Healthcare Quality And Price In The United States Sample Essay

The main problem with the economic aspect of healthcare in the U.S. is its inability to deliver the necessary level of quality at a reasonable price. This issue becomes especially apparent when compared to a similar system in other countries. For instance, the longevity of both male and female population in the United Kingdom is several years higher than that in the U.S. At the same time, the per capita costs of care is approximately 50% higher in the U.S. than in the U.K. The American system is also allocated a percentage of GDP that is almost twice as high as that in Great Britain (Edwards, 2015). However, despite the seemingly generous allocation of funds, the U.S. system constantly fails at bridging the gap between the budget and the costs of care. The following paper provides an analysis of the issue and outlines a possible solution to the problem.

The problem of deteriorating cost-efficiency can be attributed to several factors. First, the health insurance coverage provided by the employers is exempt from taxes, which requires government spending of up to $200 billion each year (Edwards, 2015). As a result, the employees with high salaries pay fewer taxes than would be possible under equal conditions. On the other hand, for many employees, the existence of a sponsored coverage makes them dependent on an employer and makes it more difficult to change jobs. At the same time, a significant proportion of the population, especially the younger demographic segment, chooses to bypass the insurance option and instead relies on emergency rooms, which introduces additional expenses. Finally, the situation contributes to inflation in the healthcare system, effectively creating a vicious circle.

The second factor is the overall inefficiency of the system. Healthcare professionals are often paid based on the number of interventions and tests performed rather than the outcome of the patients. The patients are rarely aware of the costs of procedures required for the treatment and, since the payment is usually handled by a third party, are not motivated to make an inquiry. The situation is further complicated by the enormous diversity of prices in the field, with the costs of some services within a given area ranging between hundreds and thousands of dollars.

Finally, the third factor is the existence of conflicting interests. The easiest example is the decision-making process facilitated in the collaboration between the healthcare professional and the patient (Kelly, 2012). While the latter get the advantage of making an informed decision, the former receives an opportunity to promote their services, which compromises the fairness of the market. In other words, despite the evident goal of becoming an effective private marketplace, health care consistently fails as a free market.

Admittedly, there is no simple solution to the identified problem. Nevertheless, upon closer inspection, it becomes evident that changing certain parameters of the system may result in a favorable outcome. For instance, it is possible to assume that the removal of insurance tax breaks for the employers could provide the government with the possibility to subsidize health care for the poor. In addition, the employees are expected to seek more cost-effective solutions, approaching the issue from a consumer standpoint. Simply put, the elimination of tax-exempt coverage will bring the system closer to the free market model while at the same time, providing additional subsidies to the most vulnerable population segments.

As can be seen, the problem of low cost-efficiency of healthcare is dependent on several major economic issues. Thus, an effective solution requires the involvement and collaboration of political and economic institutions. Such collaboration is only possible as a result of increased financial transparency and open communication between clinicians, managers, and policymakers, and can result in a more fair and efficient environment.


Edwards, J. (2015). What the NHS ‘A&E crisis’ looks like in comparison to America’s private healthcare. Business Insider. Web.

Kelly, P. (2012). Nursing leadership & management (3rd ed.). New York, NY: Cengage Learning.

Dark Tourism And Theories Of Its Motivation


The concept of dark tourism is becoming a more and more popular subject of research in modern studies. Scholars investigate the reasons why people are interested in dark tourism sites, and they agree that the most common motive is paying tribute to the deceased people and finding out more about their national identity. I would like to research the motivations of dark tourism because I find this topic rather relevant and interesting.

The purpose of the project is to analyze the concept of dark tourism and its motivations on the basis of a review of the literature and an interview. A more narrow objective is the investigation of recently created US dark tourism sites. Therefore, the specific research question of my study is, “What are the motives of different age groups in visiting the National 9/11 Memorial and Museum in New York as a site of dark tourism?” The study is expected to incorporate ten participants who will be asked to answer the questions of a semi-structured interview.

The reason why I chose this theme is that I feel that people need to express more respect and sympathy towards those who became victims of devastating natural or man-made catastrophes. I think that if people were more acquainted with dark tourism places, they would be more empathetic and would not think of doing anything cruel to others. The importance of the project is in its anticipated outcomes. I hope to find out the major motives of people’s visits to the National 9/11 Memorial and Museum and on the basis of the obtained data, to design the ways of encouraging tourists’ interest in such places and their significant social and humane purposes.

Literature Review

The interest of scholars in dark tourism appeared comparatively recently, and its significance in the present decade has grown. Many studies are dedicated to the theory, applications, and methods of research on the topic (Ashworth & Isaac, 2015; Biran & Hyde, 2013; Casbeard & Booth, 2012; Collins-Kreiner, 2015; Korstanje & Ivanov, 2012). Some scholars investigate particular dark tourism places and analyze different cases (Brown, 2013; Isaac & Çakmak, 2014; Kang, Scott, Lee, & Ballantyne, 2012; Ozer, Ersoy, & Tuzunkan, 2012; Yan, Zhang, Zhang, Lu, & Guo, 2016).

There are studies focused on specific implications of dark tourism (Brown, 2013; Miles, 2014; Podoshen, 2013; Stone, 2012). All of the reviewed studies come from peer-reviewed journals, and they help to understand the concept of dark tourism better by providing evidence and analysis.

Theory, Applications, and Methods

In their article, Ashworth and Isaac (2015) analyze the shifting perspectives of dark tourism. The authors remark that the theoretical investigations of dark tourism changed their focus from the places to the experiences conveyed by them. Ashworth and Isaac (2015) suggest a list of emotions that tourists at such sites usually experience: curiosity, shame, empathetic grief, psychotic disturbance, offense or anger, and fear.

Scholars note that the feeling of shame appears when visitors realize what sufferings people had to experience. Empathetic grief is the ability to perceive other people’s tragedies as one’s own. Feelings of anger, fear, and psychotic disturbance are caused by the realization of where one is and what horrible events happened in it. The article by Korstanje and Ivanov (2012) also analyzes the role of trauma in people’s motivation to visit dark tourism places. The authors note that it is difficult to understand some people’s motives since death is a mysterious concept perceived by every person differently.

Biran and Hyde (2013) suggest a shift from a purely descriptive analysis of dark tourism to a critical one. Scholars remark that there are some gaps in the methodology of dark tourism investigation, and they propose the ways of filling in these gaps. The first suggestion is to approach the study of dark tourism with the use of quantitative methods (Biran and Hyde, 2013). The second idea is that future studies should stop exploiting the traditionally accepted thanatological framework introduced by Stone and Sharpley in 2008 and start exploring the effect of dark tourism on people’s emotions and death anxiety (Biran and Hyde, 2013). Biran and Hyde (2013) also emphasize the need to investigate cross-cultural differences with regard to dark tourism.

Considering dark tourism as a product of post-modernity, Casbeard, and Booth (2012) outline some methodological problems in the field. The authors emphasize the need for historical periodization of dark tourism sites. Casbeard and Booth (2012) note that the only classification of sites is considering them the events that took place within living memory, which is approximately the last century. Thus, according to Casbeard and Booth (2012), dark tourism sites need to be classified in accordance with historical periods, and further research of the issue should be based on this classification.

Collins-Kreiner (2015) also emphasizes the significance of innovative methods in dark tourism research. The author compares the terms ‘dark tourism’ and ‘pilgrimage,’ noting that it is rather difficult to distinguish between them in modern research. Collins-Kreiner (2015) remarks that similarities between the two concepts are in the nature of the phenomena, the establishment of sites, and the issues associated with supply and demand. Therefore, while pilgrimage has existed for a much longer time than dark tourism, both concepts have some common features enabling and encouraging researchers to analyze them from the perspective of similarity.

Different Case Studies of Dark Tourism Places

Many scholars focus their research on investigating particular dark tourism sites and people’s reasons for visiting them. Brown (2013) focuses his article on the analysis of three places: the Auschwitz-Birkenau Museum in Poland, the International Slavery Museum in Liverpool, UK, and the Imperial War Museum North in Salford Quays, UK. Although all three museums have a different level of detachment to the events to which they are dedicated, Brown (2013) remarks that people visit them because they want to honor those who were murdered because of racial discrimination (the Auschwitz-Birkenau and the International Slavery Museums) and those who were killed when defending their countries against the enemy (the Imperial War Museum North).

In his study dedicated to the analysis of people’s motives for visiting the battlefield site, Miles (2014) also emphasizes the feeling of authenticity and desire to pay tribute to soldiers. Another study dedicated to battlefield memorials is focused on the analysis of Australian tourists’ interest in Gallipoli (Ozer et al., 2012). The authors note that there is one motive that makes Australians travel to Europe on Anzac day, April 25 (Ozer et al., 2012). Tourists want to commemorate their compatriots who participated in the Gallipoli Campaign in 1915-1916. By visiting this place, people hope to gain a better understanding of their nation and history.

Many research studies are dedicated to the investigation of dark tourism in places of massive deaths and sufferings of people that did not involve wars. Isaac and Çakmak (2014) investigate people’s motives for visiting a former transit camp Westerbork in the Netherlands. The authors note that tourists name curiosity, the need for self-understanding, and conscience as their major reasons. Other motives, as identified by Isaac and Çakmak (2014), are the exclusiveness of the site and its being in the top lists of tourist attractions.

Yan et al. (2016) analyze the motivation of tourists’ interest in the Beichuan earthquake relics in China. Researchers conclude that the main reason is empathy and study of local characteristics. Other causes are associated with entertainment and educational purposes. Kang et al. (2012) analyze tourists’ motives for visiting the April 3rd Peace Park on Jeju Island in South Korea. This is a place of commemorating one of the most tragic episodes in the history of modern Korea. Research by Kang et al. (2012) indicates that the major reason why people attend the site is the feeling of duty. Other motives are curiosity, social reasons, and participation in educational programs.

Specific Implications of Dark Tourism

Some scholars focus their investigations, not on concrete case studies but on particular features pertaining to dark tourism. Brown (2013) analyzes the activity of dark tourism shops. The author remarks that although the functioning of shops at dark tourism spots is limited, people still like the idea of taking home something to remember their visit. Brown (2013) notes that in order not to be criticized by the public, such shops usually limit the items they sell to books and other educational materials.

Podoshen (2013) investigates an unusual trend in dark tourism – places associated with black metal. The author concludes that the key motives of visiting such spots are simulation and emotional contagion. Also, Podoshen (2013) remarks that such tourists make attempts to draw comparisons between the landscapes imagined by them and topographical reality.

In his study, Stone (2012) views dark tourism as a mediating institution. According to the author, such an institution has a double function. The first one is providing a physical spot to connect the living with the dead. The second feature, as defined by Stone (2012), is serving as a cognitive space where a person’s self can establish the contemporary ontological essence of mortality.


The authors of the reviewed articles mainly focus on tourists’ interest in dark tourism and the motives for visiting dark tourism sites. Scholars remark that going to places of massive deaths makes individuals be more sympathetic. The majority of researchers emphasize that compassion and desire to commemorate people is the key reason why tourists participate in dark tourism. Other popular motives are entertainment and education. However, even if people visit sites for such purposes, they treat the places with due respect and consideration.

The reviewed literature is closely connected with the current research since it provides a number of investigations of dark tourism spots along with people’s motives for visiting them. The articles may be used when analyzing tourists’ interest in the National 9/11 Memorial and Museum. I will be able to compare and contrast the motives and see whether they are similar to or different from the major causes discussed in the reviewed articles.

Project Methodology

Connection Between the Reviewed Literature and the Study

Dark tourism became a popular subject of scholarly analysis comparatively recently, which explains the presence of gaps in research. Although many articles are dedicated to tourists’ motives for visiting battlefields, massacre sites, and other places of massive deaths and suffering, not all popular sites have been studied yet. Among such understudied sites is the National 9/11 Memorial and Museum in New York.

The museum is dedicated to the victims of massive terrorist attacks that took place in New York, Pennsylvania, and Washington, DC in September 2001 (Hess & Herbig, 2013; “9/11 memorial and museum,” 2017). The only investigation of the memorial as a dark tourism site was performed by Tinson, Saren, and Roth (2015) who studied the role of dark tourism in the formation of young Americans’ national identity. Therefore, I would like to explore this memorial more thoroughly. I will not limit my research to some age group since it is crucial to find out the opinions of different generations. Upon collecting the necessary data, I will be able to compare it with the findings obtained by other researchers who studied other dark tourism sites.

Study Design

The study will be qualitative and non-experimental. There will be only one group of participants. I will employ survey research to answer the research question that is “What are the motives of different age groups in visiting the National 9/11 Memorial and Museum in New York as a site of dark tourism?” The value for stakeholders will be added through such specific, achievable objectives:

  • to explore the concept of dark tourism in general and one of its most famous sites in the US, in particular;
  • to find out the major reason for people’s visits to the National 9/11 Memorial and Museum;
  • to investigate the secondary motives of tourists’ interest in the site;
  • to encourage citizens to respect and sympathize with the victims and survivors of the tragic events.

Research Strategy

The study will employ a sample of ten respondents. The participants will not be limited to their age or gender characteristics since I want to find out the opinions of diverse population groups. I do not want to focus on one gender or age because it will not present the full scope of the issue.

The selected number of participants may seem small, but it is sufficient for my study. I am planning to use a semi-structured interview, which means that people may give long answers to the analysis of which will take much time. Thus, I find this number an acceptable minimum to conduct a reliable survey and manage to do it within the suggested timeline.


The instrument employed to collect data is a semi-structured interview. The questions for the interview were not used previously and were designed specifically for my study. The chosen structure of the interview will allow people to talk more about the things that are most interesting and close to them. At the same time, the interview guide will help me to keep focused on the research question and obtain the most relevant data.

The participants will be encouraged to answer the questions of the interview in as much detail as they prefer (Appendix). Since it is a semi-structured interview, eight questions will be enough. They will serve as a guideline for the respondents, enabling them to elaborate on some issues and report briefly about the others. The participants will also report three demographic facts about themselves: age, gender, and ethnicity. This data will be used to analyze whether people with different demographic characteristics treat their visit to the museum differently or in a similar way.

Data Collection and Analysis

The process of data collection will involve going to the National 9/11 Memorial and Museum and asking people to participate in a survey at the end of their excursion. I will collect the data by myself since I want to ensure the reliability of the answers. I will stay at the museum for the whole day and will approach people at different times. Since the answers of only ten participants are needed for the study, I am planning to ask at least twenty people. This will enable me to exclude questionnaires where participants answer some questions too narrowly.

I will approach people with a smile, greet them in a friendly way, and explain the reason why I am asking them to participate in the interview. I will guarantee confidentiality for them and ask them to reveal only three demographic characteristics mentioned earlier (age, gender, and ethnicity). Then, I will invite each person to sit down and explain the procedure of the interview. To save time, I will use a voice recorder instead of writing the answers in a notebook. However, the notebook will also be necessary. If in the process of the interview I get interested in something mentioned by the participant, I will put it down and ask the people at the end of our conversation without interrupting them.

To analyze the collected data, I will listen to the answers and type them. Then, having the answers available on my laptop, I will highlight the answers that interest me most and compare and contrast them in a variety of ways. First of all, I will analyze the major motives of people’s visits to the museum. Then, I will establish secondary reasons. Further, I will establish whether people’s answers differ depending on their age, ethnicity, or gender.


The table presents a timeline of the project with major stages and dates.

Stage Tasks Date

  • – reviewing the literature
  • – coming up with the research question
  • – designing project methodology
  • – creating interview questions

The first week of November
Implementation: data collection

  • – visiting the National 9/11 Memorial and Museum
  • – asking tourists to answer the interview questions

The second or third week of November

  • – listening to the interview answers and typing them
  • – reading the answers and looking for specific information concerning motives of visiting the memorial
  • – analysing respondents’ answers

The fourth week of November – the first and second weeks of December

  • – making conclusions about the strengths and weaknesses of the study
  • – outlining the perspectives of further research

The third week of December


Ashworth, G. J., & Isaac, R. K. (2015). Have we illuminated the dark? Shifting perspectives on ‘dark’ tourism. Tourism Recreation Research, 40(3), 316-325.

Biran, A., & Hyde, K. F. (2013). New perspectives on dark tourism. International Journal of Culture, Tourism, and Hospitality Research, 7(3), 191-198.

Brown, J. (2013). Dark tourism shops: selling “dark” and “difficult” products. Journal of Culture, Tourism, and Hospitality Research, 7(3), 272-280.

Casbeard, R., & Booth, C. (2012). Post-modernity and the exceptionalism of the present in dark tourism. Journal of Unconventional Parks, Tourism & Recreation Research, 4(1), 2-8.

Collins-Kreiner, N. (2015). Dark tourism as/is pilgrimage. Current Issues in Tourism, 12(19), 1185-1189.

Hess, A., & Herbig, A. (2013). Recalling the ghosts of 9/11: Convergent memorializing at the opening of the National 9/11 Memorial. International Journal of Communication, 7, 2207-2230.

Isaac, R. K., & Çakmak, E. (2014). Understanding visitor’s motivation at sites of death and disaster: The case of former transit camp Westerbork, the Netherlands. Current Issues in Tourism, 17(2), 164-179.

Kang, E.-J., Scott, N., Lee, T., & Ballantyne, R. (2012). Benefits of visiting a ‘dark tourism’ site: The case of the Jeju April 3rd Peace Park, Korea. Tourism Management, 33, 257-265.

Korstanje, M. E., & Ivanov, S. (2012). Tourism as a form of new psychological resilience: The inception of dark tourism. Cultur – Revista de Cultura e Turismo, 6(4), 56-71.

Miles, S. (2014). Battlefield sites as dark tourism attractions: An analysis of experience. Journal of Heritage Tourism, 9(2), 134-147.

Ozer, S. U., Ersoy, G. K., & Tuzunkan, D. (2012). Dark tourism in Gallipoli: Forecast analysis to determine potential of Australian visitors. Procedia – Social and Behavioral Sciences, 41,386-393.

9/11 memorial and museum. (2017). Web.

Podoshen, J. S. (2013). Dark tourism motivations: Simulation, emotional contagion and topographic comparison. Tourism Management, 35, 263-271.

Stone, P. R. (2012). Dark tourism and significant other death: Towards a model of mortality mediation. Annals of Tourism Research, 39(3), 1565-1587.

Tinson, J. S., Saren, M. A. J., & Roth, B. E. (2015) Exploring the role of dark tourism in the creation of national identity of young Americans. Journal of Marketing Management, 31(7-8), 856-880.

Yan, B.-J., Zhang, J., Zhang, H.-L., Lu, S.-J., & Guo, Y.-R. (2016). Investigating the motivation – Experience relationship in a dark tourism space: A case study of the Beichuan earthquake relics, China. Tourism Management, 53, 108-121.


Research instrument

  1. Are you familiar with the concept ‘dark tourism’?
  2. Why did you come to the National 9/11 Memorial and Museum?
  3. Does this place bear any personal significance for you?
  4. Have you visited any similar museums or memorials?
  5. Did you come alone or with someone?
  6. Do you plan to tell anyone about your visit? If so, what will you tell them?
  7. Do you consider dark tourism a successful approach to teaching people sympathy and compassion?
  8. Why do you think some people might avoid visiting such places?


Rio 2016: Where Refugees Are Finally Being Recognized

This essay presents the main theme, two subthemes, global connections in relation to major ideas discussed. The number of persons displaced from their home countries by conflicts and persecution in the recent past is larger than in any period since more thorough record keeping started, according to the UN refugee agency recently released report, which showed that the current global migration of people was never witnessed before in these periods. In the previous year, the number of asylum seekers, refugees, and internally displaced people has exceeded 60 million relative to the period of World War II (Witte, 2015). The rapidly grow figure shows a world deep in conflict, subjected to wars in Africa, the Middle East, and Asia. However, the systems established to control movements of refugees can no longer support such a large number and aid organizations are unable to cope up with a figure that is growing daily. Consequently, it has now culminated into a ‘world refugee crisis’, which is the main theme of this article that appeared in The Atlantic, “Rio 2016: Where Refugees Are Finally Being Recognized”.

One subtheme of this essay is the recognition of refugees. For refugees who took part in the Rio Games as the Refugee Olympic Team, the goal was far from winning medals (Price, 2016). Instead, the team focused on earning dignity and advancing refugee agenda globally (Friedman, 2016). Refugees are recognized as persons who cannot depend on their countries to protect them and, thus, seeking protection from other bodies and nations. Refugees have no country flag, national anthem, and home, and the Olympic Village provided an opportunity as they mingled with other athletes from other parts of the world. The Olympic flag represents international unity and cooperation among global nations, but refugees must carry it, notwithstanding the fact they do not have a country. The Refugee Olympic Team is a source of inspiration and internationalism for other refuges and asylum seekers globally. On the other hand, the Team also reflects a failure of the international community to stop conflicts and brutality across the world since they are responsible for the rising number of refugees and asylum seekers (Lind, 2016).

Another subtheme of this essay is the role of sports in improving society. One must recognize that the Rio Games provided the first opportunity ever for refugees to participate in international sports event. Sports play critical roles in the lives of refugees who have endured various forms of human suffering. Refugees have fled their countries, homes, left their families, and endured dangerous, uncertain journeys into the unknown. With millions displaced while the underlying problems remain unresolved, refugees continue to spend their time in restricted camps without contacts with the rest of the world, and the Rio Games offered a perfect opportunity for refugee recognition and showed that the games were more than competition among nations, but a source of hope for stateless persons (International Olympic Committee, 2016).

The world refugee crisis brings out some global connections. First, wars are responsible for the current world refugee crisis. It is estimated that between 1996 and 2005, about 12 million refugees returned to their home countries, but this number dwindled to about 4.2 million between 2006 and 2015 (Lind, 2016). To understand the chief reason, one must focus on new wars. The most notorious war with the largest displacement of persons is the Syrian Civil War, which is responsible for millions of new refugees who cannot return because of the ongoing war. In addition, regions, such as South Sudan, Afghanistan, Somalia, and the Central African Republic, that have been in wars for decades have also witnessed flaring conflicts and impunity. Thus, the refugee status is becoming permanent.

Second, as previously mentioned, the participation of the Refugee Olympic Team reflected the failure of the international community to protect human rights. Rather than improving efforts to address the world refugee crisis, many developed nations have resorted to inactions and to some extent closing their borders for aliens. Olympic Games, which is a large international sports competition meant to enhance international goodwill, was therefore a better opportunity to highlight the status of refugees. Refugees wanted to portray heroism in sports and potential values they can bring to any countries that absorb them and probably inspire some political leaders to change their stand to welcome more asylum seekers and refugees. The outcome of participation in the Games remains unknown.

Finally, the International Olympic Committee (IOC) collaborated with Tegla Loroupe in Kenya to make the Refugee Olympic Team a reality for South Sudanese refugees. The global reach of the OIC focused on linking the world refugee crisis with the Rio Games when a young Syrian refugee was the touchbearer in Brazil (Jacobs, 2016). Through funding extended to Loroupe, she was able to train about 30 refugee athletes in her camp.

In summary, the use of the Rio Games to highlight the world refugee crisis did indeed brought about some elements of global connections. Wars continue to drive the number of refugees higher, but the international community has failed to address the issue sufficiently. Nevertheless, the IOC and other individuals demonstrate the role of sports in improving human society.


Friedman, U. (2016). Rio 2016: Where Refugees Are Finally Being Recognized. The Atlantic.

International Olympic Committee. (2016). Refugee Olympic Team to shine spotlight on worldwide refugee crisis.

Jacobs, A. (2016). A young Syrian torchbearer highlights Brazil’s embrace of refugees. The New York Times.

Lind, D. (2016). Rio 2016: The Refugee Olympic Team doesn’t need your cheers. They need countries to fix their crisis. Vox.

Price, S. (2016). The longest run: Olympics about more than winning for Refugee team. Sports Illustrated.

Witte, G. (2015). New U.N. report says world’s refugee crisis is worse than anyone expected. The Washington Post. Web.