Healthcare History Essays - Healthcare Reform In The United States

Healthcare History The historic payment system for reimbursing hospitals both by insurers and by Medicare has been Retrospective Cost Based Reimbursement(RCBR). This system of reimbursement encourages hospitals to over charge in order to cover the costs of the uninsured who utilize the hospital. Charges have continued to rise year after year eventually putting the employers at a point where they could no longer afford the payments. For physician reimbursements, both insurers and Medicare employed the Usual and Customary(U+C) approach to reimbursement. This practice, which averaged the charges for a procedure in a region, also encourages doctors to over-charge in order to raise the average amount paid to them for a procedure. These two systems, RCBR and U+C eventually started to suck too much money out of the insurers, employers, and the Medicare/Social Security trust fund so that interventions were deemed necessary. Perhaps the biggest intervention adopted by the private sector to reduce medical service costs was the trend toward businesses self-insuring. By doing so, they avoided state-mandated benefits that were required if they hired a third-party insurer. In addition, the money was now paid to claims as they arose rather than prospectively so income could be earned on this capital as it sat in the bank. Other intervention to reduce medical service costs mainly involved private insurers as it was difficult for small businesses to self-insure because of low-capitol. Underwriting was a typical practice of insurance companies; that is, excluding some employees from coverage if they have preexisting conditions or if they are employed in ?high-risk? areas. Payment caps are were also employed by insurers as a way to save medical costs. This practice meant setting limits for the total amount paid for selected diagnoses. These interventions ultimately led to segmentation in the insurance market. A shift occurred in the way that insurers calculated premium charges. Community rating used to be the norm. It involves placing all beneficiaries into a large group and projecting their claims. Premiums were then spread across the entire group as were risks. However, as a result of the historical hospital and physician payments schemes, insurers shifted to experience rating. That is, a rating that bases a group?s premiums on its experienced cost. Therefore, by only including low-risk, low- cost individuals under coverage, premiums for those individuals may be minimized. This effect leaves small groups behind, paying much more in premiums. These interventions mentioned as well as increased experience-rating adopted by insurers and the subsequent phenomena of market segmentation have had effects on many levels of the health care system: ?Premiums for small employers have skyrocketed for two reasons. First, administrative costs for small employers are proportionally higher than those for larger firms(Congressional Research Service) and secondly, larger firms have more market clout and are so able to seal the contracts that provide lower premiums to their employees. Larger firms are also able to spread the risks of their insured employees across a larger beneficiary base with lots of capitol to absorb any abnormality in claims from one year to the next. Small firms don?t have this luxury and as a result their premiums have increased. ?As health care costs grew, many larger businesses opted to self-insure and take the risks of their employees rather than paying an insurance company to perform this role. These employers also avoided the state mandated benefits and could use capital not prospectively paid to earn interest. ?It was in the 1980's, when employers were becoming increasingly concerned about soaring health care costs, commercial insurers were concerned about the future of traditional health insurance, and physicians were increasingly joining health plans to guarantee a steady flow of customers, that managed care really expand dramatically. As diagram 1 shows(see attachments), the number of people enrolled in HMO's in 1976 was 6 million and by 1991 had reached 38.6 million. The higher costs of medical care forced different groups into HMO's for different reasons. Doctors enrolled in HMO's gave up some autonomy but were guaranteed a steady flow of patients. The patients enrolled were guaranteed care for a fixed monthly premium at the expense of visiting only providers covered in their plan. ?The draining of the Social Security trust fund by traditional hospital RCBR method

2015 2016 Full Review of All SAT Test Dates

2015 2016 Full Review of All SAT Test Dates SAT / ACT Prep Online Guides and Tips We go through exact SAT test dates for 2015 and 2016 for freshman, sophomores, juniors, and seniors, and tell you the advantage ofeach testing date. I’ll break it down date-by-date and class-by-class so you can easily figure out the best time for you to take the test. Fall 2015 October 3rd, 2015 Freshmen and Sophomores It’s probably not worth it for you to take the test on this date, especially because the new SAT comes out in 2016, and taking this SAT is only going to provide partially relevant practice. Juniors We recommend that you take the SAT for the first time your junior fall, and this is the ideal date to do it. This date is also the first one after the summer, so it’s a good time to take the test and see whether your summer studying has paid off. Seniors This is an ideal date for seniors as well,especially if you’re applying early decision to colleges.Also, you’ll find out your results on October 22nd, which gives you enough time to study for the test date in December if you’re still unsatisfied and are applying regular decision. Question and Answer Service or Student Answer Service? QAS If you don’t know what these are, they're services the College Board offers for you to review your scores on the SAT more thoroughly (read more about them here).Some test dates offer the QAS and some offer the SAS. The QAS is more in-depth, so I will list which service is offered for each date in case some of you want to pick a date that allows you to order the QAS. November 7th, 2015 Freshmen and Sophomores Don’t take the test on this date. You’ll be taking the new SAT in 2016, and the old SAT will only provide partially relevant practice. Juniors This is one of your last chances to take the old SAT, so it’s a good date for you.You will still have the January test date to take the old SAT again if you don’t do well (you’re not going to have much time to react in between getting your scores back and the December test date). Seniors On the whole,you shouldn’t bother with this test date. You won’t get your scores for November back in time to study much for the December test, so you should just wait and take that one. You might take the November SAT as a senior if you’re really intent on getting better scores on different sections for superscoring, and you’re going to take the December test regardless of your November scores (great!).You might also take it if you didn’t take the SAT in October and are applying Early Decision to colleges.November test scores are the latest scores that most schools accept from Early Decision applicants. Question and Answer Service or Student Answer Service? SAS December 5th, 2015 Freshmen and Sophomores Again, you probably don’t want to take the test on this date because it’s still going to be the old SAT. Juniors You might be better off waiting for the January test date so you’ll have more time to study in between taking the SAT for the first time in the fall and your next attempt.The January test date is still offering the old SAT. Seniors This is a prime test date for seniors.It's probably your last chance to take the SAT and submit your scores to colleges.Many schools (including Stanford) don’t accept scores from test dates later than December. Question and Answer Service or Student Answer Service? SAS This is the perfect time to coerce your friends and family into bringing you lots of cookies because you're studying so hard. Winter and Spring 2016 January 23rd, 2016 Freshmen and Sophomores It’s still going to be the old SAT, so the advice for the dates before this stands. Your time will come, young ones. Juniors This is your last chance to take the old SAT, so it’s a good date for you!It will also be after your holiday break, so you will have had a nice chunk of time to devote to studying. Seniors This could be a fallback test date for seniors.Make sure the colleges you’re applying to accept scores from test dates this late before you decide to take the SAT. Question and Answer Service or Student Answer Service? QAS March 5th, 2016 Look out world, the new SAT is HERE! Freshmen and Sophomores Finally, the moment you’ve been waiting for has arrived.You would be smart to take the test on this date to get familiar with the new format. After you take it, you’ll have the whole summer to review your scores and study in an informed way. Juniors Don’t necessarily aim for this test date.You can take the new SAT in March if you want, but it might be better to hold off until later so you'll have more time to study and better study materials are available. Seniors Not applicable! Woo! Question and Answer Service or Student Answer Service? SAS May 7th, 2016 Freshmen and Sophomores Just like with the March date, it could be a good idea for you to take the new SAT here to get a feel for what it’s like. Juniors Again, you should probably hold off.Since the new SAT is so, well, â€Å"new†, most test prep resources are not up to speed on what you need to know. Question and Answer Service or Student Answer Service? QAS June 4th, 2016 Freshmen and Sophomores This could also be a good date for you to check out the new SAT. You should probably go for a date earlier in the spring though because you don’t want to be taking the SAT at the same time as finals for your regular classes. Juniors You still might want to wait until the fall to take the new SAT.A lot of test prep materials for the new SAT will come out in the summer of 2016, so you'll have better resources to prepare if you wait it out. Question and Answer Service or Student Answer Service? SAS Special Sneak Peek: October 2016 All Years This will be a good test date for everyone!By this time, lots of great prep materials for the new SAT will have come out, and you will have had the whole summer to study them.Go forth and conquer this new frontier. Fulfill your maniTEST destiny. Question and Answer Service or Student Answer Service? QAS What's Next? Find out which exact dates you want to choose with our Table of 2015-2016 SAT Test Dates. Know which SAT test date you're going to pick? Get your studying started with these plans for sophomores and juniors, seniors, and a complete plan for everyone. You should also figure out your target SAT score and decide how long you'll need to study for the test. Check out our tips for getting high scores on every section of the SAT so you can make the most of your studying! Want to improve your SAT score by 240 points?We've written a guide about the top 5 strategies you must be using to have a shot at improving your score. 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Informative Paper - Evolution of Internet Governance and Its Effect on Research

Informative - Evolution of Internet Governance and Its Effect on Global Internet Users - Research Paper Example 6). The term governance also had its share of controversy when it came to its interpretation. Many considered governance to have an extremely related meaning to the word government. The meaning, which is accepted by the Internet community, considers governance as governing the conducts and behavior of any institution, inclusive of the non-governmental institutions. A government project formed the origin of the Internet. In 1960, the United States of America sponsored a project considered as the mother of the Internet. This was a resilient communication project mandated with the development of the research named DARPA Net. With time, there took place the invention of Transmission Control Protocol/Internet Protocol (TCP/IP), which evolved the Internet (Gelbstein & Kurbalija 2005, p.11). The Internet is distributed in nature; one of them is the data packets nature to take a different path through any network, enabling the Internet to avoid traditional barriers, as well as control mechan isms. This theory is a total proof that, in the early days, in relation to the Internet, there is no central government, grand design and central planning. This made people consider the Internet as a unique tool, which could offer an alternative solution to the modern politics. In the 1980s, the term Internet governance was introduced, and it described the technical management of the Internet core resources globally. The core resources included IP address, domain names, Internet protocols as well as the root server system. The term Governance was used to show the outstanding differences between government and governance. After the emergence and discoveries of technology advancements such as the telegraph, the government in the early... According to the paper Internet governance is summarized as the act undertaken by Governments, civil society, and the private sector in the role of development and applications; it also involves their respective roles of shared norms, decision making procedures, rules, principles, and other elements that shape the process of Internet evolution. A computer specialist views Internet governance in the form development of various applications and standards. Lawyers focus mostly on the dispute and jurisdiction resolution. The essay makes a conclusion that the evolution of Internet Governance has been a long journey, which at the end has yielded fruits to all Internet users. The World summit on the Information Society has done an outstanding job to make sure that Internet governance is achieved. Other significant players associated with the success of developing and implementing Internet governance include private sectaors, international organizations, governments and young users. Currently, there are large numbers of young users using the Internet and the Internet governance has affected them in various manners. Internet governance has had both positive and negative social effects on the Internet users. However, studies show that the pros outdo the cons; therefore, Internet governance can be considered a success that has had a couple of challenges. Internet governance is a significant contributor towards forming a conductive social environment for the young Internet users. Therefore, the role of Inter net governance to the youth’s social life is of exceptional benefits.

The Devils Bermuda Triangle Essay Example | Topics and Well Written Essays - 500 words

The Devils Bermuda Triangle - Essay Example The Bermuda Triangle is one of these locations of the world that has been a source of curiosity and attraction for thousands because of a course of inconceivable events linked to it. Bermuda’s Triangle also known as the Devil’s Triangle is located in the North Atlantic Ocean and Miami, Bermuda and Puerto Rico form the boundaries of this imaginary area of the triangle in the ocean. This particular area of the ocean gained the world’s attention when five Navy planes known as Flight 19 disappeared fifty-eight years ago into the ocean mysteriously. Neither the crew members nor the remains of the planes were found in the ocean which has not been explained logically up till now. The disappearance of the crew members and the aircraft leftovers in 1945 was the event that made this area highly controversial and many theories and explanations have been put forward to this day. Apart from Flight 19, which was the most conspicuous event, many other ships, aircraft and yachts have mysteriously vanished along with the onboard travelers which add up to the puzzling nature of this place. Many explanations have been put forward to explain the rationale behind this inconceivable string of incidents occurring in the Bermuda Triangle. Some label these incidents to be caused by the supernatural forces or extraterrestrial forces which lead to the disappearance of anything that enters into the boundaries of the Devil’s Triangle. On the other hand, others explain these occurrences in the light of scientific knowledge by blaming the ocean weather, violent waves or human errors.

Generally Accepted Accounting Principles Essay Example for Free

Generally Accepted Accounting Principles Essay 11. a. Year 0 Year 1 Year 2 Year 3 Year 4 Before-tax cash flow $(500,000) $52,500 $47,500 $35,500 $530,500 Tax cost (7,875) (7,125) (5,325) (4,575) After-tax cash flow 44,625 40,375 30,175 525,925 Discount factor (7%) .935 .873 .816 .763 Present value $(500,000) $41,724 $35,247 $24,623 $401,281 NPV $2,875 Investor W should make the investment because NPV is positive. b. Year 0 Year 1 Year 2 Year 3 Year 4 Before-tax cash flow $(500,000) $52,500 $47,500 $35,500 $530,500 Tax cost (10,500) (9,500) (7,100) (6,100) After-tax cash flow 42,000 38,000 28,400 524,400 Discount factor (7%) .935 .873 .816 .763 Present value $(500,000) $39,270 $33,174 $23,174 $400,117 NPV $(4,265) Investor W should not make the investment because NPV is negative. c. Year 0 Year 1 Year 2 Year 3 Year 4 Before-tax cash flow $(500,000) $52,500 $47,500 $35,500 $530,500 Tax cost (5,250) (4,750) (8,875) (7,625) After-tax cash flow 47,250 42,750 26,625 522,875 Discount factor (7%) .935 .873 .816 .763 Present value $(500,000) $44,179 $37,321 $21,726 $398,954 NPV $2,180 Investor W should make the investment because NPV is positive. 16. a. Opportunity 1: Year 0 Year 1 Year 2 Taxable income (loss) $(8,000) $5,000 $20,000 Marginal tax rate .40 .40 .40 Tax $(3,200) $2,000 $8,000 Before-tax cash flow $(8,000) $5,000 $20,000 Tax (cost) or savings 3,200(2,000) (8,000) Net cash flow $(4,800) $3,000 $12,000 Discount factor (12%) .893 .797 Present value $(4,800) $2,679 $9,564 NPV $7,443 Opportunity 2: Year 0 Year 1 Year 2 Taxable income $5,000 $5,000 $5,000 Marginal tax rate .40 .40 .40 Tax $2,000 $2,000 $2,000 Before-tax cash flow $5,000 $5,000 $5,000 Tax (cost) or savings (2,000) (2,000) (2,000) Net cash flow $3,000 $3,000 $3,000 Discount factor (12%) .893 .797 Present value $3,050 $2,679 $2,391 NPV $8,120 Firm E should choose opportunity 2. b. Opportunity 1: Year 0 Year 1 Year 2 Taxable income (loss) $(8,000) $5,000 $20,000 Marginal tax rate .15 .15 .15 Tax $(1,200) $750 $3,000 Before-tax cash flow $(8,000) $5,000 $20,000 Tax (cost) or savings 1,200 (750) (3,000) Net cash flow $(6,800) $4,250 $17,000 Discount factor (12%) .893 .797 Present value $(6,800) $3,795 $13,549 NPV $10,544 Opportunity 2: Year 0 Year 1 Year 2 Taxable income $5,000 $5,000 $5,000 Marginal tax rate .15 .15 .15 Tax $750 $750 $750 Before-tax cash flow $5,000 $5,000 $5,000 Tax (cost) or savings (750) (750) (750) Net cash flow $4,250 $4,250 $4,250 Discount factor (12%) .893 .797 Present value $4,250 $3,795 $3,387 NPV $11,432 Firm E should choose opportunity 2. c. Opportunity 1: Year 0 Year 1 Year 2 Taxable income (loss) $(8,000) $5,000 $20,000 Marginal tax rate .40 .15 .15 Tax $(3,200) $750 $3,000 Before-tax cash flow $(8,000) $5,000 $20,000 Tax (cost) or savings 3,200 (750) (3,000) Net cash flow $(4,800) $4,250 $17,000 Discount factor (12%) .893 .797 Present value $(4,800) $3,795 $13,549 NPV $12,544 Opportunity 2: Year 0 Year 1 Year 2 Taxable income $5,000 $5,000 $5,000 Marginal tax rate .40 .15 .15 Tax $2,000 $750 $750 Before-tax cash flow $5,000 $5,000 $5,000 Tax (cost) or savings (2,000) (750) (750) Net cash flow $3,000 $4,250 $4,250 Discount factor (12%) .893 .797 Present value $3,000 $3,795 $3,387 NPV $10,182 Firm E should choose opportunity 1. 1. a. (1) Year 0 Year 1 Year 2 Before-tax salary/income $80,000 $80,000 $80,000 Marginal tax rate .25 .40 .40 Tax on income $20,000 $32,000 $32,000 After-tax cash flow $60,000 $48,000 $48,000 Discount factor (8%) .926 .857 Present value $60,000 $44,448 $41,136 NPV of salary received by Mrs. X $145,584 (2) Before-tax payment /deduction $80,000 $80,000 $80,000 Marginal tax rate .34 .34 .34 Tax savings from deduction $27,200 $27,200 $27,200 After-tax cost $(52,800) $(52,800) $(52,800) Discount factor (8%) .926 .857 Present value $(52,800) $(48,893) $(45,250) NPV of salary cost to Firm B $(146,943) b. (1) Year 0 Year 1 Year 2 Before-tax salary/income $140,000 $50,000 $50,000 Marginal tax rate .25 .40 .40 Tax on income $35,000 $20,000 $20,000 After-tax cash flow $105,000 $30,000 $30,000 Discount factor (8%) .926 .857 Present value $105,000 $27,780 $25,710 NPV of salary received by Mrs. X $158,490 (2) Before-tax payment /deduction $140,000 $50,000 $50,000 Marginal tax rate .34 .34 .34 Tax savings from deduction $47,600 $17,000 $17,000 After-tax cost $(92,400) $(33,000) $(33,000) Discount factor (8%) .926 .857 Present value $(92,400) $(30,558) $(28,281) NPV of salary cost to Firm B $(151,239) c. Year 0 Year 1 Year 2 Before-tax payment /deduction $140,000 $45,000 $45,000 Marginal tax rate .34 .34 .34 Tax savings from deduction $47,600 $15,300 $15,300 After-tax cost $(92,400) $(29,700) $(29,700) Discount factor (8%) .926 .857 Present value $(92,400) $(27,502) $(25,423) NPV of salary cost to Firm B $(145,325) This proposal is superior (has less cost) to Firm B than its original offer. d. Year 0 Year 1 Year 2 Before-tax salary/income $140,000 $45,000 $45,000 Marginal tax rate .25 .40 .40 Tax on income $35,000 $18,000 $18,000 After-tax cash flow $105,000 $27,000 $27,000 Discount factor (8%) .926 .857 Present value $105,000 $25,002 $23,139 NPV of salary received by Mrs. X $153,141 Mrs. X should accept this counterproposal because it has a greater NPV than Firm B’s original offer.

Adolescents How Society Affects Them

As we all already know that adolescence is the developmental stage between childhood and adulthood, generally referring to a period ranging from age 11 and 19. Adolescence has many psychological and social stages, as well as biological. Because it is filled with constant changes and uncertainty, the risks of losing the sight of the right path is quite high. Let me talk about how and who affects them.As children grow, develop, and move into early adolescence, involvement with one's peers increases. In order to be included in a group of friends they are easily swayed to do something wrong.They are faced with decisions to try new things, such as drugs, changing fashion, slang words, alcohol, sex etc.   The use of drugs by teenagers is the result of a combination of factors such as peer pressure, curiosity, and availability (Cotterell, 135).   Peers are the ones who most frequently initiate one another into drug use.Family members are the most important source of peer pressure. I bel ieve family is the most influential foundation for several reasons. For one, peer pressure is encountered first at home. The mother and father play the biggest role in our lives because they teach their children right from wrong.For example, as a child my parents would always warn me about a girl whom I hung out with and lived in my neighborhood. They advised me a million times to not associate with her because they thought she was â€Å"bad news.†Similarly, religious institutions are another great source of influence. The young adults that participate in religious institutions, come from families which are not into drugs, alcohol, violence, or any sort of crime. So the effects these religious institutions have are great on young people in society.Religious adolescents can encourage one another to be successful in school, sports, and other activities. In my own past experiences when growing up, the people I have chosen as friends weren’t always the coolest, or craziest , but they were always good for their word. These types of friends are valuable for positive peer pressure and are important to keep.Friends, as it is seen, are a major source of peer pressure that one encounters when growing up. I believe from past experiences, friends have the strongest influence on us.   The effects from our friends can sometimes be really good or truly bad.If one friend brings the bottle to the hang out and tells another teen to try it because it is â€Å"so cool,† he or she will experiment with it not knowing what effects it can lead to. One of the reasons that our society finds it difficult to handle teen’s drug use is because adolescent culture does not consist of â€Å"one uniform, homogeneous group.† (Miller, 107).Teens and children are also having sex at a young age because most of their friends may be doing the same thing.   They want to fit in and be part of the â€Å"in-crowd† so they will not follow what they feel is rig ht and so they will take part in sexual behavior in order to be â€Å"cool.†Sex is just one issue that adolescents are faced with. Consumption of alcohol is another factor that can lead to bad decisions based on the friendships that they make.Choosing the friends one hangs out with can sometimes be difficult.   Even though we know what is right from wrong we still have the tendency to do the wrong thing.Even though there are a lot of negative effects from friend’s influences, there are just as many positive effects too. I believe the right friends can push one to doing the right things such as belonging to a soccer team or joining the band club.In conclusion, peer pressure is always surrounding us and affecting us. Our friends, family members, and religious institutions are the main sources in which peer pressure comes from.With the proper guidance and right choice of friends, one will not have any trouble with life’s difficult decisions, and will hopefully do the right thing when faced with difficult problems. Adolescence is a powerful time in one's life with an array of chances to ruin a bright future, so I guess forewarned is forearmed.ReferencesCotterell, John.   Social Networks and Social Influences in Adolescence.   New York:   Thomson.   1996.Miller, Michelle, Alberts, Jess, Hecht, Jess, and Robert Krizek.   Adolescent Relationships and Drug Use.   London: Lawrence Erlbaum Associates.   2000.National Institute on Alcohol Abuse & Alcoholism. Retrieved from http://www.niaaa.nih.gov

Containment Americas Plan to Curtail Communism

Containment was a foreign policy of the United States of America, introduced at the start of the Cold War, aimed at stopping the spread of Communism and keeping it contained and isolated within its current borders of the Union of Soviet Socialist Republics  (USSR or the Soviet Union) instead of spreading to a war-ravaged Europe. The United States feared specifically a domino effect, that the communism of the USSR would spread from one country to the next, destabilizing one nation which would, in turn, destabilize the next and allow for communist regimes to dominate the region. Their solution: cutting communist influence off at its source or enticing struggling nations with more funding than communist countries were providing. Although containment may have specifically been meant as a term to describe the U.S. strategy for the curtailment of communism from spreading outward from the Soviet Union, the idea of containment as a strategy for cutting off nations such as China and North Korea still persist to this day. The Cold War and Americas Counter-Plan for Communism The Cold War emerged after World War Two when nations formerly under Nazi rule ended up split between the conquests of the USSR (pretending to be liberators) and the newly freed states of France, Poland, and the rest of Nazi-occupied Europe. Since the United States had been a key ally in liberating western Europe, it found itself deeply involved in this newly divided continent: Eastern Europe wasnt being turned back into free states, but under the military and increasingly political control of the Soviet Union. Further, western European countries appeared to be wobbling in their democracies because of socialist agitation and collapsing economies, and the United States began to suspect that the Soviet Union was using communism as a means to make western democracy fail by destabilizing these countries and bringing them into the folds of communism. Even countries themselves were dividing in half over the ideas of how to move forward and recover from the last World War. This resulted in a lot of political and indeed military turmoil for the years to come, with such extremes as the  Berlin Wall  being established to separate East and West Germany due to the opposition to communism. The United States wanted to prevent this from spreading further Europe and on to the rest of the world, so they developed a solution called containment to attempt to manipulate the socio-political future of these recovering nations. The U.S. Involvement in Border States: Containment 101 The concept of containment was first outlined in George Kennans Long Telegram, which was sent to the U.S. Government from his position in the U.S. Embassy in Moscow. It arrived in Washington on February 22, 1946, and circulated widely around the White House until Kennan made it public in an article called The Sources of Soviet Conduct — this became known as X Article because the authorship was attributed to X. Containment was adopted by President Harry Truman as part of his Truman Doctrine in 1947, which redefined Americas foreign policy as one that supports the free people who are resisting attempted subjugation by armed minorities or outside pressures, according to Trumans speech to Congress that year. This came at the height of the Greek Civil War of 1946 - 1949 when much of the world was in conflict over which direction Greece and Turkey should and would go, and the United States agreed to help both equally to avoid the possibility that the Soviet Union could coerce these nations into communism. Acting deliberately, at times aggressively, to involve itself in the border states of the world, to keep them from turning communist, the United States spearheaded a movement that would eventually lead to the creation of NATO (North American Treaty Organization). These acts of arbitration could include sending funds, such as in 1947 when the CIA spent large amounts to influence the result of Italys elections helping the Christian Democrats defeat the Communist party, but it also could mean wars, leading to US involvement in Korea, Vietnam and elsewhere. As a policy, it has drawn a fair amount of praise and criticism. It can be seen to have directly affected the politics of many states, but it drew the west into supporting dictators and other people simply because they were enemies of communism, rather than by any broader sense of morality. Containment remained central to American foreign policy throughout the Cold War, officially ending with the fall of the Soviet Union in 1991.