arrests can influence criminogenic effects that can possibly make arrestees more defiant and may end up committing more crimes (National Sheriff’s Association, 2005). Research indicates that such arrestees often become highly prone to anger and are likely to engage in child abuse and domestic violence. There is a need to evaluate the Zero Tolerance programs in relation to its possible long-term negative implications on those arrested, and possibly short-term effects on the an area crime rates. It is important that the police unit opt for a program that fosters a high level of legitimacy in the process of making arrests. It is clear that police may incorrectly arrest individuals, which may affect them emotionally and damage the existing relationship between police officers and the public. Such arrests can also possibly stir up a criminal mindset among arrestees, especially juveniles.

It is also clear from various literature reviews that the Neighborhood Watch program is relatively ineffective in the reduction of crime. Randomized evidence from Minneapolis, which tried to strategize a group watch program in alternating presence and absence of police officers, indicated that such Neighborhood Watch programs have an insignificant effect especially in areas with relatively high rates of crime (Cohen & Felson, 1979). This is primarily because such areas prove to be the most likely to be reluctant to organize. People in such places often avoid attending community meetings partially because they do not trust their neighbors. This makes such a program ineffective in managing crime. However, Neighborhood Watch programs are highly effective in middle-class areas where trust among community members is high, though such areas will likely have little crime issues to address making it relatively to measure the possible implication of such program on crime rates (Beato & Silveira, 2015). To this juncture, the stated program cannot be justifiably considered as an effective tool for eliminating the fear of crime among the middle class.

The success of the police in compelling crime also depends on the available infrastructure (Cohen & Felson, 1979). The police force needs to have all the tools needed in the security set up. This includes financial provisions and equipment. Many police units are characterized by inadequate resources. Studies indicate that the police service is only effective if they can obtain the necessary infrastructure. This includes buildings and other facilities that are used in handling and incarceration of juvenile offenders and appropriate utilization of police vehicles. The police salaries and incentives is also a determinant factor in the eventual results in their efforts to curb crime. Studies indicate the reluctance by the police to carry out their duties due to low salaries (Sherman, 2009).


There is existing evidence on two main conclusions about policing as a crime reduction strategy. Firstly, it is clear that police effects on crime are considerably complex and can be surprising. It is quite hard to prove and conclude that the police can be used to eliminate crime in a specific setting considering evident related negative effects. They are complex in light of the possible implications of arrests on the arrestees. The police in various settings arrest suspects and charge them with criminal acts regardless of the extent of crime. Various studies indicate that such arrests can rather serve to increase crime rates (Sherman, 2009). Traffic enforcement can significantly reduce gun crime and robbery, while on the other hand, a 15-minute presence in the affected area by a police patrol can trigger deterrent effects. However, such effects often fade within a short time if police practices are not renewed or modified.

Secondly, the effectiveness of police in crime management is dependent on how much the police strategy is focused (Sherman, 2009). This is significantly connected to a possible failure to achieve the desired crime prevention due an insufficient number of police officers or a longer response time, which imply that those responsible are not arrested. The success of the police in their efforts to prevent crime is clearly dependent on the existing relationship between the community and the police. Therefore, several modifications are required if the police are to be effective in crime reduction or prevention.





Beato, C., & Silveira, A. (2015). Effectiveness and evaluation of crime prevention programs in Minas Gerais. International Journal of Security and Development.

Bratton, W. J., & Malinowski, S. W. (2008). Police performance management in practice. Policing, 1-6.

Cialdini, R., Reno, R., & Kallgren, C. (1990). A focus theory of normative conduct: Recycling the concept of norms to reduce littering in public places. Journal of Personality and Social Psychology, 1-10.

Cohen, L. E., & Felson, M. (1979). Social change and crime rate trends: A routine activity approach. American Sociological Review, 1-17.

Kelling, G. L., Pate, T., Dieckman, D., & Brown, C. E. (2003). The Kansas City preventive patrol experiment.

McElvain, J., Kposowa, A., & Gray, B. (2013). Testing a crime control model: Does strategic and directed deployment of police officers lead to lower crime? Journal of Criminology, 1-11.

National Sheriff’s Association. (2005). Neighborhood Watch: A manual for citizens and for law enforcement.

Schultz, W., & Tabanico, J. J. (2007). A social norms approach to community-based crime prevention: Implicit and explicit messages on Neighborhood Watch signs. 1-92.

Sherman, L. W. (2009). Policing for crime prevention.

Sousa, W. H. (2001). Do police matter? An analysis of the impact of New York City’s police reforms. Manhattan Institute Civic Report.

The John Howard Society of Alberta. (1995). Crime prevention through social development. 1-75.

United States Department of Justice. (2011). Crime in the United States.

Walsh, W. F., & Vito, G. F. (2004). The meaning of compstat: Analysis and response. Journal of Contemporary Criminal Justice, 1-17.



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Morals and ethics have always been a contentious issue for philosophers at all ages. One of the issues that come up with regard to morals is the issue of what should be considered to be moral, and the question of whether morals are universal. Philosophers like Emanuel Kant addressed the issue of moral and specifically, the universality of the morals. First, he defines the universality of morals, arguing that if morals were not universal, humans could use their rationality to redefine them, and then there could be no morals or ethics at all. In his Grounding for the Metaphysics of Morals[1], he argues that one has to consider the issue of priory and posterior metaphysics. Ethics and morals form one of the three branches of philosophy, and just like the others (physics and causation) morals and ethics can be divided into two categories such as pure and practical[2]. Pure ethics are, or in the case of Kant, should not be affected by rationality and only affected by reason.  In the following article, Kant’s attitude rests on the idea that morals can only be stabilized if they are universal and accepted by all human beings at all time and place.

Kant believes that actions are not truly moral if they conform to moral law but are not motivated by universal morality. For instance, a person who has never stolen somewhere form another entity cannot be said to be moral, if the motivation for the person not to steal does not come from his or her recognition of the universal moral obligation that he or she has to not steal.

To Kant, a person is supposed to act in a moral way for he same of morality and not from their personal interest. Kant’s interpretation received a lot of criticism from his contemporaries who did not agree with his idea of universal morality. They argued that morality is affected by rational thinking and not just pure reason. While Kant’s idea of morality may be controversial, it does have some string point. For instance, he strongly argued for the moral rules to not only be universal but to also be natural and not subject to rationalization. Even in the modern context, the need for morality to not be rationalized is important because with rationalization, any moral law can be reshaped. If people are allowed to rationalize situations, they can be able to rationalize anything and make unethical decisions for self interests. Kant’s idea may rhyme with the deontological ethics which supposes that people should take the ethical actions, regardless of the potential outcome, unlike utilitarian ethicists who support the choice of the action that will bring the most benefit to the most people. For Kant and deontological ethicists, a woman who has committed murder should face the prescribed punishment, regardless of whether this punishment will lead to something that is even worse than the wrong that the person had committed. For instance, if such a woman is pregnant or has a young baby, deontological ethicists would still want her to be imprisoned even though this would be bad for the child who has to go to prison with her mother despite the fact that it has not committed wrong. Utilitarian ethicists on the other hand would seek to arrive at the decision that would lead to the most benefit, especially to the child involved.

Kant insistence that morals should be based on pure reason- not based on prior human experiences is based on his belief that if morality is based on rationalization, then they could be interpreted in any way. This leaves a leeway or a loophole for those who do not want to conform to laws of morality to rationalize their immoral or unethical acts, in any way. Kant argues that ethics and morals based on empirical reason are subject past human experience as a well as personal interest.

In the Critique of Pure Reason, Kant postulated that with regard to phenomena, most ideas about the world as it exists are notions that are based on a priori concepts, that is, they pre-exist in the human mind and are not acquired after birth. He argued that these are hardwired into human brain before birth as opposed to them being extrapolated from a person’s experiences. Kant used this argument to extrapolate the idea that morals pre-exist in the human mind, and that they are therefore universal, that is, all people are born with the notions of morals. According to Kant, the proof that the morals and ethics are universal is given by differentiating the two forms of beings. For instance, he argues that a person can be defined as a human being (his nature) and as a rational being. In this regard, if another rational being that is not a human being (maybe from another world) comes to earth and does something that according to this rational being is moral but not moral according to human beings, such a creature would still be judged using the moral code of ethics, and not according to its code of ethics. In this regard, human beings would not rationalize his action and exonerate it based on the fact that according to its moral compass it did not do anything wrong.

According to this grounding of the metaphysics of morality therefore, morals should be attached to the form of existence of being a human being, as opposed to the other form of human existence, which is rational being. According to him, as soon as particular circumstances are in consideration, it becomes impossible to think of moral motivations as being entirely pure. This is because in any particular situation, people will have personal and sometimes selfish interests and concerns that then becomes their motivation for morality and ethics.

The other strong point for Kantsim with regard to the universality of morality and moral concepts is the fact that if moral ideas are to be drawn from personal experiences, then they cannot be able to have universal validity because each person have their own personal set of experiences. In this regard, Kant argued that moral ideas can only have universal validity only if they are based on the intrinsic validity of a priori concepts[3]. The contention in this case is whether the moral concepts need to have universality. From Kant’s ideas, universality is for moral concepts is necessary for them to be able to have stability. If moral concepts are not universal and based on the concept of priori, they would have no meaning at all. Not only that, a universal moral system that is based in the concept of priori is superior to a moral system accepted by only one group of people.

However, not everyone agrees with Kant on the issue of the universality, and especially the priority of moral concepts. For instance, critics of Kant have argued that people do not reason about morals but rather rely on intuition rather than analysis to determine what they feel is the moral course of action.  However, his only proves Kant’s idea that morals are intrinsic and that human are born with them rather than learn them through experience.

However, some may argue that it is impossible to separate rationality from nature and culture, meaning that both of them play a role in defining morality for people. In this regard, what makes sense to a person is determined by the ideas and prejudices that such a person learns from the community he or she lives in.

One of the issues with regard to Kant’s ideas of morality being universal and predetermined by nature is that it does not address all ethical and moral issues. For instance, although this conceptualization may apply to some ethical issues that are common to all societies, it does not deal with some that are specific to some communities and societies. For instance, these ideas may apply to moral issues of murder, lying, cheating and beating another person, but they do not apply to other moral issues such as whether a parent should send his child to school or not. Some moral issues are universal in terms of time and space, while others are determines by time and space. Morality seems to evolve with time and some of moral issues that were moral a few years ago may not be moral anymore.  They are also determines by place. For instance, in some African communities, female genital mutilation is not only accepted but actually an important rite of passage. Therefore, this indicates that some moral issues are not universal, neither are they preset by nature or natural laws.

Regardless of the problems with Kant’s ideation of morality as being universal and determined by priori, it has had a massive impact on some issues in the modern world. For instance, the issue of universal human rights derives or borrows a lot from Kant’s idea of universal morality. With universal human rights, it the issue of place (geographical location) does not matter. Using the concept of universal human rights, it has been possible to prosecute some rogue African leaders who committed crimes against humanity, something that would be impossible without this conceptualization of the universality of human rights.


The Grounding for the Metaphysics of Morals by Emanuel Kant is based on his belief that morality is not only universal, but that it is prefabricated on the human mind. Kant believed that the conceptualization of morality is not determined by the experience that a human being goes through in life, but that human, regardless of their race, space and time, are born with it. This kind of thinking is both right and wrong in that while some moral and ethical issues have a level of universality, others do not have this universality. At the same time, while it is possible to prove the universality of some moral principles, it is harder to determine whether their universality derives from the fact that they are prefabricated in the human mind, or are because of human experiences and socialization.




Kant, Emmanuel. Grounding for the Metaphysics of Morals, “Preface” [387–92], “Transition from the Ordinary Rational Knowledge of Morality to the Philosophical” [393–405]

Kant, Emmanuel. Grounding for the Metaphysics of Morals, “Transition from Popular Moral Philosophy to a Metaphysics of Morals” [406–45]; “Transition from a Metaphysics of Morals to a Critique of Pure Practical Reason” [446–47]


[1] Kant, Emmanuel. Grounding for the Metaphysics of Morals, “Preface” [387–92], “Transition from the Ordinary Rational Knowledge of Morality to the Philosophical” [393–405]

[2] Kant, Emmanuel. Grounding for the Metaphysics of Morals, “Transition from Popular Moral Philosophy to a Metaphysics of Morals” [406–45]; “Transition from a Metaphysics of Morals to a Critique of Pure Practical Reason” [446–47]

[3] Kant, Emmanuel. Grounding for the Metaphysics of Morals, “Transition from Popular Moral Philosophy to a Metaphysics of Morals” [406–45]; “Transition from a Metaphysics of Morals to a Critique of Pure Practical Reason” [446–47]

Cost Control in Health Care – What can Governments Do?

X. Government cost intervention in healthcare

Germany has been experiencing increased healthcare costs that have majorly been attributed to increasing number of old people in the population. However, old age is not the only factor that has led to the increased cost of healthcare in the country. Other factors such as technological advanced, poor regulation and increased population, all play a major role in the increasing cost of healthcare. Although the per capita healthcare cost in Germany is not the highest among the developed nations, it is one of the fastest growing, thus leading to increased concern among policy makers. This has led to many regulations, most of which are not necessarily effective. The many regulations and reforms in German healthcare can be classified as either supply side controls such as reference pricing, pharmacy rebates for sickness funds, auti dem, a negative list, price reductions, and directives. On the other hand, the demand side regulations and controls include increasing co-payments for both physician visits and drugs. Some of these controls are not as effective as others are and it is necessary for the government to be able to know which work effectively and which do not.

X. Effects of cost intervention in healthcare

Evidence seem to suggest that supply side cost controls are more effective than the demand side cont controls in healthcare. For instance, the use of reference pricing seems to be more effective not only in bringing the cost of healthcare down, but also in maintaining these cost savings in the long term. Some factors also need to be considered in order to make sure that the interventions are not only effective, but also do not lead to unintended negative outcomes. This is more so with regard to the issue of quality due to reducing the cost. Although high costs do not necessarily mean better quality, the relationship between the two is clear and evident. It is therefore necessary for the government be careful with these interventions. In the following report, the different types of interventions are discussed in detail with an aim of establishing which is the most effective one and why. The conclusions section is drawn from the analysis and the recommendations indicate what methods the government should use for managing costs, based on the analysis and consecutions.

1. Supply Side Cost Containment

1.1 Reference pricing

Reference pricing is geared towards managing the costs by encouraging the patients, and specifically, insured people to only visit health providers who offer the best prices. The government, or the healthcare insurance providers does an analysis of the market and seeks to make sure that it is able to know the average, or better still, the optimal payment for certain healthcare services. Once this has been identified, the healthcare providers’ places a cap on how much they can insure for a certain healthcare service. This means that the consumers will have to seek those providers who are able to provide the best service. The long-term effect is that the other providers who were charging higher prices for the same services will have to lower their service costs, thus leading to a situation where the entire cost is brought down in the overall healthcare market. According to Busse, Schreyo, and Henke (2005), this seems to be the most effective form of cost control in healthcare, not only due to its ability to actually bring down costs, but also due to its ability to have long term effects in doing so. In other words, when the government uses this method, there will not only be positive impact, these impacts will also be felt in the long term.

However, there is a problem with this strategy of managing costs in healthcare. First, if not well managed, it can lead to low quality of healthcare, which is probably worse than the high costs. Germany is one of the few countries where healthcare delivery has always emphasized on high quality, probably when the costs have been escalating. Using price referencing, this could be a negative incentive which in the long run lead to low quality. As a result, even as this is the most effective cost control factor, it is necessary for the policy makers to be aware of the fact that it can lead to low quality of healthcare in the long run. It is therefore necessary for this method to be considered with ultimate care, while placing mechanisms for sustaining the high quality of German healthcare system.

1.2 Physician spending caps

Physician spending caps is another way to manage costs in healthcare. As Milbank (1993) says, it’s another effective way of managing cost because it helps in bringing the costs of healthcare down, as well as, long terms effects. Germany can use this strategy to manage its costs in healhtcare. However, just like price referencing, it has its weakneses in that if not well managed, it can lead to reduced quality fo healthcare delivery. As a result, it is necessary for all the stakeholders to be invested in this in order to make it a success. In this regard, this cost manangent strategy would be most effective if stakeholders such as physians and hosptials providers are able to cooperate. As Milbank (1993) says, price caps are only succesful when implemented as a negotiaiton process, when the main stakeholders are able to reach an agreement. At the same time, the government has to be careful in making sure htat this does not spirl into system of low quality healhtcare.

1.3 Pharmacy rebates for sickness funds

This is also another way to manage healthcare costs. Pharmacy rebates for sickness funds, while not as effective as the price capping and the reference pricing, is also another effective way to manage cost of healthcare. Pharmacy rebates refers to the coordination and corporation with pharmacy and drugs companies to manage cost of drugs. There are two elements to this form of cost management in healthcare. First, it is necessary to note that while it can be used to manage costs, it only manages costs on the pharmacy side. In this regard, it does not provide a fully-fledged way of managing healthcare costs. However, given the fact that drugs have become an important cost factor in healthcare in the last few years, due to pharmaceutical companies hiking their prices, it would be a formidable way to make sure that such issues do not affect the overall cost of healthcare in a country like Germany (Henschke, Sundmacher, & Busse, 2013). The major problems with this cost management strategy is that it requires massive negotiations with the stakeholders, which are always many. This means that it is difficult to be able to reach to a situation where an amicable solution can be reached. Furthermore, market forces that are necessary in setting the prices also affect it. The important thing with this method of cost control is the fact that there is a rise in the cost of drugs and the rise is mainly based on the profit seeking nature of these firms.

1.4 A negative list

This strategy works very similarly to the price referencing strategy and depends on the ability to affect the players in the healthcare sector to be able to be compliant in the way they address the cost issue. A negative list is used to identify the least reliable providers based on cost and sometimes efficiency and quality. With this, it is possible for the government to be able to reduce costs while at the same time maintaining high quality. However, this method of managing costs also has its own problems in that it may not work as expected. Even in cases where the government maintains a negative list as a way to manage the costs in the healthcare sector, this does not always work in reducing cost while maintaining high quality of healthcare service. The negative list only works as a strategy to manage costs when the government can work closely with the private sector.

2.0 Demand Side Cost Containment

2.1 Co-payments for physician visits

Co-payments for physician visits is a demand side cost control strategy that is geared towards making sure that healthcare users are more careful in the way they regard healthcare. According to Winkelmann (2004), this is not usually effective in that it does not have an influence in the way people visit the physician. Co-payments for physician visits is a strategy that is geared towards minimizing the number of unnecessary times a patient visits the physician. As some scholars have been able to identify, due to lack of planning, most patients end up visiting the physician too many times. With better planning, the patients can visit the physician fewer times and at the same time get the same quality of healthcare they need. The government, when using co-payments for physician visits as a strategy to minimize the costs for healthcare seeks to reduce the cost by reducing the number of times that a patient needs to visit the physician.

However, as Herr and Suppliety (2012) has found out, the co-payments for physician visits are not effective in managing the costs and therefore do not deliver the intended results. The major reason is that this does not deter the patients from the unnecessary excessive visits to the physician. As a result, even though this strategy has the potential to minimize costs in healthcare, it is not effective and therefore needs more work.

2.2 The co-payments for drugs

The co-payments for drugs as a strategy is another demand side strategy that the government can use to deter the hiking prices in healthcare. It is very similar to the Co-payments for physician visit. However, this is geared towards management of costs associated with drugs. This method also has its own challenges and therefore not as effective as it should. Just like the Co-payments for physician visits, it has potential, but has problems in that the targeted audience does not necessarily conform. Using this strategy therefore needs to have proper mechanisms that will guarantee that the patients will conform to what is being implanted. At the same time, it is necessary to note that even if the co-payments for drugs was to be effective, the cost reductions would be minimal and therefore have a less impact to help in bringing the national health costs down.

2.3 Auti dem prescriptions

The auti dem prescription is a strategy of cost management that is used all over the world, but which is very popular in Germany. Recently, German doctors are required to provide auti dem prescription when prescribing drugs to a patient. The rationale is that some prescriptions have cheaper alternatives which can reduce the cost for the patient and even for the government. In Germany, like in most developed counties such as the United States the issue of generic drugs is important. Most patient are critical of the generic medications. However, some generic medications, as much as they are effective as the branded drugs are not as costly as the branded ones. In most cases, the cost of medication can be reduced to as much as 90% if the patient is wiling to replace the generic medication with branded drugs. With the auti dem prescription, the customer is given the opportunity to use alternative prescription that is cheaper but just as effective as the main prescriptions that the physician gives to the patient. However, the main problems is that most patient, because they are averse to the non-mainstream drugs, are not willing to use the alternative drugs. As a result, it is necessary to note that this is not the most effective way to mange costs.

3. Discussion and Analysis

It is very clear that some of the cost control that are geared towards cost control in healthcare are not effective. In particular, the demand side cost controls are not effective in that they are not able to reach the desired results. However, the supply side cost control strategies are more effective than the demand side cost controls. One more issue that came up is the fact that the reason why most of the demand side supply is not effective is the fact that there are negative attitudes towards these the elements of these controls. For instance, the auti dem cost control is not effective because the patients are averse to the use of alternative medicine.

The implications of this is that since most people are averse to these alternative medications that are cheaper but just as effective as the mainstream prescriptions, the government should do an awareness campaign that is geared towards making sure that people are well educated with regard to which generic drugs are good and which are not good. For the government to use the demand side control, it has to be able to use various forms of awareness in order to help the public to have a better attitude towards generic medicine.

With regard to the contention between generic and branded medicine, two issues need to be addressed. First, there is the issue of the fact that some generic medicine as just as effective as the branded medicine, but the patients do not trust this medicine but trust these medicine. Secondly, there is the issue that the reason why most patients do not trust this generic medicine is the fact that some of them are not very good and can in fact affect the health of the users in a negative way.

4. Conclusion

It is very clear that that some cost interventions are more effective than others are. However, even among the successful ones, they also have their own issues. A common issue that emerged is the fact that supply side interventions are more likely to be more effective than the demand side interventions for cost control in healthcare. It was also very clear that the reason why the demand side cost interventions are less likely to be successful is due to the fact that they are more likely to be affected by patients negative attitudes. A good example was the auti dem, which is affected by the fact that most patients are likely to distrust the alternative prescriptions that the doctors give. This means that the demand side interventions, while they high potential for cost control, need more work to be effective.

The auti dem, co-payments for physician visits, and the co-payments for drugs are not effective in managing healthcare cost, not because they do not have potentials to do so, but because the public attitudes are not right. This can be addressed by making sure that the public is sensitized with regard to these issues. For example, the auti dem method is not effective in cost management in healthcare ins that most people are not very comfortable wit the use of alternative prescriptions. Even in cases where the patient can access alternative medicine that is just as effective as the main prescription that the physician gives, it is always hard for the physician to be able to convince the patient to be able to use the alternative prescription. This means that the government, when using this strategy as a way to manage costs in the healthcare is supposed to be able to carry out campaigns that will sensitize the employees with regard to the use of prescription drugs, especially the generic ones.

However, there is a need to make sure that the patients are protected from the less effective generic drugs. One of the main problems that have led to most of the public being averse to the generic or alternative drugs is the fact that some of them are not as effective as the branded ones. As a result, for the auti dem strategy of cost management in the healthcare sector to work, the users to drugs need to be able to be protected from the less effective generic or alternative medicine.

It is also necessary to note that the main issue is not high costs, but the rate at which the costs are growing. For instance, although German’s per capita cost for healthcare is higher than that of some developed countries, it is not necessarily the highest. For instance, the per capita healthcare cost for United States is roughly twice that of German. This is even after consideration hat the quality in the German healthcare system is much higher than that of the United States. In this regard, the cost interventions strategies would most be most effective if they are geared towards managing the growth of the costs rather than in trying to pushing the costs down than they already are.

5. Recommendation on What the Government Can Do

From the analysis and the conclusions, it is necessary to note that some of the interventions that are more effective than others are. In this regard, it was very clear that supply side cost interventions are more effective than the demand side cost interventions. As a result, it would be necessary to make sure that the government focuses on the supply side cost interventions. The supply side interventions are effective because they have the ability to not only reduce the costs but also to do that in the short term as well as the long term. Two major supply-side interventions seem to be the most effective than any other interventions, and this should be the focus on the government if it intends to bring down the high costs of healthcare. The first one is the reference pricing which refers to controlling the market elements that determine demand and supply. Reference marketing can be used to curb artificial demand hikes especially for healthcare services.

Reference pricing and capped pricing should be the primary strategy that the government should use to curb costs in healthcare. The second one is the physician spending caps. This method is also very effective in helping the government to control and to curb costs from hiking. Like the reference pricing, this works by placing proper mechanisms that will prevent costs from hiking, such as from the artificially related demand. The two can be used together in order to get the best results.

In using these two cost interventions strategies, the government should be wary of negative unintended impacts that may arise. For instance, as it was identified, the German healthcare is one of the very few in the developed worlds that focuses on quality delivery of healthcare. Since quality and cost are tied together, the chance that reducing one will reduce or increase the other is high. For instance, if the costs are reduced, this has the potential to diminish the quality. This means that there is a chance that as the government seeks to reduce the costs, especially through the reference pricing and cost caps, the quality may end up going down and this could even be worse than high costs.

The cost of low quality healthcare is very high and this should not be the result of any cost control strategy of any kind. At the same time, the need to reduce the cost, and especially to curb the high rates of growth for health costs is high. What the government should do is to make sure that all stakeholders, including private insurers, pharmaceutical companies, and even health care providers. The government should be very concerned in making sure that these stakeholders are on board in order to ensure t that these types of cost interventions are effective and will not lead to unintended negative results.

The government should also consider demand side interventions in the long term. Although it is clear that these are not effective in the past, the government can do a few things to make then effective in the future. For instance, one of the issues that came up clearly was he fact that the reason they are not effective is that the public has a negative attitude towards most of them. However, with the use if awareness campaigns to overcome the barriers that avoid the demand side cost interventions from working, it is possible to make the demand side cost interventions to be effective albeit in the long run. This means that for the short term (next 5 to 10 years), the focus of the government with regard to cost intervention should be based on the demand side cost interventions strategies while at the same time trying to address the issues that make it difficult for the demand side cost interventions to be effective. In the long run, and after addressing the barriers affecting, the demand side cost interventions, it would be necessary to use demand side interventions as a way to save on costs.

6. References

Busse, R., Schreyo, J., & Henke, D. (2005). Regulation of pharmaceutical markets in Germany: improving efficiency and controlling expenditures? international journal of health planning and management, 20 , PP. 329–349.

Henschke∗, C., Sundmacher, L., & Busse, R. (2013). Structural changes in the German pharmaceutical market: Price setting mechanisms based on the early benefit evaluation. Health Policy, 109 , PP. 263– 269.

Herr, A., & Suppliety, M. (2012). Pharmaceutical Prices under Regulation: Tiered Co-payments and Reference Pricing in Germany. DICE Discussion Paper, No. 48 , PP. 2-37.

Milbank, Q. (1993). How expenditure caps and expenditure targets really work. Health Care Finance Review, 1, 5 , pp. 89-94.

Winkelmann, R. (2004). Co-payments for prescription drugs and the demand for doctor visits ^ Evidence froma natural experiment. Health Economics, 13 , PP. 1081–1089.