Expanding Nation Essay

In the 1830’s and 40’s the westward movement of population left the valley of the Mississippi behind and penetrated the Far West all the way to the Pacific. Pioneers pursued fertile land and economic opportunity beyond the existing boundaries of the United States and thus helped set the stage for the annexations and international crises of the 1840’s. Some went for material gain, others for adventure, and a significant minority sought freedom from religious persecution. But whatever their reasons for migrating, they brought American attitudes and loyalties into regions that were already occupied or at least claimed by Mexico or Great Britain. Whether they realized it or not, these pioneers were the vanguard of American expansionism. The domestic controversies aroused by the Mexican War and the propaganda of Manifest Destiny revealed the limits of the mid-nineteenth century American expansionism and put a damper on additional efforts to extend the nation’s boundaries. Concerns about slavery and race impeded acquisition of new territory in Latin America and the Caribbean. Resolution of the Oregon dispute clearly indicated that the United States was not willing to go to war with a powerful adversary to obtain large chunks of British North America, and the old ambition of incorporating Canada rapidly faded. After 1848, American growth usually took the form of populating and developing the vast territory already acquired. The expansionists of the 1840’s saw a clear link between acquisition of new territory and other forms of material growth and development. In 1844 Samuel F. B. Morse perfected and demonstrated his electric telegraph, a device that would make it possible to communicate rapidly over the expanse of a continental nation. Simultaneous, the railroad was becoming increasingly important as a means of moving people and goods over the same great distances. Improvements in manufacturing and agricultural methods led to an upsurge in the volume and range of internal trade, and the beginnings of mass immigration were providing human resources for the exploitation of new areas and economic opportunities. After gold was discovered in newly acquired California in 1848, a flood of emigrants from the East and several foreign nations arrived by ship or wagon train, their appetites whetted by the thoughts of striking it rich. The gold they unearthed spurred the national economy, and the rapid growth of population centers on the Pacific Coast inspired projects for transcontinental telegraph lines and railroad tracks. When the spirit of Manifest Destiny and the thirst for acquiring new territory waned after the Mexican War, the expansionist impulse turned inward. The technological advances and population increased of the 1840’s continued during the 50’s. The result was an acceleration of economic growth, a substantial increase in industrialization and urbanization, and the emergence of a new working class (Billington, 1956). The first movement west aimed not for the nearby plains but for California and Oregon on the continent’s far shore. It started in the 1849 Gold Rush to California and in the next three decades perhaps as many as half a million individuals made the long journey. Some walked; others rode horses alone or in small groups. About half jointed great caravans, numbering 150 wagons or more, that inched across the 2000 miles between the Missouri River and the Pacific Coast. More often than not men made the decision to make the crossing. Wives either went with their husbands or faced being left behind. Four out of five men on the overland trail had picked up stakes and moved before, some of them several times. People moved west for many reasons. Some sought adventure; others wanted to escape the drab routine of factory or city life. Many moved to California for their health. What ever the specific reasons most people moved west to better their lot. On the whole their timing was good, for as a nations population grew, so did the demand for the livestock and the agricultural mineral and lumber products of the expanding West. Opposite to older historical views the West did not act as a major safety valve or an outlet for social and economic tensions. The poor and unemployed did not have the means to move there and establish farms. Most people moved West in good times, in periods of rising prices, of expanding demand, when the prospects for making money from this new land looked brightest; and this aspect characterized the whole pattern of settlement and greatly improved the whole of the economic growth for the U. S. In the last three decades of the nineteenth century a flood of settlers ventured into America’s newest and last west (Jones, 1960). The West became a great colonial empire, harnessed to eastern capital and tied increasingly to national and international markets. Western economies depended to an unusual degree on the federal government, which subsidized their railroads, distributed their land, and spent millions of dollars for the upkeep of soldiers and Indians. Regional variations persisted and Westerners remained proud of their hardy, individualistic traditions. Yet they imitated the East’s social, cultural, and political patterns. By the 1890’s the West of the buffalo and Indian was gone, and instead there were cities and towns, health resorts, Paris fashion and the latest magazines. The frontier line had reached the edge of the timber country of Missouri by 1840. Beyond lay an enormous land of rolling prairies, parched deserts, and rugged, majestic mountains. Emerging from the timber country, travelers first encountered the Great Plains. These lands were treeless, nearly flat, and an endless sea of grassy hillocks. The Prairie Plains, the eastern part of the region, enjoyed rich soil and good rainfall; it included parts of present day Wisconsin, Minnesota, the Dakotas, Nebraska, Kansas, Oklahoma, and Texas. To the west covering Montana, Wyoming, Colorado, New Mexico and Arizona were called the High Plains. They were rough, semiarid, rising gently to the foothills of the Rocky Mountains (Faragher, 1979). The original incentive to mechanize northern industry and agriculture came in part from a shortage of cheap labor. Compared with the industrializing nations of Europe, the United States of the early nineteenth century was a labor-scarce economy. Since it was difficult to attract able-bodied men to work for low wages in factories or on farms, women and children were used extensively in the early textile mills, and commercial farmers had to rely heavily on the labor of their family members. In the face of such limited and uncertain labor supplies, producers were greatly tempered to experiment with labor saving machinery. By the 1840’s and 50’s industrialization had reached a point where it could readily absorb a new influx of unskilled workers. Factories required increasing numbers of unskilled operatives, and railroad builders needed construction gangs. The growth of industrial work opportunities helped attract a multitude of European immigrants during the two decades before the Civil War (Fishlow, 1965). Between 1820 and 1840 an estimated 700,000 immigrants arrived in the United States, mainly from the British Isles and German-speaking areas of continental Europe. During the 1840’s this substantial flow suddenly became a flood. No less than 4,200,000 crossed the Atlantic between 1840 and 1860, and about 3 million of these arrived in the single decade between 1845 and 1855. This was the greatest influx in proportion to total population that the nation has ever experienced. The largest single source of the new mass immigration was Ireland, but Germany was not far behind. This massive transatlantic movement had many causes; some people were pushed out of their homes, while others were pulled toward America. The great push factor that caused a million and a half Irish to forsake the Emerald Isle was the great potato famine. Escape to America was made possible by the low fares then prevailing on sailing ships bound from England to North America. The million or so Germans who also came in the late 1840’s and early 50’s were somewhat more fortunate. Most of them were also peasants, but they fled hard times rather than outright catastrophe. What attracted or pulled most of the Irish, German and other European immigrants to America, was the promise of economic opportunity (Jones, 1992). By 1860 industrial expansion and immigration had created a working class of men and women who seemed destined for a life of low paid wage labor. This reality stood in contrast to America’s self image as a land of opportunity and upward mobility. Wage labor was popularly viewed as a temporary condition from which workers were supposed to extricate themselves by hard work and frugality. According to Abraham Lincoln in 1850 of the North’s free labor society, â€Å"there is no such thing as a freeman being fatally fixed for life, in the condition of a hired laborer. This ideal still had some validity in rapidly developing regions of the western states, but it was mostly myth when applied to the increasingly foreign born industrial workers of the Northeast. Both internal and external expansion had come at a heavy cost. Tensions associated with class and ethnic rivalries were only one part of the price of rapid economic development. The acquisitions of new territories became politically divisive and would soon lead to a catastrophic sectional controversy. From the late 1840’s to the Civil War, the United States was a divided society in more than one sense, and the need to control or resolve these conflicts presented politicians and statesmen with a monumental challenge (Gutman, 1976). Many have searched for the underlying causes of the crisis leading to the disruption of the Union but have failed to agree on exactly what they were. Some have stressed the clash of economic interests between agrarian and industrializing regions. But this interpretation does not reflect the way people at the time expressed their concerns. The main issues in the sectional debates of the 1850’s were whether slavery was right or wrong and whether it should be extended or contained. Disagreements over protective tariffs and other economic measures allegedly benefiting one section or the other were clearly secondary. It has never been clear why the interests of northern industry and those of the South’s commercial agriculture were irreconcilable. From a purely economic point of view, there was no necessity for producers of raw materials to go to war with those who marketed or produced them. The critical period of Civil War diplomacy was in 1861 to 1862 when the South was making every effort to induce foreign powers to recognize its independence and break the Union blockade. The hope that England and France could be persuaded to involve themselves in the war on the Confederate side stemmed from the fact that these nations depended on the South for three quarters of their cotton supply. In the case of Britain, the uninterrupted production of cotton textile appeared essential to economic prosperity (Stampp, 1950).

The eNotes Blog Edgar Allan Poe Un-Masqued 10 Things You Didnt Know About the GothicWriter

Edgar Allan Poe Un-Masqued 10 Things You Didnt Know About the GothicWriter Youd be hard-pressed to find a student that doesnt enjoy (or, at the very least, find interesting) one of Edgar Allan Poes short stories- even if you polled  the most literature-hating students, theyd  still be able to quoth the raven everslightly. Poes stories and poems  have  a unique staying power with many readers, whether theyre  keen on  his Dark Romantic writing or  hungry to latch  onto anything taught in class to  fuel angst-ridden high school  years (*cough* totally was me *cough*).  If the  questions we get on are any indication  of  readers endless fascinations of Poeit holds  completely true. Our Homework Help content library is chock full of interesting questions that delve into Poes  writing style, explain his important influences, and reveal some  quirky bits of trivia. They are asked by students seeking  essay help  and by  casual readers looking to expand their  knowledge alike. Did you know that Poe had his own Sherlock-esque character, or  that gifts mysteriously appear on his tombstone? If not, read on. Here are ten fascinating Homework Help questions to help you learn  a little bit more about the man behind the masque. 1. What inspired Edgar Allan Poe to write? Poe probably considered himself primarily a poet, and he wrote poetry to express his feelings. There never has been much money in poetry, and Poe was alwayscontinue  reading  Ã¢â€ â€™ 2.  Is it true that Edgar Allan Poe did not suffer from mental illness or drug addiction? According to Poe’s bitter enemy Dr. Thomas Dunn English, Poe did not have a drug addictioncontinue reading  Ã¢â€ â€™ 3.  In Poes literary works, how does he generally create mood? The mood in a story is the atmosphere that pervades the work with the intention of evoking a certain emotion or feeling from the reader. Edgar Allan Poe evokes specific moods in his short stories in several ways.   Most of his stories are gloomy, horrific, and eeriecontinue reading  Ã¢â€ â€™ 4.  How did Edgar Allan Poes work reflect white American culture? Part of the point of this question is to make you apply some version of what critics call critical race theory or whiteness theory to Poecontinue reading  Ã¢â€ â€™ 5.  What was Edgar Allan Poes signature writing style? Edgar Allan Poe wrote short stories and poems. His stories are of two types: horror stories, which are his most distinctive, and detective storiescontinue reading  Ã¢â€ â€™ 6.  Do Edgar Allan Poes stories provide any information about his personal life? While it is tempting to want to read many of Poes works as being about his own personal life, or even to assume they are autobiographical, generally this is known to be untruecontinue reading  Ã¢â€ â€™ 7.  Did Transcendentalism affect Edgar Allan Poes writing? Transcendentalism affected Edgar Allan Poe’s literature because he abhorred it. Poe’s writing, considered part of the American Romantic period, was Dark Romanticcontinue reading  Ã¢â€ â€™ 8.  Someone has left a bottle of cognac and roses on Edgar Allan Poe’s grave since 1949. Has anyone ever discovered who it is and why? Any ideas? As the 207th anniversary of the birth of Edgar Allan Poe falls on the 19th of January, 2016, speculation again revolves around the identity of the individual or individuals responsible for a decades-long tradition of placing three roses and half-empty bottle of cognac on the late poet and author’s gravecontinue reading  Ã¢â€ â€™ 9.  What are the similarities and differences between Edgar Allan Poe and Sir Arthur Conan Doyle when it comes to their writing styles, themes, and their  method of â€Å"crime-solving† Arthur Conan Doyle did not shy away from acknowledging the influences upon his own writings- notably his American predecessor Edgar Allan Poecontinue reading  Ã¢â€ â€™ 10.  Was Edgar Allan Poe insane? Is Stephen King insane? Or any other author of horror and/or gothic fiction? Despite the dark nature of his poems and short stories, we dont have the evidence to say whether he was mentally illcontinue reading (multiple answers!)→ Homework Help is a great way to get homework help (its in the name!) or to simply learn something new. Read  more of our answered Poe questions and his bio and works, and, as always,  remember to ask your own questions to our team on any subject matter. Happy learning!

Animals Intentional Literary Effects In Miss Julie

Animals Intentional Literary Effects In Miss Julie In Miss Julie, Julie’s dog, Diana, serves as an embodiment of Julie’s fate. Diana gets into an affair with a pug of lower standing, the â€Å"gatekeeper’s pug†. Through the use of antitheses- purebred bitch and gatekeeper’s pug it foreshadows the future dualism- aristocrat and commoner where Julie transcends her social boundary by having a sexual affair with Jean. This parallelism follows that just as Diana faces severe consequences for her actions â€Å"that Miss Julie won’t allow†Ã‚   [ 2 ]   , Julie’s sexual folly has dire consequences. Julie in demanding Christine prepares â€Å"some filthy muck†Ã‚   [ 3 ]   for an immediate abortion conjures ideas of death, termination and annihilation engendering in readers an ominous, apocalyptic mood which foreshadows Julie’s termination of her own life. Coupled with the sensual engagement with the use of an olfactory imagery in â€Å"the [abortion potion] smellâ€⠄¢s infernal†Ã‚   [ 4 ]   , it has overtones of fiendish punishment creating an image of hell, invoking in audience the wrathful punishment for follies such as these, heightening the foreboding sinister horizon ahead. After Julie’s sexual folly later on in the play, audiences are once again reminded â€Å"She, who all but had poor Diana shot for running after the gatekeeper’s pug!†Ã‚   [ 5 ]   , provoking heightened apprehension of Julie’s punishment as has been prescribed to Diana. Miss Julie then â€Å"enters in travelling clothes with a small birdcage.†Ã‚   [ 6 ]   By engaging audience with a visual image, it explicitly shows Julie is trapped just like the bird in a small birdcage. The bird’s confinement in this tiny cage is symbolic of Miss Julie being trapped by the consequences of her action for which there is no absolving. This parallels Julie’s anguish at recognizing her actions are unforgivable and would not be pa rdoned. Eventually, Jean snatches the bird from Julie, â€Å"takes it to the chopping block and picks up the kitchen axe†Ã‚   [ 7 ]   . This act of snatching the bird from Julie is symbolic of Jean taking control of Julie and Julie losing control over her own being. The killing of the greenfinch foreshadows Julie’s eventual suicide. Like the Finch who dies at the hands of Jean, Julie’s eventual suicide death is dictated by Jean and is emblematic of patriarchal society. Preceding this, arising from her aristocracy, Julie asserts dominance over Jean who belongs to the working-class. Contrastingly, this very act of snatching the bird and Jean â€Å"bringing down the axe† signifies the reversal of roles on grounds of the more dominant sex regardless of economic position.   [ 8 ]   Jean’s act, true to social Darwinism, clearly show that it is the male that defines the female, it is he on whom she will hinge her existence into, her existence is lar gely defined by how he allows [or not] it to be.   [ 9 ]   Like the Greenfinch, Julie succumbs to her own ruin, analogous to female sensibility succumbing to the male, phallic, patriarchal order, reaffirming man’s control over human affairs.   [ 10 ]    Similarly, like the death of the greenfinch which cannot survive outside, and who is saved through Jean’s brutality, Julie’s death is an escape. Julie’s eventual suicide dictated by Jean is the fulfillment of the sado-masochistic ritual where the victim desires her fatal end, the consummation of her masochistic fantasy.   [ 11 ]

IOM Essay Example | Topics and Well Written Essays - 2000 words

IOM - Essay Example her, this report will highlight some ways Redgate can attain best results by improving the culture of organization and methods of motivation of employees. Redgate Software has been selected for this analysis report because it is a highly advanced and state of the art technology company in the world it was founded in 1999 in England by Neil Davidson and Simon Galbraith. It is based (headquarters) in Cambridge, England and its motto is â€Å"ingeniously simple tools†. At the end of 2012, the number of employees of Red Gate Software was 290. Red Gate Software was named after Via Porta Rossa (Red Gate Street) situated in Florence (Italy). The name of this place was selected because Neil Davidson was used to live in that street. In 2010, Redgate Software acquired HyperBac from Quest Software. Simple Talk is a famous online technical journal of Redgate and it provides support to MS .NET and MS SQL Server developers. There are a lot of products of Redgate Software. The main objectives of this report are to shed light on the importance of motivation skills and culture of organization to get best results. Moreover, another objective of this report is to study the motivation style and culture of Redgate in detail. Then in the end of the report we would like to relate the theory with practice by combining the important of motivation skills and culture of an organization with the motivation skills and culture of Redgate. It is important to discuss the importance of motivation and culture for an organization before we discuss the problems related to motivation and culture in Redgate. In analysis part we will discuss motivation and culture in general and then we will discuss the motivation and culture related problems at Redgate. Motivation is a very important tool for a manager or supervisor. Motivation is necessary to get best results from employees. Motivation is a important to make sure the right way to address an issue is adopted. Motivation can be defined as a

Week 1 discussion 2 Essay Example | Topics and Well Written Essays - 250 words

Week 1 discussion 2 - Essay Example For example, pronunciation of words with /s/ or /z/ requires one to keep the tongue locked behind the teeth. Use of symbolic sound: this refers to one syllable words or sounds that are easy to produce; for example, â€Å"moo† or â€Å"woof†. Using symbolic sounds encourages vocalization and allows children to relate words with similar sounds; hence, pronounce them in the same way. Observation skills: comprise of skills that require children to focus on a specified task. In relation to pronunciation difficulties the instructor might assign a simple observation task to the student. This task will require the child to observe the instructor’s mouth as he/she pronounces different sounds. Activities and strategies to help develop Speech and Language Skills. (2013, January 15). Retrieved from i Communicate: http://www.icommunicatetherapy.com/child-speech-language/child-speech-language-development/activities-strategies-help-develop-speech-language-skills/ Gagen, M. R. (2007, January 13). Addressing Speech Difficulties During Reading Instruction Tips for Helping a Child Pronounce Specific Sounds. Retrieved from Right Track Reading:

Health Promotion Activity Essay Example | Topics and Well Written Essays - 1250 words

Health Promotion Activity - Essay Example Also the organization would have low employee turnover as the employees appreciate the organization’s concern about their wellbeing (Infinite Wellness Solutions, 2008) At present numerous health issues need to be addressed and selecting one among those is a challenging task. However, in recent times obesity has garnered the attention of everyone as this medical condition leads to many complications such as cardiac problems and diabetes. There have been a lot of studies which have demonstrated the prevalence of the condition in most of the families in America. Statistics reveal that in 2003-2004, the risk of overweight percentage in children and adolescents was 33.6% with the percentage of overweight children being 17.1%. This is a considerable increase when compared to the results of the year 1999-2000 (Ortiz, 2006). The prevalence of the condition has increased in the recent times due to the fast pace of life, increased consumption of junk food and lack of physical activity. However, this condition can be brought under control with lifestyle changes and support and would offer a lot of positive outcomes for both the employee and the organization. After identifying the problem that needs to be addressed the next step is to garner the support of the management. The organization should understand the significance of the health promotion activity and should be able to allot adequate funds for the implementation of the same. The next step would be to set goals for the activity and then form a health promotion team or a planning committee (Infinite Wellness Solutions, 2008). Goals need to be established in order to proceed and accomplish what you hope the program will do. It serves as a sort of framework identifying the current situation and the future course after the implementation of the program. A person would head the committee and would focus primarily on the activity, strategies for making the program work and to meet the

A Business Plan of Medical Services Marketing Essay

A Business Plan of Medical Services Marketing Essay The medical tourism industry is in a rapid state of growth, both in Singapore and globally. Growth in consumer demand for health services delivered by foreign medical professionals continues to grow for a variety of reasons, including insufficient regional health care systems and the growing expense of performing domestic procedures in their countries of origin. Sometimes, booking a medical tourism package is simply an excuse to visit a foreign land whilst also to consolidate their travel interests and save costs. This growth in medical tourism provides enormous opportunities for launching Singapore MedTours and ensuring it can grow and be sustained. Medical Services Tourism is not without many business risks, including high levels of competition from intermediary companies designed to help consumers plan itineraries for medical services. There are also risks to the client that must be considered, including ensuring that they fully understand their own health risks so as to secure liability factors for the business itself. In terms of strategic objectives, a comprehensive risk management system must be developed. However, outside of these risks, profit potential is quite considerable due to the large customer demand that exists in many different foreign countries. Singapore was chosen as the country to launch the new Medical Services Tourism Company because of its award-winning infrastructure, the ability to raise new capital through a variety of means and even for the education system that can provide quality employment for the business by skilled professionals. Singapore is ideal for Medical Services Tourism and this business plan provides a comprehensive plan for the launch of the company. 2.0 Business description Medical tourism involves availing medical procedure in a foreign country. Westerners form a large segment of medical tourists who are attracted to quality healthcare and large savings as compared to the medical costs in their own countries. The patients then can take a vacation in the host country after receiving their medical treatments. Often patients can cover their surgery expense, flight and hotel accommodation charges for quarter of the operation cost they would have paid in their country (Puah, 2008). The Company would be named Singapore MedTours and it will be a Private Limited Company (See Appendix 1). The firm will act as an agent that facilitates tourism of international citizens looking for quality and affordable health care that they might not be able to achieve in their home country. It will be a start-up company with an onsite facility for receipt of travellers and to satisfy their inquiries on medical tourism. The agency will make profit by charging commission on these transfers and any additional profitability received from supplementary, non-medical tourism that might be booked through the agents or its online website. Mission Our mission  is to provide Safe, Affordable and Quality health care options to our customers through world class health care system of Singapore. Source: Author 2.2 Industry background The medical tourism market has nearly doubled in recent years, and is currently valued at over $20 billion every year (Gaddum, 2010). This makes medical tourism ideal as a profit-generating business with huge growth potential. Medical tourism fills a valuable niche that is desperately needed in countries with bureaucratically flawed or unaffordable healthcare (discovermedicaltourism.com, 2008, p.2). One of the reasons that make foreign travel so appealing to a variety of international tourists is in areas of cost. For example, in the United States, it might cost approximately $30,000 for a knee replacement surgery, where in Singapore these costs will be much less at only $18,000 (placidway.com, 2010). It is largely this cost difference, for the same medical expertise, that is making medical tourism such a booming business not just in Singapore. Some of the major countries that are offering Medical Tourism in the world are: Countries Medical Inbound Tourists 2002 2004 2005 2006 Thailand 390,000 520,000 Malaysia 210,000 320,000 374,000 410,000 Singapore 117,000 179,000 India 100,000 150,000 Source: http://www.ihf-fih.org/pdf/25-28.pdf Singapore is among the most attractive destinations for health care travelling. The country has been awarded as the Best Medical/Wellness Tourism Destinationin 2007 and will be the Leading Destination for Health Care Service in Southeast Asia (MedTourismReview, n.d). 2.3 Goals and Potential of the Business According to Singapores minister of trade and industry; Singapore is a good place to raise funds, both equity and loans, including venture capital. (Satapathy, 2003, p.1745). Singapore was chosen as the start up location because of the ease of access for funds related to the launch as well as securing future loans or capital for improvement and expansion of the business. Because of the quality availability to investment funds and other loan-generating entities in Singapore, the business has several goals for short term gain: Source: Author A long term goal of Singapore MedTours is to create an internationally-recognised name in medical tourism that outperforms competition. There is massive potential for creating a strong marketing presence internationally based not only on growing consumer demand, but because of the systems already in place in Singapore to assist in developing a sound advertising programme with higher global exposure. 2.4 Uniqueness of service Singapore MedTours will have several unique features designed to make it outperform competitive entities in this industry. Singapore MedTours would offer a low-risk guarantee to enable the customers in moving forward with their medical tour with strong faith. In any case if after arriving at the destination, the conditions of treatment seem unacceptable to the client, we will give the liberty to cancel the surgery. The only charge the client will be responsible of is the air fare and accommodation. To our knowledge, were the only medical tourism company  that  offers this type of protection in Singapore. Also MedTours would be unique in supplementary services related to medical tourism that will improve profitability and improve the word of mouth reputation for the business. Offers the founder of Scotland-based Company Globe Health Tours; This is a huge word of mouth business (Crawford, 2006, p.1). Therefore, Singapore MedTours will be equipped with high quality service dimensions that please the travelling tourist and also improve customer relationships using advanced CRM systems (Customer Relationship Management software). 3.0 Marketing Marketing will be crucial to the success of this new business launch because of the importance of word of mouth to the company. With high levels of competition in this industry, an improved and superior marketing presence must be available and the funds needed to make this a reality will be allocated to this effort. 3.1 Target market identified There is no one, singular market available to this business because of the ability to capture the attention of many different consumers hailing from many international locations. No two patients are the same, either in their needs or the type of journey they either want or require (newsweekshowcase.com, 2010, p.1). This means that it would be quite difficult for the business to isolate a single target market strategy that would fit the needs of the majority of travellers who look toward our services. However, despite these unique consumer needs, medical tourism industry is dominated by patients from United States. In 2008 alone estimates put that more than 1.3 Americans travelled abroad for the exclusive purpose of seeking medical care (Health-Tourism.com, 2008). The marketing strategy should take into consideration the high volume of customers that will come from this region and use communications strategies that fit the needs of this high profit-generating customer client. Other international customers will be measured using software and database tools to determine which international location brings the highest volume of customers, and ongoing, future research methods will be used to determine their needs as they arise. Market Survey Research Objectives To analyze the growth potential for the business. To analyze the consumer needs according to their relative priority. To analyze the level of favourable consumer expenditure. Customer Profiling and Characteristics Customer profiling is important as it aids in identifying and catering to customers in every possible way (Anderson, 1997, pg 71). Based on the market survey conducted, most of the respondents show favourable response for medical tourism. A majority of respondents with negative response towards medical tourism shifted to need more information aspect when medical tourism benefits were mentioned. However the two main factors motivating respondents to be favourable to medical tourism are cost savings and high quality healthcare from internationally accredited hospitals. The most preferred service attribute is high standards of service with considerable savings indicating that not all consumers bargain hunters. It also indicates that respondents are not willing to compromise on quality for cost reduction. Determining the critical factors for success majority of respondents preferred English speaking population and highly accredited hospitals. The most influential means of promotion is word of mouth followed by hospital referrals and company website. In addition, with the various competitors positioning and competitive comparisons, most consumers decisions are influenced by Brand equity and awareness play an important role. Target market Based on the Market Survey conducted, Singapore MedTours will focus on target markets which are of high growth potential. The market is divided into the following segments which in turn will provide the company with clear focus to direct its marketing strategies Geographic segmentation: North American Citizens. Demographic segmentation: Age: 45-65 Income: U.S $24000- $70000 Psychographic segmentation: Customers keen on quality of service and interested in good savings while not in favour to comprise on safety. US Medical Tourism Market According to the Market indicators United States medical tourism has got good prospects in coming decade and beyond. In the United States, medical surgeries are very expensive, and every year millions of Americans default to pay for the health care expenses they require they are either uninsured, uninsurable or underinsured. According to a study in 2007 50% of personal bankruptcies are related to medical crises (Star Health Vacations, 2010). 3.2 Market size and trends In 2006, Singapore drew 410,000 international customers that received medical services primarily in form of Liver Transplants, Cardiac Surgery, and Joint Replacement (Hadi, 2009). And this number of inbound patients will exceed 1 million by 2012, with forecasted value of 3 Billion USD (The Internet Journal of healthcare Administration, 2010). Scotland-based Globe Health Tours experienced a 600 percent increase in business only after six months of operations (Crawford, 2006). In all, Singapore Medical Tourism is aiming to become a leading health care destination in all Asia and it witnessed a steady growth of 11.9% per year from 2004 to 2008 (prlog.org, 2009). 3.3 Competition Intensive competition exists in medical tourism, both internationally and in Singapore itself. Therefore, the company must create strong marketing presence and advertising know-how to make the business outperform competition step by step or service by service. Within the country, there are currently 29 hospitals that already provide health services to foreign travellers, with services being performed by over 7,000 physicians and 15,000 registered nurses (health-tourism.com, 2010). Because these hospitals already have contracts and/or relationships with other health tourism agents, there is a great deal of marketing work that needs to be performed by the business to make it stand out and be the preferred agency for these profitable customer groups. This well-developed network of physicians and agencies can be quite risky to the business model and require competitive focus to ensure improved customer preferences for the company. U.S agencies operating in Singapore: There are several U.S based medical tourism agencies, like Health Base Medical Tourism Agency, Planet Hospital, which are providing health tourism services in Singapore to patients of America. The companies are similar to each other only differing in the fact that they are tied up with different hospitals in different locations. U.S Agencies operating in other medical tourism countries: These agencies are tied up with budding medical tourism countries such as India, Thailand, etc. Key players include World Med Assist, Indus health, Quest Tourism, Med Journeys, Med Retreat SWOT Analysis of Singapore MedTours Strength Well trained staff with heavy focus on building customer relationship before and after their stay in Singapore. Creating an easy to use Website and employing advance Customer Relationship Software to attract and retain clients interested in Medical Tourism. Singapore is ranked 6th in world for the quality of health care provided by the World Health Organization (WHO). Medical tourists should not be able to witness chaotic events during their stay in comparison to the other Asian countries as Singapore is urbanized and clean country. JCI-certified hospitals and healthcare facilities are found in abundance throughout Singapore. English is one of Singapores official dialects. Though the cost of healthcare in Singapore is not as low as India or Thailand but they are still lower in comparison to Western Europe and the USA. Weakness The cost expenses in medical processes and treatments in Singapore are relatively high when compared to other Asian medical tourism countries like Thailand, Malaysia and India. The geographical location of Singapore is such that the climate is rather hot and humid which maybe a hindrance to the westerners especially during the post procedure and recovery stages. Accommodation, transportation and the cost of goods in Singapore is more expensive as compared to other Asian countries The travel times to Singapore are considerably very lengthy for the US medical patients. Opportunities World-class tourism service industry present in Singapore can help in recruiting best talent for the Medical Tourism. High market Growth Healthcare services from countries with aging population increasingly seek medical tourism. U.S. workforce is seen to be increasing more in context to globalization Low-cost global air travel had made Singapore all the more accessible for inbound patients. Employers and health plans targeting commercial populations have become accepting of the various benefit of medical tourism. Threats There is seen to be fierce competition posed by other Asian medical tourism countries like Malaysia, India and Thailand. Popularity of Medical Tourism may encourage more competition to open business in Singapore. New technological breakthroughs can make previously very expensive healthcare affordable in the clients home country. Global endemic outbreaks like H1N1, SARS, and Bird-flu etc in western countries can inhibit travel of foreign travellers to Singapore as government may impose restrictions. Source: Author 3.4 Estimated Market Share In order to estimate the market share few of the assumptions has been taken into account: That the rate of people seeking foreign medical services continues to grow at the same pace, with 1 million people entering Singapore in 2012 for this purpose. Very High volume of competition present in the country. Based on the above two considerations the firm is taking the minimum target of just 0.1% Market share, i.e., 1000 customers for the 1st year which it plans to grow to 1,500 in 2nd year and by 2013 the target is to reach 2,000 customers. The firm believes that this extremely low market share can be easily achievable by utilizing good marketing and promotion strategy and following best practices in the business. 3.5 Market strategy Positioning MedTours intends to work on a clear positioning statement of Quality, You can be Assured off which encourages customers to have complete faith in the company. The company will position itself as a reliable and friendly agency with utmost importance given to customer safety. The point of difference which separates the company from its competitors is the Quality Guarantee what the company provides and the idea of personalization of medical tours. This will help the company stay competitive while being positioned as a differentiated medical tourism agency. To be able to live up to the positioning the company will tie up with best in class hospitals and service providers with highest priority given to details of service dimensions. The company will purchase advanced CRM systems to improve overall delivery of customer services. The business will use, as one, marketing strategy, advanced training for its employees related to customer service to make the short encounter with the company one that is remembered and would help in creating good word-of-mouth publicity. Product Singapore MedTours will offer best of the medical services present in the Singapore by getting tie-ups with world-class hospitals of Singapore. Specific focus will be made on JCI-Accredited (Joint Commission International) hospitals like Alexandra Hospital, Changi General Hospital, Raffles Hospital, Parkway Group etc; so that inbound patients from US and other countries are assured that they are getting best quality service in a very safe environment. Services Offered By Singapore MedTours The following are the exact nature of services being offered by Singapore MedTours. Personal  preferences of patients would be given priority to select best hospitals and doctors. Source: Author Place Singapore MedTours will have a dedicated well-furnished office from where its entire staff can operate. Also in this office the customers would be received first and will be given initial briefing about the Medical Services they would be going through as well as general information about Singapore, its culture, famous tourist attraction etc. The main purpose of the office would be to make sure customers have one single easily identifiable and approachable location from where they could satisfy all their queries and solve their problems during their stay in Singapore. Promotion Approximately 78 percent of all medical travellers use the World Wide Web as their first choice for booking medical tourism (medicaltourism.com, 2010). Because of this high volume, market strategy will include a strong Internet presence that will require the expertise of information technology specialists to give the business a colourful, interactive and engaging online booking experience. The majority of the business will likely come from Internet exploration, therefore the budget must be allocated to a web design that outperforms competition and has the necessary information to make Singapore MedTours their first choice in booking their travel needs. The first publication of choice to improve visibility and awareness in customer groups will be the Medical Tourism Magazine, a bi-monthly publication that is distributed in a variety of international countries. Costs for these ads are $4000 for a full page ad and $2000 for a half page ad (medicaltourismassociation.com, 2010). This is a respected and well established advertising publication that will give Singapore MedTours better marketing presence. The company will purchase half page ads several times yearly to update its literature based on consumer research and success with other marketing formats. Additionally, web-based advertising will be part of the ad strategy that includes links to visit our business website on partnership or contract agreements with different hospitals, travel agencies, and physician websites. The goal of this rather inexpensive advertising method is to simply give the company more ad presence and ensure budget needs are met. Since most customers will not visit the business location prior to making their travel needs, web presence is vital to building higher profit and consumer demand. 3.6 Pricing Cost of Medical Treatment in Singapore If the procedure would cost $6000 in the U.S. financial savings might not be realized by the patients even if the same surgery costs $1500 in other country. By the time the airfare, accommodation and stay charges are covered patients may only realize a break-even scenario (Med Retreat, 2010). Hence with careful consideration the following procedures would be offered by Singapore MedTours. Comparison of cost between Medical procedures in USA and Singapore Source: http://www.health-tourism.com/singapore-medical-tourism/ Although the industry standard is 15% (See Appendix X) for each referral to the hospital by an agency but the firm would initially keep the commission fee at minimum 12% in order to gain competitive edge while start-up. This also aligns with our market survey where cost saving has been attributed as most important consideration for the customers. People Since this is highly service-oriented industry and the mission of Singapore MedTours is to have best customer experience as possible, so Singapore MedTours will make sure that it will hire competitive employees. Furthermore sufficient training would be given so as and when needed in order to cope up with market demands and competition. Lastly special packages and policies will be design to reward and retain the best employees of the firm. Process Process is extremely important part of any Service-oriented industry. Hence Singapore MedTours will make sure that its process is as efficient and as customer-friendly possible. Quality Control would be done regularly to identify and improve any bottlenecks and promote the best practices. Reviewing and Approving Online Membership Forms: Once an application is filled, detailed information based on the customer requirement will be provided allowing customers to make an informed decision. Assignment of an U.S Consultant to the patient: The consultant would cater to patients medical needs by designing a health tour plan. Informing the Medical Doctor: By sending digital copies of clients medical transcripts to the affiliated doctors for their approval to receive patient. Arranging for a Facilitating interaction between the Client and Surgeon: The process will be coordinated via email, teleconference etc. in this stage. Collection of Expectations Form and Desired `Travel Dates: To plan for exact tour plan. Checking Hotel Reservation at desired dates: The information will be obtained in this stage in order to be able to provide price quotations to the clients. Submitting the final price quotation for the health tour to the client: This is to avoid any further confusion and also to provide relevant information to the client. Deposit of necessary funds for health tour by client into Singapore MedTours bank account. These next few processes occur simultaneously: Finalize Clients medical consultation and surgery dates with the preferred doctor and hospital. Assisting clients in acquisition Passport/Visa Book clients Air Travel Itinerary which best suits their preferences. Reservation of accommodation for client Sending the booked travel and hospital information back to client: Now the client will make the trip from his or her own country to host country (Singapore). Assigning Destination Program Manager (DPM) to the client: Upon arrival of client in Singapore a DPM will be assigned permanently to client and the person will be their Personal assistant throughout the visit. This person will accompany the client to all their doctors appointments and medical treatments. Arranging for Pre-Surgery consultation with the surgeon: This process would be completed within 24 hours of clients arrival. The surgeon would review medical transcripts and tests to ensure that procedure can be performed on the specified dates. Assistance to client during surgical procedure and post surgery recuperation: After the client would be discharged from the hospital they would be accommodated in resort or hotel to begin recuperation process. Arranging for Post treatment vacation: After obtaining an authorization letter from surgeon, an enjoying vacation would be arranged for in Singapore. Assisting for Safe Return home of the clients: At the end of the tour the client will be send back to home country and the assigned US consultant would assist in any post-medical needs. 4.0 Operations Operational aspects of how the business is managed and structured will be key to its success. 4.1 Identify location The main requirements of indentifying the location for our business are: Low cost per square feet, large pedestrian volume and easy access to transportation (Abrams Kleiner 2003, pp67-68). Thus, after searching on the internet and checking the reality of the information with the agent, following address can be an alternative to the location of our business. Source:http://www.singaporeexpats.com/housing-in-singapore/singapore-property/code4349017-commercial-industrial-buy-FRONTIER.htm This location, compared with other places, satisfies the above requirements. The charge for buying this office is expected at around 570,000 SGD, and by using the yellow line MRT routine, the dense population of UBI become bigger and bigger. Also two MRT stations (Tai Seng and Macpherson) are very near to the location (gothere.com). The business prefers to buy the office instead of renting because in 3-4 years time the amount of rent paid would be equal to the total value of the office and since Singapore MedTours is looking for long term viability of the business hence it is buying the office. Source: http://www.gothere.sg/maps#q:52%20ubi%20avenue%203 4.3 Zoning Various Districts of Singapore: Source: http://www.propertyhub.com.sg/images/M_images/singapore_district_map.jpg The Zoning of the office was carefully selected while keeping the following considerations: The office should have as low as possible per square feet cost. It should be present in or near the heart of the city. Also the office should be near the Changi International Airport. The current identified location of the office is in district 14 which is quite near the Central Districts 6 12 of the Singapore. Simultaneously the location is near the District 17 in which the Changi Airport is located. It is very important for the office to be near airport as majority of its firms clients would be international medical tourists who would be arriving via air-travel. 4.4 Taxes The low tax rates and positive and encouraging business policies give Singapore a reputation of attracting FDI. The taxes in Singapore are much lower than most others developed countries and regions (Asia Biz). Whats more, the tax rates have continued to decline significantly over the years (Appendix 2). Therefore, from the tax perspective, Singapore is an attractive nation to do the business. Overall, to our service business, the following kinds of taxes are needed to be considered before starting the business: Income Tax: The amount of Income Tax is based on the income of our companies, and according to Appendix 1, the income tax rate is 17% and as a new start business, some partial tax exemption will be applicable to us. Goods Services Tax GST, also known as VAT, is a broad-based consumption tax levied on the  import of goods, as well as nearly all supplies of goods and services in Singapore. And the rate of GST is 7% (IRAS 2008). Only the sales and leases of properties and financial services need not to pay GST. Therefore, our company needs to pay 7% GST. Stamp Duties Stamp duty is a tax on executed documents relating to properties or interest in properties and shares or interest in shares. Documents such as a lease, sale and purchase, or mortgage of property need to pay stamp duties (Appendix 3). Thus, our company needs to pay this kind of tax. 4.5 Proximity to supplies There will be little concern over supply chain issues because of the quality distribution system that exists in Singapore. But also, the business will only need access to marketing literature and internal office/software support systems that can be easily procured with its renowned infrastructure for these tools. If the need arises for additional supplies, there are 3,000 logistics and supply chain companies operating in Singapore to assist with these needs at no risk to the business (worldcustomsjournal.org, 2007). All supplies needs can be easily satisfied. 4.6 Access of transportation Singapore has a well developed transportation network consisting of Metro Rail Transport (MRT) systems, Bus systems and Taxi Services that are all air conditioned. As it can be found in the location map, the location of our company near to two MRT stations, which provides convenience to our customers to reach our company. The mass rapid transit system in place is comprehensive and connects to almost all parts of the country (Lim, 2008). It is also considered among the best in the world (app.www.sg, 2009). Also with one of the world best airports, Changi International, the access of transportation to other nations is unobstructed (Changi). Transport is no risk to the business and can sustain all traveller needs. 5.0 Management 5.1 Management Team and Key Personnel Singapore MedTours being a private business therefore Management team would initially be comprises of the primary investors of the organization. The following will be the structure of the Management Team: Source: Author Deep Kamal Agarwal (CEO / Financial Director): Deep Kamal Agarwal is successful Information Engineer from an Internationally Accredited College in India. His both parents are respected doctor with over 25 years of experience and hence he has natural affinity and knowledge about the Medical Service Industry. He posses 2 years industry experience as an operational manager in Sunrise Naturopathy Health Resort in India. His forte lies in encountering any business problem and working out prompt solution for it. He believes in holistic business approach and is critical person for the firm to provide vision