Berlin The purpose of this study is to decide whether it is feasible to open a medical tourism headquarters facility in Western Europe? Medical tourism is the process of traveling outside of your home country of residence to receive medical care. Medical tourism is growing in popularity and has captured the attention of policymakers, researcher, and the media (Mestrtovic, n.d.). Due to the global growth in patient flow and health professionals, medical technology has increased the popularity of medical tourism. The healthcare sector continues to grow primarily medical tourism. In fact, Western Europe’s healthcare sector is expected to grow by 4% by 2020. Also, healthcare spending is stable in Western Europe overall it accounts for 10% of the GDP ( Deloitte, n.d.). Comment by Grammarly: Deleted:for Comment by Grammarly: Deleted:he purp Comment by Grammarly: Deleted:se of Comment by Grammarly: Deleted:ing Comment by Grammarly: Deleted:es Comment by Grammarly: Deleted:ec Comment by Grammarly: Deleted:l Today overall there has been an experience has been a shift in patient mobility as the wealthier travel to less-developed and regulated countries for more affluent patients who can receive the treatments a lower cost. Tourism over is a billion-dollar industry, and with healthcare costs increasing in the United States many U.S. citizens are starting to utilize medical tourism to reduce costs. ` Comment by Grammarly: Deleted:w Comment by Grammarly: Deleted:hier Comment by Grammarly: Deleted:s The medical tourism quality and standards are of care the same those in the U.S. they use teams of highly qualified Doctors, Nurses, and other healthcare professionals to perform the procedures. The most common procedures performed utilizing medical tourism are common elective procedures such as cosmetic surgeries and dental procedures. Also, more serious procedures such as organ transplants, cardiac surgeries, orthopedic surgeries and other traditional and alternative medical procedures are performed (Green, Lunt, n.d.). Comment by Grammarly: Deleted:tiliz The three cities that will be explored to determine the best location for the new headquarters are Belgium, Berlin, and Barcelona. Belgium is located in northwest Europe and borders France and The Netherlands. Belgium has one of the best healthcare systems in the world (Expatica, n.d.). The next city is Berlin which is the capital of Germany its busiest city. Germany offers their citizens universal health care and both public and private healthcare insurance. Their medical facilities are also top of the line, and people come from all over for treatment (Inter National n.d.). The last city Barcelona is located in Northwest Spain the second most populated city in Spain the sixth largest city in Europe. Barcelona also has an excellent healthcare system, and their doctors are rated 6th in the world for quality. Comment by Grammarly: Deleted:, Comment by Grammarly: Deleted:v Comment by Grammarly: Deleted ...

1. Berlin
The purpose of this study is to decide whether it is feasible to
open a medical tourism headquarters facility in Western
Europe? Medical tourism is the process of traveling outside of
your home country of residence to receive medical care.
Medical tourism is growing in popularity and has captured the
attention of policymakers, researcher, and the media
(Mestrtovic, n.d.). Due to the global growth in patient flow and
health professionals, medical technology has increased the
popularity of medical tourism. The healthcare sector continues
to grow primarily medical tourism. In fact, Western Europe’s
healthcare sector is expected to grow by 4% by 2020. Also,
healthcare spending is stable in Western Europe overall it
accounts for 10% of the GDP ( Deloitte, n.d.). Comment by
Grammarly: Deleted:for Comment by Grammarly: Deleted:he
purp Comment by Grammarly: Deleted:se of Comment by
Grammarly: Deleted:ing Comment by Grammarly: Deleted:es
Comment by Grammarly: Deleted:ec Comment by
Grammarly: Deleted:l
Today overall there has been an experience has been a shift in
patient mobility as the wealthier travel to less-developed and
regulated countries for more affluent patients who can receive
the treatments a lower cost. Tourism over is a billion-dollar
industry, and with healthcare costs increasing in the United
States many U.S. citizens are starting to utilize medical tourism
to reduce costs. ` Comment by Grammarly: Deleted:w
Comment by Grammarly: Deleted:hier Comment by
Grammarly: Deleted:s
The medical tourism quality and standards are of care the same
those in the U.S. they use teams of highly qualified Doctors,
Nurses, and other healthcare professionals to perform the
procedures. The most common procedures performed utilizing
medical tourism are common elective procedures such as

2. cosmetic surgeries and dental procedures. Also, more serious
procedures such as organ transplants, cardiac surgeries,
orthopedic surgeries and other traditional and alternative
medical procedures are performed (Green, Lunt, n.d.).
Comment by Grammarly: Deleted:tiliz
The three cities that will be explored to determine the best
location for the new headquarters are Belgium, Berlin, and
Barcelona. Belgium is located in northwest Europe and borders
France and The Netherlands. Belgium has one of the best
healthcare systems in the world (Expatica, n.d.). The next city
is Berlin which is the capital of Germany its busiest city.
Germany offers their citizens universal health care and both
public and private healthcare insurance. Their medical facilities
are also top of the line, and people come from all over for
treatment (Inter National n.d.). The last city Barcelona is
located in Northwest Spain the second most populated city in
Spain the sixth largest city in Europe. Barcelona also has an
excellent healthcare system, and their doctors are rated 6th in
the world for quality. Comment by Grammarly: Deleted:,
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This report will look at the factors to consider when deciding to
open a regional headquarters facility in either Belgium, Berlin
or Barcelona for Medical Tourism. This paper helps to give the
Senior Management Team information on what the International
Human Resources Team decided to make the recommendation to
open the facility in that city.
Analysis of Need
Healthcare in Berlin is in high demand and the proper
management of the quality of healthcare relies heavily on the
talent. The workforce has highly skilled workers within Berlin
also has many host- country and third-country nationals who
speak both German and other languages. They have the best
chances of employment in the Medical Tourism and. Many other
multi-national companies within Berlin who hire English
speaking Expats. Third country nationals from other countries

3. in Europe as well as Australia, Canada, Hong Kong, South
Korea, Israel, Japan, New Zeeland and the United States
(Expatica, n.d.). Comment by Grammarly: Deleted:reat
Comment by Grammarly: Deleted:f
Whereas the need for talent in Belgium’s healthcare sector has a
growing shortage of qualified workers to meet their needs. They
have a high a standard of education, and 24% of Belgium’s
healthcare employers have positions they cannot fill. The
Belgium healthcare sector does not have enough third-country
country nationals available to fill the accessible healthcare the
positions. Comment by Grammarly: Deleted:op Comment by
Grammarly: Deleted:n Comment by Grammarly:
Deleted:Although English speaking workers are always in
demand.
Whereas in Barcelona the healthcare talent is thriving for expat
workers in particular highly skilled workers such as medical
professionals. However, without speaking Spanish limits your
job prospects ( Expatica, n.d.).
All the of the countries are in demand for healthcare workers
and expats. Also, workers who speak English and the native
language seem to have the most opportunities. All of the
countries need skilled workers such as healthcare professionals,
and their Medical Tourism industries are growing. However,
from the research, it does appear that Belgium does have the
most significant shortage of qualified talent. Berlin has the
largest workforce with the smallest shortage of labor. Lastly,
Barcelona does not have enough workers to but reply to more
pay workers to staff their healthcare sector. Comment by
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Cultural Dimensions
The cultural dimensions of Berlin are influenced greatly by
Europe. Berlin is at the center of Europe both geographically,

4. economically and politically. Most of the reason for this is
because Germany is the second most populated country in
Europe with over 81 million people according to Factbook (
site). The German economy is the largest on the continent and
the 5th largest in the world. Comment by Grammarly:
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In Berlin German is the official language spoken by the people.
However, English is the official language of business in
Germany. So, businessmen and women speak both English and
German, and it is recommended that anyone was trying to work
or start a business in Germany speak and understand some
German. This is a sign of respect to the German culture and
people. The people of Germany place a high value on structure,
privacy, and punctuality. This is important the when working to
make it is vital in Berlin to make sure that these values are
always respected. The Germans believe in thriftiness and hard
work too and are also very organized people. The Germans are a
lot about environmental issues, social responsibility and other
green issues. Comment by Grammarly: Deleted:f Comment by
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Organizational Structures
In Germany's most larger companies have a supervisory board
who manages and appoints a management board. The
management board makes all the final decisions regarding
policies that affect the overall business, and they have most

5. companies do have a chairperson. However, the chairperson
does not have much power like they do here in the United
States. In German, the chairperson is treated as a figurehead and
lack full control all of the decisions are made by a majority vote
by the management board. Comment by Grammarly:
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Most German companies have a rigorous hierarchy approach to
running the company that all employees of the company must
follow. This hierarchy specificities what roles and
responsibilities a person has are they are very tightly defined.
The businesses run very methodically and have stringent rules.
In German, the business structure is stiff and very inflexible.
Comment by Grammarly: Deleted:ve Comment by
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Nepotism
Nepotism is somewhat familiar in Berlin throughout Germany
but hard to detect. Although nepotism is growing concern in
Berlin and throughout Germany, most companies deny that
nepotism denies that it exists because the government and other
officials place very tight restrictions on nepotism in the
workplace and the consequences of non-compliance of including
hefty fines and imprisonment.
Week 4 – SQL Exercises

6. Student Name :______________________________
www.microsoft.com
Use the data model shown above and create the following SQL
statements:
SQL Exercises
1. Create a new table that will be used to track employee
location. The attributes associated with the table: employee id,
location id, location description, street address, city, state,
zipcode. Create a new table the attributes listed above. Please
identify the primary key. It has a relationship with employees.
Provide SQL statement below.
2. Add three additional columns to the Books table. The
attributes are book ISBN, book secondary desc, and purchase
price. Provide SQL statement below.
3. Create a query to select all data from the customers table
Provide the SQL statement below:
4. Create a basic query that will extract the following
information from the books, title id, title, publisher, pubdate,
edition and cost. Order by publisher. Provide the SQL statement
below:
5. Find all find all customer orders placed between January
2014 and June 2014. Provide the SQL statement below:
6. Create a new query to display all authors with last name of
“Smith” and all books by this author. Show author id, author
first name, author last name, title id, and title. Group data by
title id. Provide the SQL statement below:
7. Update the new fields added to the book table for title id 123.
Please provide the SQL statement below:

7. 8. Delete all orders placed before January 2011. Provide the
SQL statement below.
Condition
Brussels 9-11 by ghazala virk
Brussels is one of the most important cities across the globe
primarily since it has acquired an incredibly technical, political
and economic relevance both at the national level as well as the
international level. At the international level, the city hosts
different companies, organizations, and agencies that are active
all over the world while at the national level, it serves as the
capital of Belgium. The city has a growing space that represents
both a more fluid and advancing concept of citizens, paired with
a more extensive approach to technology and development. With
a population of approximately 1.2 million inhabitants, Brussels
is quoted as a vibrant cultural scene as well as a unique,
dynamic, multilingual and multicultural city (Petit, 2016).
However, in the recent times, the city is facing increased
challenges similar to those that are affecting Europe today
including the Euro crisis, migrant attack, the increased
antagonism between Dutch-speaking and French-speaking
communities, the debt crisis and terrorist attacks.
Cultural dimensions
First, Brussels city exemplifies an extraordinary political,
financial and specialized pertinence. Just like other cities and
region in Europe, Brussels was devastated by the financial crisis
which led to severe cuts in public funding especially in the last
few years. However, the city’s perseverance and resilience of
the local art scene has undeniably remained intact and has no
signs of weakening or declining (Phalet & Swyngedouw, 2013).
The home of associations and organization with global

8. dynamics has always been on the front foot in envisaging
powerful mechanisms of steering innovation and improvement
through its municipality structure (Petit, 2016). The
municipalities in Brussels pay a yearly contribution in reducing
proportion to their population which is calculated according to
the infrastructure for the elderly and the population figures.
Brussels also capitalizes on progress and more flexible ideas of
the subject as it seeks to ensure that its people, especially those
who are less privileged such as the youth and the elderly,
acquire distinctive services. While there has been increased
social and economic evolutions over the past two decades,
social institutions in Brussels has continued to deteriorate
leading to growing social inequalities and higher rates of
unemployment primarily due to the evolution of the labor
demand. However, the city continues to work on unique ideas
which aid in including both skilled and semi-skilled workers
which play a significant role in ensuring that the state of the
economy does not aggravate further (Swyngedouw & Baeten,
2001). 82 percent of expats in Brussels value the city's cultural
ideological which in turn influence their choices while the
cultural ideologies do not merely teach by are known to convey
an additional component of motivation to their reality. The city
is open to culture and is profoundly influenced by other cultures
primarily from France and Netherlands thus always cultivating
on improvement. Brussels continues to enhance its control of
the general populace space as well as new applications to good
living via ensuring technical knowledge amongst its youths
(Prange, 2005). The critical Wiels art center provides excellent
insight into the diversity of contemporary art in Brussels while
urban trends of life enhance access, training, and jolts to a
culture that is profitable to youngsters. Furthermore, the youths
have advanced a few ventures which interface the city, its
digital space as well as culture.
Organizational structure- The way organizations are structured
in the country
When it comes to the organization structure, power is mostly

9. centralized with the superiors having more privileges and are
often inaccessible. Furthermore, social inequalities in the
country are allowed with the attitude towards managers being
mostly formal. Information is also controlled by power and
usually is unequally distributed depending on the level of
management, administration, and control (Phalet &
Swyngedouw, 2013).
Individual and private opinions are more factored with more
people seeking to take care of themselves as opposed to
belonging to a group. While the city is highly inhabited, people
are only supposed to voice their opinions towards those who
hold less power or their peers. The managerial focus in the
country is mainly in the European Union, and it is thus named
alongside the municipalities as the capital of the EU. Brussels
also comprises the tremendous focal town and specific regions
that are inside the noteworthy Brussels-Capital Region (Petit,
2016). Training and teachings in the city are more deductive
while rules and security are welcome in the management
structure. Thus, planning is favored while some level of
expertise is always welcome.
Nepotism
In 1999, before the end of the Santer-led Commissions,
cronyism thrived in the Europe ruling squad although it would
later come to an end as the ruling faction resigned. As members
of the European commissions, Brussels had to adhere to a code
of conduct. Today, nepotism has been seen to return with more
incline on ethnic associations. With the recovery of the Flemish
dialect having been met with substantial protection from
political groups as well as Francophone foundation, the Walloon
development came up thus connecting with the Francophone
communist group (Swyngedouw & Baeten, 2001). The Flemish
political groups brought about changes to ensure that their
dialect was successful against the already dominant
Francophone. There has also been an extraordinary of the rights
group, for example, the Vlaams group, a secessionist and far-
right political party that pushes for an anti-immigration

10. platform especially in Brussels. The Vlaams group embrace the
Flemish nationalism ideologies and have been calling for the
independence of the Flanders since it was formed in the late
1970s (Prange, 2005).
Furthermore, there has been increased hatred worker groups and
the national state in Brussels, especially in the recent times.
While most people in Brussels tend to stick to their roots, there
has been the increased rise of expatriate Belgian community
made up of business people who largely reflect natural
flexibility and pragmatism in the mind-set of the Belgians a
well as cultural ambiguities. Additionally, the rehabilitation of
the Flemish language was highly resisted by political parties as
well as Francophone establishment (Petit, 2016).
The scientific question has always been a source of ethnic
ensure in the capital. In fact, a Walloon movement which was
mostly connected to the Francophone socialist party came up in
the Flemish movement reaction. Despite the fact that the
Flemish are the majority regarding population density, their
parties have continued to promote reforms meant to protect their
language against the domination of the Francophone (Phalet &
Swyngedouw, 2013). This has continued in different areas
including the organizations thus bringing about increased cases
of nepotism among the residents of Brussels. The Flemish also
claim that following the emigration of Francophone inhabitants
of Brussels to other areas in the surrounding villages resulted to
inflation in the real estate prices thus making it impossible for
the staying of the Flemish population. There is thus need for
behavioral guidelines to ensure there no door for fiddling.
References
Petit, F. (2016). By people/in cities: Brussels city profile.
Culture 360. Retrieved from
https://culture360.asef.org/magazine/peoplein-cities-brussels-
city-profile.
Phalet, K., & Swyngedouw, M. (2013). Measuring immigrant

11. integration: the case of Belgium. Studi Emigrazione, 773-804.
Prange, S. (2005). Nepotism returns to Brussels. Cafebabel.
Retrieved from http://www.cafebabel.co.uk/article/nepotism-
returns-to-Brussels-2.html.
Swyngedouw, E., & Baeten, G. (2001). Scaling the city: the
political economy of local'development-Brussels' conundrum.
European Planning Studies, 9(7), 827-849.
Analysis of Human Resource International Management
1
Analysis of Human Resource International Management and
Barcelona Healthcare
2
Barcelona 9-11
Healthcare Management
Barcelona hosts one of the biggest and leading hospital in
Spain; the Hospital Vall d’Hebron. The hospital has four centers
which include maternity, general hospital, pediatric and
traumatology centers. The hospital also offers outpatient
services. Besides this hospital, there are also a number of
hospitals in Barcelona which in both public and private sectors.
In trying to analyze the Healthcare of Barcelona City, it is
important to look into the pros and cons of healthcare in this
particular city.
One of the advantages of Barcelona healthcare is that the city
has a lot of public hospitals. The public hospitals include but
not limited to Hospital de Mar, Hospital de Sant Joan de Deu,
hospital Santa Creu I Sant Pau. With many health centers in
within the city, many people do not waste time in the long
queues in an attempt to get healthcare services. This means that

12. emergency and casual departments of healthcare centers in
Barcelona are not too busy to save lives in cases of
emergencies.
It is also important to note that Barcelona hosts one of the
biggest hospitals in the country. This means that there is a
number of services within reach for Barcelona people. The
hospital (Hospital Vall d’Hebron) has over four centers that
handle different healthcare issues. One of the centers in this
particular hospital is the “general hospital” where individuals
can access the general health care services. There is also a
section of maternity where the mother care services are given.
The pediatric center is also available where the city children are
taken care of. There is also rehabilitation centers under this
particular Hospital where citizens with drug addictions are
getting services to better their lives.
There are also a number of private hospitals in Barcelona. This
helps patients who wish to seek private services to achieve their
dreams. Presence of private hospitals in the city reduces the
pressure on the public hospitals hence emergency issues can be
attended to in time. Another advantage of Barcelona healthcare
is that the private hospitals also allow those with healthcare
insurance to get their services. Healthcare centers in Barcelona
also allow those Barcelonans with E-111 to receive free
treatments for three months.
Almost all hospitals in Barcelona offer outpatient services.
Outpatient services give people less restrictive policies hence
patients do not have to stay for a prolonged period of time in
hospitals. This assists those patients who want to keep some of
their commitments while at the same time seeking medical
services.
In general, the healthcare system in Barcelona is quite
impressive, especially in the private sector. All legal residents

13. of Barcelona are eligible for receiving public healthcare in their
entire life provided you have your social security number.
Contrary to the good features of Barcelona healthcare programs,
there are also a good number of practices within the healthcare
of Barcelona which do not give good impressions at all. Of the
cons of Barcelona healthcare is that the dentists of almost all
health care centers do not get healthcare coverage. Meaning
patients with healthcare problems are likely to use their own
funds in getting g health care services in this town. The social
security healthcare also does not cover the opticians. Citizens in
Barcelona, therefore, will part with some funds to access optical
services. Another disadvantage is that the private health centers
in Barcelona tend to give qualified services but at a very high
cost. It is therefore very expensive for low-income earners to
access healthcare services in Barcelona.
Barcelona is one of the largest cities in Spain with a population
of 1.6 million. The city has a mix of cultural dimensions that
can really affect its functionality in housing business operation.
In an attempt to analyze international human resource
management of this city, some of the cultural dimensions that
are seeming to affect its capability in housing business
operations include but not limited to individualism, uncertainty
avoidance as well as indulgence/restraint and masculinity-
femininity.
Performance-oriented dimension will impact the Barcelona’s
ability to house the business. Appadurai, (1996) defines this
dimension as the rate which excellent performance and
innovations are encouraged and rewarded. Dimension gives a
positive attribute towards Barcelona giving the business a good
opportunity for its operation. The culture of Barcelona people
upholds this dimension and values competitiveness as well as
materialism. Their expectation will be the business to invest a
lot in training to promote improvements and performance.

14. Masculinity-Femininity culture dimension will also affect
Barcelona. This dimension gives a positive effect on Barcelona
to hoist the regional headquarters for the business. A feminine
society is one that gives a slight differentiation between the
genders in the society. The culture of Barcelona upholds this
dimension as most of the people are from both genders now
joins high learning institutions and joining professions that
were previously occupied by one gender. Operating in a
feminine culture will boost the operations of the business as
there will never going to be issues of role-playing in the
business organization?
Indulgence and restraint cultural dimension in Barcelona is a
key factor in thriving a business in this location. Indulgence is a
cultural value that tends to give control of personal life.
Restraint tries to give a perception of helplessness.
(Appadurai,1996). That what happens in one's life is far beyond
their control. The location gives a culture of indulgence as the
people of Barcelona feels that they have a total authority and
control over their future levels of functionality. This will mean
that the business will be operating in an environment with a
workforce that is focused and future-oriented.
A Spanish organization structure provides a hierarchal system
of the structure. The Spain business hierarchy is dominated by
individualism and the value of teamwork is not important.
However, this is changing at a faster rate as it was majorly
practiced in the traditional Spanish structures. The organization
structure in Spain is made in such a way that the top most
people in the organization are the managing directors. The
structure treats this position to be occupied by the owner of the
company or organization. The position is tasked with taking
major decisions and making the strategic plan for the business.
The future of the company will, therefore, depend on the skills
and capabilities of the person sitting in this position. It is

15. therefore very important to have this position under a very
capable individual.
The structure gives the position of the board of directors just
after the managing directors. The Spanish organization structure
defines the key responsibilities of this position as to evaluation
of the performance of the senior level managers as well as
looking into the financial viability of the organization. It will
be therefore important for the business to ensure that their
boards of directors are people who are capable of executing the
said tasks as well as tackling other stakeholder’s concerns. The
position is also a key to organizations future.
The structure also gives the position of senior managers. This
position should be made up of individuals capable of dealing
with resources of the organization. The organization, therefore,
should strive to fill this position with individuals who are
capable of motivating the subordinate staff to ensure that they
give their best towards the achievement of the company goals.
This position is tasked with making improvements on the
standards of work and services in the organization.
There is also a position of executives in the structure.
Executives in the Spanish organization structures enjoy the
challenging and exciting position. (Masuda & Visio, 2012). It
combines many things such as negotiation and closing of deals,
sales and marketing. The position helps the company to grow
through direct or indirect revenue generation. The position
holder also builds the company’s resources by meeting with
potential partners and stakeholders. The staffs are the last
position in the organization's structure in Spain. They are
responsible for implementing the policies of the company. The
staffs are considered to be the company’s greatest asset. They
are composed of both skilled and non-skilled laborers. The
current organizational structure of Spain is undergoing
numerous influences from outside and it is belied there will be

16. the effective adoption of busi9ness etiquette culture that will
lead to high business growth.
Nepotism is the act of favoring relatives or friends in a work
environment. (Masuda & Visio, 2012). Spain is considered to be
one of the countries affected most by this act. Some people may
argue that it is the best place to live and the worse place to
work. It is most affected by nepotism and lack of transparency.
In trying to establish the organization's headquarters at
Barcelona, it would be important to evaluate some of the effects
nepotism will have in this venture. Having the regional
headquarters situated at Barcelona will mean that the company
will have to employ Spain nationals to head different
departments as well as the subordinates. This attitude of
nepotism, it is likely that the organization will be affected in
several ways such as lack of control.
When the staffs employed were recruited on the basis of
nepotism then controlling such staff will be a nightmare. The
managers will lack the ability to exercise control and authority
over their subordinates because of the relations that exist
between them. This will seriously affect the operations of the
organization. Involving relatives in the company also spoils the
company’s ethics. This will affect both the company and the
employee morale to give their best. Any level of nepotism in an
organization ruins the good image of an organization as well as
its culture.
Having family members and friends working together in a
company may bring so many issues from their past personal
lives which later evolve to big problems for the company
leading to interference of its key operations. To end this act, it
will be proper for the organization to ensure that all its
recruiting processes are transparent. It should have a laid down
strategies for making all its recruitment processes transparent
before establishing its headquarters at Barcelona.

17. Reference
Appadurai, A. (1996). Modernity at large: cultural dimensions
of globalization (Vol. 1). U of Minnesota Press.
Guillén, M. F. (2001). The limits of convergence: Globalization
and organizational change in Argentina, South Korea, and
Spain. Princeton University Press.
Masuda, A., & Visio, M. (2012). Nepotism practices and the
work-family interface. Nepotism in organizations, 147-170.
Schwartz, S. H. (1994). Beyond individualism/collectivism:
New cultural dimensions of values. Sage Publications, Inc.