“The Land of Hope: Chicago, Black Southerners, and the Great Migration” by James Grossman has sparked a debate beyond the conventional survey about the urban ghetto formation and the motivating factors for immigrants. The author offers a fresh and inspiring perspective on migrants’ dreams of modern America, deepening people’s comprehension of the most dramatic and transformative socioeconomic and cultural complexities of the African American exodus. Grossman’s choice of using Chicago shows people the diverse push and pull factors that moved about one million African Americans from the South in the twentieth century. The great work proclaims Grossman since its withdrawal from the cultural, ideological continuities of Southern African-Americans. This paper explores the book’s strengths, weaknesses, themes, and how Grossman has used these concepts to educate the audience and make it fascinating.
The theme of immigration has primarily been used in the story by Grosmann. He paints the migrant as a strategist who contemplates the questions of relocation, which many thoughts. Immigrants in the novel are not guided blindly to the promised lands by job and railway officers, nor are they enslaved. They were also uninterested in the letters and newspaper columns about Chicago’s wealth. Grossman considered the North’s liberties and the South’s families, kin, and culture. According to the author, southern African-Americans recognized citizenship, democracy, and freedom philosophies (Grossman, 1991). Also, they were fully aware of their citizenship rights. Hopeful for movement and private investment for a short time, first-class citizenship and freedom were interlinked with farm possession and production. Liberty of choice became indefinable in their natural home when Jim Crow America overshadowed reality.
Furthermore, the Southern Nacks chose foreign land ownership in exchange for the prospect of unskilled or half-skilled industrial employment, religion, and extensive kin network, social institutions in the urban North, and schooling. In contrast to these, the author claims that the refugee did not exaggerate the city’s splendors. According to the author, he combined Southern culture components into these already developed African American societies out of a desire to live alone in a pluralistic society (Grossman, 1991). Though possibly limited by race, even in the North, the newcomers set out to reconstruct in these urban areas.
The first chapter of the book is devoted to a narrative that compares the South’s Southerners with the factors contributing to the Great Migration’s drive to the North’s hopes and pulls. The refugees’ effect is determined by America’s urbanization and black and white Southerners’ plans to incorporate African southerners in the area. In this case, readers can learn that the theme of race is depicted in the story to show how it impacts people’s life. Mnay individuals have experienced racial-based discrimination in the community. Consequently, this concept addresseed how factors such as origin and ethnicity can affect how an individual interacts with others in society.
Grossman uses Chicago as his migration analysis in the second chapter. In Chicago, he believes, has hope, success, a bright future, and great potential. The city’s newspaper, The Defender, was essential in most of the southerner’s home, which narrated the city’s strengths with the great extensive shoulders. Fair salaries, social justice, affordable accommodation, work opportunities, better educational services, and a life free of the fear and lowliness associated with apartheid’s philosophy and reality were all part of the story (Grossman, 1991). Aside from that, it was a symbol of racial and cultural diversity. Readers have confronted with the Chicago that the migrant found through Grossman’s halt into existence. In the workplace, new economic options were prohibited. During this time, Chicago’s dominant labor unions kept African-American workers out of most industries, trades, and skilled positions.
In this situation, the black community’s mistrust of white institutions was fulfilled, resulting in blacks being used as strikebreakers. Therefore, the theme of trust has been introduced in the book as it primarily impacts how people interact in society. Furthermore, even the most trusted and long-standing race organizations, such as the Chicago Urban League, we’re unable to comprehensively improve the quality of life for the ever-increasing number of new migrants. These factors made it difficult for the migrants’ skills to be transferred to Chicago’s urban economy. Moreover, the majority were channeled into low-wage non-industrial labor and services such as factories and domestic services.
There are two notable strengths of Grossman’s work in the book. The first is African-American society’s and networks’ role in establishing and sustaining the Great Migration. These grassroots mobilization networks aided the newcomers and helped with the transition. The familiarity of restaurants, acquaintances, and family, as well as local clubs, was ensured. Even though some African-American community members were uncomfortable with some of the migrants’ folkways and customs, the latter became crucial to joint political and economic development (Grossman, 1991). Grossman does not follow up on the reader’s discussion about how certain migrants are elevated to the middle class in terms of thinking, economics, values, and race consciousness. Despite being isolated and marginalized, this group led to developing a new multi-cultural Chicago in politics and the community at large by challenging the old guard and shaping much of the New Negro’s heritage.
Second, the author demonstrates his ability to enable migrants to identify their position in society and provide them with the intelligence to understand their rights and contributions. His treatment’s illogicalities are fascinating. It’s evident in the author’s explanation of the principle of forced migration vs. volunteer versatility. Grossman demonstrates self-determination in the book because he recognizes the importance of education in obtaining and preserving these rights (Grossman, 1991). However, he falls short in his rushed discussion of education’s critical value. Correspondingly, as this grim chapter would lead the reader to believe, prejudice did not discourage or undermine in one community the trust in education and hope for the future.
In conclusion, the book has created a discussion beyond the traditional survey on how the ghetto evolved. The author offers a fresh and inspiring perspective on migrants’ dreams of modern America, deepening our understanding of the most dramatic and transformative African American exodus’s socioeconomic and cultural complexities. Grossman paints the migrants as strategies who contemplates the puzzle of relocating. He also notes that the earlier migrants readily swapped their lands to exchange job opportunities and education. Even though these newcomers were limited by race, they were determined to settle in the urban areas. Grossman also discusses how he chose Chicago as his area of interest. The book has both strengths and shortcomings. First, it recognizes the participation of the African-American community in founding and maintaining the great migration. However, the author failed to explain how the migrants were raised to the middle-class standard. Secondly, Grossman proves his ability to define his understanding and contributions to the history of black migration. Grossman falls short in his abrupt discussion on the vital importance of education. Nonetheless, the story can educate people about various issues such as cultural differences and social changes experienced by different pople in the community.
Grossman, J. R. (1991). Land of Hope: Chicago, black southerners, and the great migration. University of Chicago Press.
“Sonny’s Blues”: Relationships Between The Brothers
One of the main themes in the short story “Sonny’s Blues,” written by James Baldwin, is family support, which is essential for uniting the characters and allowing them to solve their problems. However, it is mostly described in a negative light throughout the narrative, which changes to a more positive outlook by the end of this piece under the influence of the power of music. From this perspective, the significance of Sonny’s occupation is in the fact that it marks the beginning of difficulties in his relationships with his brother. Meanwhile, it not only creates issues between them but also heals them by serving as a component connecting their varying views of reality. Hence, shared pain and suffering in life are initially misinterpreted by the characters, and the gap in their understanding of circumstances could be overcome only with the help of a specific link, which was music.
Dealing with Pain and Suffering
The principal evidence of the lack of connection between the narrator and Sonny is reflected in the way they express themselves. This factor greatly affected the selection of the career of an algebra teacher by the former and the latter’s only desire to become a jazz musician. During their conversation about the future and the necessity to make a living, they demonstrate varying standpoints in terms of better ways of dealing with pain. Thus, the narrator’s perspective is limited by the considerations of feasibility, the practicality of decisions, the time spent on the achievement of the set goals, and other similar thoughts (Baldwin, 1957).
In contrast to him, Sonny does not view this approach as the best method to avoid the adversity of life and ensure his wellbeing in the future. He claims that courage is the key to finding one’s true self and their place in the world, and music corresponds to this perception more than the rationality of choices (Baldwin, 1957). In this way, the conflict between these people can be described as the collision of opposite stances concerning the appropriateness of choices for avoiding suffering.
The difference between the brothers’ perspectives is connected to the degree of responsibility for the consequences of their actions they are willing to accept. In the case of the narrator, it is extremely high as he tends to consider any occupations related to personal desires as unworthy of time. When discussing the matter with Sonny, he states that “people can’t always do exactly what they want to do,” thereby confirming a full awareness of the risks of improper choices regarding one’s career (Baldwin, 1957, p. 15).
For him, stability is the only possible way to deal with the prospects of suffering since it guarantees the clarity of expectations and provides one with opportunities to rely on the environment. On the contrary, Sonny’s attitudes seem less serious as he does not emphasize the importance of these factors in his decisions. By saying that “people ought to do what they want to do, what else are they alive for?,” he highlights the significance of finding meaning in one’s life (Baldwin, 1957, p. 15). Thus, his guarantee of wellbeing is based on emotions, and this fact implies less control over negative events.
As can be seen from the outcomes of the two men’s choices in life, the practical approach happens to be more effective than relying on the interests in pursuing goals without paying attention to everyday needs. Nevertheless, it is not a perfect solution for maintaining contact between family members, and this circumstance explains the narrator’s failure to stay away from his brother’s struggles. In other words, a detached and well-thought outlook on the problems does not contribute to a lesser degree of suffering since people tend to involve in the challenges of their relatives. Thus, the narrator does not manage to remain objective when he remembers the promise not to leave Sonny he gave to his mother (Baldwin, 1957).
In addition, when talking to one of his brother’s friends at the beginning of the story, he expresses the intention to understand why people end up in such painful conditions (Baldwin, 1957). Therefore, it is clear that he would not be able to stay out of this event in the continuation of this piece.
The reminder of Sonny’s fate and the significance of other people on this occasion is also explained by his old friend. In their conversation with the narrator, he states that even he feels the responsibility before Sonny even though they have not seen each other for many years (Baldwin, 1957). This idea not only triggers similar thoughts in the man but also leads to the intention to write Sonny a letter when he loses his daughter (Baldwin, 1957).
This decision seems appropriate from the perspective of support, which only family members can provide in difficult times. The desire to receive it is mutual since, in return, Sonny claims that he did not want to hurt anyone and still cares about his brother (Baldwin, 1957). In this part of the story, it becomes clear that, regardless of the different adopted mechanisms of coping with pain and suffering of the two characters, there is a common trait in them. Both men highlight the importance of relatives in this aspect of life and are willing to overcome the past challenges to establish healthy relationships, which they once lost.
The Importance of Jazz/Blues for Healing
The above intention to find a compromise between the opposing views of reality expressed by the two brothers is not an easy task. In order to successfully perform it, a connecting link between them should be created and, in the story, music serves as the factor contributing to their healing. Its power is initially understood only by Sonny, whereas it is neglected by the narrator as he considers it inessential for survival and, consequently, one’s wellbeing (Baldwin, 1957).
However, the change comes after Sonny arrives to visit him in Harlem and manages to explain his position in life with regard to this occupation. During the conversation of the two characters, he compares music to heroin, thereby emphasizing its power to affect one’s mind (Baldwin, 1957). This comparison seems striking to the narrator who has never perceived it in this way. Meanwhile, it serves as a turning point of the story as, since this moment, Sonny’s brother appears to admit that the opinion, which drastically differs from that of his own, is no less justified.
In the continuation of this piece, the importance of music in expressing suffering and promoting healing is emphasized by Sonny when discussing street musicians with his brother. According to the narrator, the main peculiarity about them was that “all they had were their voices and their Bibles and a tambourine” (Baldwin, 1957, p. 20). Seeing them was strange for the man as he had never thought about these meetings and their significance for the lives of their participants (Baldwin, 1957).
The key idea of this scene is the need for self-expression in troubled times and the presence of the only means to do so, which is music. This situation was the proof that it is as important as any other profession. Even though for some people healing is possible through stability, as in the case of the narrator, for others, it is achieved through artistic expression. The understanding of this phenomenon came to the man only later in life, and he finally admits that Sonny’s choices were valid.
From this point of view, the invitation of Sonny to join him at the concert where he is going to play can be considered as an attempt to demonstrate the world he belongs to. In this situation, his refusal to allow his brother to enter his life in the past was conditional upon the latter’s unwillingness to see others’ perspectives (Baldwin, 1957). Subsequently, the shift in this aspect defines the possibility of a compromise between them in the future.
The fact that the narrator feels excluded from this area of Sonny’s life is emphasized by the attitudes of other people during the event, who see him only as Sonny’s brother (Baldwin, 1957). However, despite the insignificance of his presence, he manages to understand Sonny’s feelings and buys him a drink, which he accepts while being on the stage (Baldwin, 1957). This gesture confirms the ultimate reconciliation of the two men, who have varying means of ensuring wellbeing.
The possibility of this outcome was determined by the shared memories of their family brought to life when listening to the music. It showed to the narrator that Sonny’s tendency not to express his emotions with words does not indicate his neglect of any familial ties or other people (Baldwin, 1957). On the contrary, it demonstrates his inability to process the related suffering and pain in any other way but through playing the piano.
This episode proves that the main difference between them is in the selection of different communication means, and, in this case, jazz is Sonny’s language (Baldwin, 1957). His world simply is uncharted territory for his brother, which does not mean that their feelings differ. Therefore, the healing made on its grounds is sufficient for dealing with this fracture. In turn, the expression of struggles by adopting different methods for this purpose indicates the impossibility of understanding each other, which is possible only if one is willing to enter another’s world.
To summarize, shared pain and suffering in the lives of the brothers from the story is connected to the source of their misunderstanding. This circumstance is explained by the differences in career choices, the degree of responsibility they are willing to accept, and practicality conflicting with the search for one’s place in life. Nevertheless, despite these conditions, the narrator is not indifferent to Sonny’s struggles, even though he does not want to admit it.
This resistance is explained by the fact that the two men are speaking different languages when communicating either with the help of words or music. In this situation, the healing and the creation of healthy relationships between them are possible only when one of the characters enters the world of another, thereby attempting to understand his means of self-expression. Thus, it can be concluded that jazz serves as a connecting link between the brothers and defines their ultimate reconciliation.
Baldwin, J. (1957). Sonny’s blues. Penguin Books.
Healthcare Reimbursement In The US
Reimbursement and the Revenue Cycle
What Reimbursement Means to a Healthcare Organization
The U. S. healthcare system is rather complicated due to the existence of several approaches to paying for the provided care. Private payers (insurers and individuals) as well as the government (through Medicare or Medicaid) pay for the healthcare services to providers (Harrington, 2019). Healthcare reimbursement can be seen as the financial foundation of healthcare organizations as this is the money they receive for provided services and use to ensure their proper functioning. Another difficulty related to the payment system in the United States is the fact that patients receive services first, and after that, payers provide the corresponding amount of money. If the provided services are not paid on time, a healthcare organization will lack money to cover its expenses, including but not confined to employees’ salaries, equipment, and maintenance.
The healthcare revenue cycle encompasses the provision of services and receiving funds for all the provided care. Healthcare organizations receive funds from the government, private insurers and patients, based on the plans patients have. If the insurer or the government does not cover this or that service, the patient has to pay for the received care. Sometimes hospitals find it difficult to collect money from patients, so they address collection agencies that help them. This is the last resort for healthcare organizations as they try to maintain effective communication and proper relationships with their patients.
Flow of the Patient Through the Cycle
As mentioned above, the revenue cycle can be referred to as the flow of money associated with the provision of healthcare services. The primary department that plays a key role in the reimbursement process is the financial unit. This department ensures that all services are paid and collects funds if some disruptions occur. The cycle starts at the front office, where a patient first addresses the hospital with their problem (Harrington, 2019). The front office employees collect the necessary data, which implies the completion of the electronic health record (EHR) (Pepper, 2019). At that stage, the employee arranges the meeting with the corresponding healthcare professional who provides care. The latter makes a diagnosis, develops a treatment plan, completing the EHR. Many healthcare organizations address third parties that encode the services they provide to patients, and the encoded services are sent to the corresponding insurer or governmental agency. Some hospitals do not address third parties, so their employees (mainly the medical staff) encode the service at once. Thus, at this point, the IT department, front-end employees (the medical personnel) are involved in revenue cycle management.
Once the insurer or governmental agency (or the patient) pays for the service, the financial department becomes central to the process. If some issues occur (some bills are rejected), the financial department communicates with the representatives of the partner to settle the issue and collect the necessary amount of money. In some cases, the legal department should also participate in funds collection as sometimes patients try to prove that they did not receive quality care or failed to receive the needed services at all (Harrington, 2019). When the issues are settled, financial data is processed in the financial department, and the associated data is added to the patient’s record. Importantly, modern technology makes the cycle more efficient as previously as a considerable part of operations are often automatized. The departments mentioned above (excluding the financial unit that is the key player in the process) have been ordered based on their place in the cycle rather than their importance. It is hard to identify the most important department in terms of the reimbursement cycle management as each of them is an indispensable part that completes specific functions that are equally relevant.
Departmental Impact on Reimbursement
The Impact of Departments
As mentioned above, every department involved in the reimbursement cycle plays an important role in the process, having a similar impact with certain specifics. For instance, if the front-end personnel complete the EHR with errors, the reimbursement process may be disrupted (Pepper, 2019). These are also people who communicate with the patient, which is a part of the provided services. Hence, the staff should be able to develop effective communication channels and appropriate relationships with patients. The audit of the record completion (with the focus on errors and processing time), as well as the technologies and strategies, should be implemented (Green, 2020). In order to measure the impact of the department, it is possible to estimate the number of returning and leaving patients, error rate, and patient satisfaction.
The medical staff provides care and identifies the exact health-related services that are needed. The audit of this department can involve the audit of medical errors and the use of clinical procedures (Green, 2020). The quality of provided services can be the primary measurement to identify the exact impact of this department on pay-for-performance incentives. The financial unit has the central impact as it ensures that all expenses are covered, and all bills are filed properly. As for auditing this department, the common accounting audit should be implemented. The impact of this unit can be measured by the detection of the unresolved issues and errors in financial records. Finally, the legal department plays a key role in settling legal cases if such take place. The way the department addresses these aspects can be a matter of audit. It is essential to identify whether the employees try to communicate effectively and settle issues without going to court. This can also display the impact of the department on the pay-for-performance incentives.
As mentioned above, the front unit employees communicate with patients and guide them through the process of reimbursement. Such data as EHR-related errors and patient satisfaction should be collected to estimate whether changes are necessary for ensuring the effective flow of operations (Pepper, 2019). As for medical staff, they provide care, communicate with patients, and provide information regarding reimbursement and available resources (Green, 2020). The analysis of such data as EHR in terms of diagnosis, medical errors, the relevance of clinical procedures, proper encoding, treatment effectiveness, and patient satisfaction should be conducted.
The financial department checks the billing, codes compliance, and collection of funds. In order to measure the performance of this department, it is important to implement regular accounting audits (Green, 2020). The exploration of patient satisfaction linked to the interactions with the financial unit can shed light on the quality of provided services and unveil the gaps that need to be addressed. Finally, the legal department ensures that all patients’ litigations are addressed properly. The unit employees also consult patients on various aspects associated with legal issues. The rate of resolves cases and client satisfaction can be the measurements of the effectiveness of the department.
Employees Responsible for Compliance
Health information management professionals are responsible for ensuring the organization’s compliance with codes and bills. These professionals are a part of the financial unit in most cases. These employees check the records completed by the staff and third parties (in case the organization uses such services). The team of these practitioners should be updated on all changes so that they could inform their peers about novelties. Clearly, if they make an error or fail to ensure proper compliance, the reimbursement cycle can be disrupted. Moreover, the organization may be sued by the patient or be fined by the governmental agencies.
Green, M. (2020). Understanding health insurance: A guide to billing and reimbursement – 2020 (15th ed.). Cengage Learning.
Harrington, M. K. (2019). Health care finance and the mechanics of insurance and reimbursement (2nd ed.). Jones & Bartlett Learning.
Pepper, J. (2019). The electronic health record for the physician’s office: For SimChart for the medical office (3rd ed.). Elsevier Health Sciences.