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HAS 3000-The Healthcare System

Assignment Parameters:

  • Each student or team must select a topic from the list provided by the professor and schedule a time to make their presentation.
  • The paper and presentation should discuss all sides of the issue and the impact that alternative courses of action may have on the health care system.
  • The paper should provide current information on the topic, updating data in the text.
  • The purposes of the presentation are to demonstrate a well-rounded understanding of the topic on the part of each team member and to provide the class with in depth information on a current issue in American health care.
  • Papers must be presented in good form and must cite at least five sources from current (2001-present) journals or periodicals. Must be at least 10 full pages, double spaced, but not more than 15 pages.

Table of Contents

Possible Term Paper Topics

Prescription Drug Costs and Financing

  • How much have prescription drug prices and total costs risen in the last 10 or 20 years? What are the factors in this increase? What has been the impact on consumers, insurance plans, employers, governments? What are insurance plans and Medicare doing or talking about doing to control costs? What are the pros and cons of the major alternatives?


Liability and Tort Reform

  • What impact do liability/malpractice losses have on the healthcare system? What major reforms have been enacted or are under consideration? Discuss the pros/cons of each.

Current and Projected Status of the Medicare Program

  • How much is the accumulated surplus or deficit of the program? What has its yearly surplus/deficit been in recent years? What is projected for this year and the future? What is the projected impact of reforms that have been enacted in the last five years? What reforms are under serious consideration and what is their projected impact?

Healthy People 2010

  • Describe this initiative. How is it funded and who oversees it? Who participates? What are its main goals? How does it compare with Healthy People 2000? What progress has been made toward the goals? Be sure to use journal articles commenting on the initiative and not just the Healthy People web sites.

Current and Projected Supply of Caregivers

  • Discuss physicians, both primary care and specialists, as well as other caregivers such as nurses, therapists, physicians' assistants, etc. What is the overall supply versus demand as well as the distribution? What is projected?

Impact of Managed Care

  • Discuss impact on physicians, hospitals, and other providers. Discuss financial impact as well as impact on quality and job satisfaction from the point of view of providers. What changes have consumers had to make as they moved from traditional insurance to managed care plans? How do consumers feel about managed care plans? (Be sure to quote valid sources--not just personal opinions!) How have managed care plans impacted total health costs in America? What measurable impacts are there on quality and access?

Consumer Driven Health Care

  • Backlash against restrictions has led to a weakening of managed care controls and resurgence in health care costs. Many articles recently have examined a new approach labeled consumer driven health care or defined contribution health benefits. What are the key elements of this approach? How is it different from managed care? What does current literature suggest to be advantages, concerns, and the projected future for this approach?

Alternative Medicaid Systems

  • What are the main issues that Medicaid programs have struggled with in recent years in Utah and nationally? What strategies has Utah implemented? What strategies have some other states used? Be sure to include data that measure the success or failure of these alternatives.

National Health Insurance

  • Does national health insurance work in a free market economy? Socialized medicine has been touted as the solution for improving access, quality and cost for the U. S. Health system. In the past other countries such as Canada, Germany, U.K. and Sweden have been used as examples where socialized medicine works. In the last few years there have been troubling reports of problems funding health care and increased limitations on access for citizens of those countries. What can we learn from the experience of other nations and how would it work or not work in the United States?

Medicare Reforms of 2003

  • Describe the main points of the Medicare Prescription Drug, Improvement, and Modernization Act that was enacted late in 2003. What are the major impacts expected to be? Be sure to talk about access, quality, and cost.

Mandated Insurance Coverage

  • In April 2006 Massachusetts enacted legislation requiring everyone in the state to have health insurance. Describe the law and how insurance will be paid for different groups of people (covered through employer, not covered through employer, high income, low income, etc.). What advantages and disadvantages of this approach have been described in the literature? Have other states enacted or seriously considered similar legislation?

Books on Managed Care & Other Healthcare System Issues

  • A second opinion: Rescuing America's healthcare: A plan for universal coverage serving patients over profit RA395.A3 R45 2007 (one copy each at Stewart and Davis libraries)
  • Fads, fallacies and foolishness in medical care management and policy R729.5.H43 M37 2007
  • Health care at risk: A critique of the consumer-driven movement RA394.J67 2007
  • Health care politics, policy, and services: A social justice analysis RA395.A3 A4795 2007
  • Health care reform now!: A prescription for change RA395.A3 H3449 2007
  • Restoring fiscal sanity 2007: The health spending challenge RA410.53.R488 2007
  • Sick: The untold story of America's health crisis-and the people who pay the price RA395.A3 C635 2007
  • Medicine and the market: Equity v. choice RA410.53.C352 2006
  • The Elgar companion to health economics RA410.E46 2006
  • Medicare: A policy primer RA412.3.M658 2006
  • The truth about health care: Why reform is not working in America RA395.A3 M4184 2006
  • Medicare matters: What geriatric medicine can teach American health care RA412.3.C39 2005
  • Essentials of the U.S. health care system WSU Davis RA395.A3 S486 2005
  • Managed care and monopoly power: The antitrust challenge  RA395.A3 H32 2003
  • The ethics of managed care: A pragmatic approach RA413.A618 2001
  • Medical justice: A guide to fair provision  RA445.A95 2001
  • Code Blue Archives RA413.5.U5 M33 2000
  • Case management: A practical guide to success in managed care  RT90.7.P67 2000
  • Good but not perfect: A case study of managed care RA413.E66 2000
  • The economic evolution of American health care: From Marcus Welby to managed care RA413.D73 2000
  • Organization ethics in health care RA413.O74 2000
  • Regulating managed care: Theory, practice, and future options KF1183.R44 1999
  • Managed care:  Financial, legal, and ethical issues  RA413.M264 1999
  • Understanding the U.S. health services system RA395.A3 B27 1999
  • Ethical challenges in managed care: A casebook RA413.E876 1999
  • Managed care and the inner city: The uncertain promise for providers, plans, and communities RA413.5.U5 A57 1999
  • Managed care contracting: A practical guide for health care executives RA413.5.U5 G37 1999
  • Managed care: What it is and how it works RA413.5.U5 K655 1998
  • Managed care ethics: Essays on the impact of managed care on traditional medical ethics R725.5.L3 1998
  • Managed care and public health RA395.A3 M356 1998
  • Integrating managed care and ethics: Transforming challenges into positive outcomes RA413.5.U5 R58 1998
  • Health care in the United States: The facts and the choices RA395.A3 A96 1996
  • Essentials of managed health care RA413.E87 1995
  • Medicine's dilemmas:  infinite need versus finite resources  RA410.53.K55 1994
  • The private regulation of American health care  RA395.A3 L496 1994
  • Beyond crisis: Confronting healthcare in the United States  RA395.A3 B48 1994

Finding Articles

Use a combination of in health-related, business, and general databases for a more well-rounded presentation:

Tip:  You may search each database individually, or you may search Business Source Premier, Academic Search Premier, Health Source, MEDLINE, and CINAHL at the same time.  To do this, go to the EbscoHost list, select all the databases you want to search, and click the continue button at the bottom of the screen.

Also, remember that you only want articles published from 2001-present.  Newer articles will appear first in your search, so you may only need to look at the first few screens.  You may also limit your search to articles in that time frame to retrieve fewer results.

Healthcare Statistics & Demographics Sources

Utah Sources

  • Kids Count Data Book Reference Table 5B  HQ792 .U5 K53
  • Utah Health Profile  RA447 U8U8  
  • Utah's Vital Statistics - Abortions  Reference HQ767.5 U5S745
  • Utah's Vital Statistics - Births and Deaths   Reference  HA 661.U838 
  • Maternal and Infant Health  Reference RG 961.U8R4
  • Child and Adolescent Hospitalizations for Most Frequent Conditions in Utah Reference RJ 242.C46 
  • Suicide in Utah   Reference HV 6548.U5S8552
  • Utah Youth Household Survey on Substance Abuse 1997   Reference HV 4999.3.U8U80
  • Mortality by Cause, Sex, Age and Autopsy, Residents: Utah 1998     Reference HB 1355.U8M66
  • Leading Cause of Death in Utah by Age and Sex  Reference  HB 1355.U8L4 
  • Injuries in Utah  Reference HB 1323.A2I15
  • Women's (and Men's) Health in Utah   Reference RA 410.8.U8W65
  • Community Health Status: Selected Measures of Health Status by Small Area in Utah   Reference RA 447.U8C6 
  • Chronic Medical Conditions in Utah  Reference RA 407.4.U8C4 
  • Measures of Child Well-Being in Utah HV 742 .U8 M43 - Table 5B
  • Mortality by cause, sex, age and autopsy, residents: Utah HB 1355 .U8 M66 T3b
  • Statistical Abstract of Utah HA661 .S723 - Ref Desk
  • Utah's Health, An Annual Review RA395 .A4 U83
  • Utah Public Health Outcome Measures RA407.4 .U8 U826
  • Overview of the 1996 Health Status Survey   Reference  RA 161.O7 1998 
  • Kids Count Data Book   Reference Table 5B  HQ792 .U5 K53
  • Measures of Child Well-Being in Utah    Reference Table 5B  HV742 .U8 M43
  • Health Care State Rankings RA407.3.H423 - Reference Table 5B
  • Women's Health in Utah  1996 RA 407.4 .U8 W6 - Reference
  • Utah Dept. of Health
  • Utah Health Care Statistics
  • IBIS  Utah Department of Health Indicator Based System for Public Health
    Health Care Statistics, Vital Statistics & Records,  Public Health Assessment.  IBIS-PH Provides a primary point of access to a variety of information available through the Utah Department of Health, including reports, health measures, and numeric public health data. 
  • Utah Health Facts from the National Center for Health Statistics
  • Substance Abuse in Utah
  • Utah - County Quick Facts
  • Utah County Demographics and Economics
  • American Factfinder Provides statistical data at the zip code level (use the Fact Sheet option at the top of the page)
  • Utah Agency List
    Scroll down to Health or Human Services for links to Utah government agency sites.


US Sources

  • Centers for Disease Control and Prevention
  • MMWR: Morbidity and Mortality Weekly Report
  • National Center for Health Statistics
    Collects and analyzes and disseminates health statistics, such as the U.S. Vital and Health Statistics
  • WHO Statistical Information System (WHOSIS)
    Statistical reports on many topics. From the World Health Organization.
  • Statistical Abstracts of the U.S.
    Since 1878, the Statistical Abstract has been the single most authoritative source of facts about the people, institutions and economy of the country. This is a publication of the Census Bureau and is compiled from government and private sources and is an excellent place to start when looking for statistics.  This is an annual and covers a broad range of topics, mostly United States, but includes some international.   Most recent print edition is located at the Reference Desk.
  • U.S. Census Bureau
  • Health, United States 
    "Health, United States presents national trends in health statistics on such topics as birth and death rates, infant mortality, life expectancy, morbidity and health status, risk factors, use of ambulatory care and inpatient care, health personnel and facilities, financing of health care, health insurance and managed care, and other health topics. " HE 20.7042/6: - Reference Table 5B.  Older editions are in Government Documents. 

  • Statistical Record of Health & Medicine  
    "This book provides statistics on : health status and lifestyle of Americans; health care establishments; health care programs; medical professions; politics, opinions, and law; medical practices and procedures; health care costs; and international rankings and comparisons. Data gathered from approximately 300 sources including the U.S. federal government, newspapers, business periodicals, trade magazines, association publications, and others. The source is listed for each set of statistics. The Keyword Index is cross-referenced for easy access."  RA 407.3H423 - Reference Table 8B.

  • Health & Healthcare of the United States  
    Compilation of demographics, vital statistics including births and fertility as well as  deaths and causes, healthcare resources including healthcare personnel and  facilities, and Medicare data.  Data has been compiled from various federal and  private sources and is available at the county and metropolitan area level.  LB 2846.6E38 - Reference Table 8B.
  • Mental Health, United States  
    "Provides summaries of statistical information on topics that will be of concern in health care reform. Covers such topics as: policy considerations; behavioral managed care approaches; managed behavioral health care; behavioral health care in HMOs; mental health epidemiological data; Medicare and Medicaid programs on mental health; mental health services in rural areas; and data on mental health providers."  HE 20.8137: Reference Table 8B.

  • Injury Facts
    National Safety Council - "Source of accurate, comprehensive & objective statistics on unintentional injuries, their costs, trends and other characteristics.  New estimates of deaths, disabling injuries and costs for 1998 Final mortality statistics for 1996,  Updated occupational injury and illness incidence rates from BLS (for 1997), and the Council's Occupational Safety/Health Award Program (for 1998), new information on lifetime risk of fatal work injury,  occupational risks to young workers, new information on length of disability due to upper extremity musculoskeletal disorders, new research on the effects of recent speed limit increases, Current data on the nature of injury in home fire deaths, & new data on commercial chemical incidents."  Formerly known as Accident Facts.

  • Vital Statistics of the United States 
    National Center for Health Statistics. Detailed statistics on marriage, divorce, abortions, and mental health hospitalizations.  HE 20.6210 - Government Documents.  1988-1996 in print.  1994-2002 online. National Vital Statistics Reports are online also.

  • Health Care State Rankings  
    "This annual publication contains over 500 tables ranking each of the fifty states by a variety of health and medical service criteria. Broad categories include births and reproductive health, deaths, medical facilities, finance, incidence of disease, medical providers, and physical fitness."  RA 407.3S732  Reference Table 8B.

  • Best of Health: Demographics of Health Care Consumers  Reference Table 5B
  • Healthy People 2010   
    "Healthy People 2010 is a national health promotion and disease prevention initiative that brings together national, state, and local government agencies; nonprofit, voluntary, and professional organizations; businesses; communities; and individuals to promote the two overall goals of:  Increased quality of life and years of health life and the elimination of health disparities."     HE 20.2 P 39 Government Documents   Also  online
  • Center for Disease Control Data & Statistics  
  • White House Social Statistics Briefing Room
  • Statistical Resources on the Web- Health
    University of Michigan


International Sources

  • World Development Indicators, 1998  Reference Table 5B
  • Statistical Abstract of the World  Reference Table 5B
  • Europa World Yearbook  Reference Table 5A

Organization Web Sites

Citing Sources

Be sure to completely and accurately cite all of the sources you use in your paper!  Accurately documenting sources used for research is an important part of the writing and research process. Documentation is important because:

  • It is used to give credit for information originally written elsewhere.
  • Documentation enables others to find the same information again.
  • Failure to give credit for drawing on the work of others constitutes plagiarism.


A proper citation should include the following information when relevant:

  • Author(s)
  • Title of book or title of journal article
  • Source information
    • For an article (publication name, volume, issue, year, page numbers)
    • For a book, or other item (publisher and place of publication)
  • Date published ( for most items)
  • URL with date retrieved (for Web sites)
  • Database where information was retrieved (for many electronic publications)


APA and MLA are the two most popular citation styles for undergraduates. See the Stewart Library guide on citations or use the links below to view citation examples.

  • APA American Psychological Association
  • MLA Modern Language Association

For more information on citing sources using APA consult the Publication Manual of the American Psychological Association, Fifth Edition (2001).  For complete rules and guidelines for MLA format see the 6th edition of: Gibaldi , Joseph. MLA Handbook for Writers of Research Papers.

Both of these sources may be found in the reference area of the Stewart Library.


Tips for a More Effective Search

  • RATS (Read All The Screens!):  Be sure to read the search screens on your database carefully.  Some databases only search a certain default time range (e.g. only six months).  You may have to change this in your search to find what you need.  Also, look to see what field options (title, author, company name, etc.) you have in your advanced search screen- this will really help you narrow down your search.  

  • PDF:   Some full text articles come in PDF format, which requires Adobe Acrobat software.  You can download this for free at home.   Downloading files using Acrobat can be very slow over a 56Kb modem, but many people do it.  If you are impatient, downloading articles from a student computer lab or any terminal with high-speed Internet access is a better option.

  • Printing, downloading, emailing:   Most databases provide you with the choice of printing, downloading, or emailing the full text of the articles to your email account.  Look for tabs or buttons on the database screens for these options.

  • Saving articles to disk:   When you save articles to a floppy or zip disk, make sure that you always save the file as a text file (.txt).  This way, it doesn't matter what word processing software you use (Word, Word Perfect, WordPad, NotePad, etc.); they all read text files.  If you are unsure how to do this, call the reference desk at 626-6415 and ask.

  • If you ONLY want full text , be sure to tell the database that's what you want.  On most databases, there is a 'full text only' box that can be chosen from the search screen.

  • Locating 'scholarly ' or 'professional' journal articles:  If you are required to use ONLY scholarly, academic, or professional business journals, most databases will have a 'peer-reviewed' or 'refereed' option to check on the search screen.  If you check this box, you will NOT get magazines or newspapers.

  • Customizing your search: 

    • To broaden your search, use truncation symbols.  Truncation will pick up any ending to a particular word.  For example:  market* finds articles with the word market, markets, marketing, marketer, marketers, etc.   Account? will find articles with the word account, accounts, accounting, accountable, accountancy, accountant, accountants, etc.  The symbols may be different for each database. 

      • ABI/Inform uses  the ?   

      • Business Source Premier, CINAHL, MEDLINE, Academic Search Premier, and Health Source use the *   

      • If you're not sure what the symbol for another database is, call the reference desk and ask (626-6415).

    • For a better, more customized search, always used 'advanced' search screens .  These will give you multiple search boxes, instead of just one, and most will offer various fields for a more narrow search.  For example, when searching for information on a specific company, use the 'company name' field instead of just typing in the company name.  That way, you'll pull up articles that focus on your company, instead of those that just mention your company somewhere in the article.


Research Assistance

When searching for materials, try a variety of databases- ask a librarian for suggestions based on your topic.  Remember- different databases will have different coverage, and will look a little different.  One good strategy is to try to find one or two GOOD articles- once you've found them, look at the terms they use, and try another search using those terms.  For more detailed information on finding full text articles from business database, see 'finding full text articles online'.

GET STARTED EARLY!  If you can find it, we can get it, but you need to start your research early.  You might find some really great stuff that is not available in full text, or articles from journals that we don't have access to.  If this is the case, all you have to do is use our Interlibrary Loan service.    These things might take a few days or a week.

Remember that you can always ask me for help:

G. Megan Davis

Health Sciences Librarian

Room 149, Stewart Library


If you STILL can't find exactly what you need, or have questions...

  • CALL the Reference desk at:  626-6514
  • CLICK on the Live assistance button for real time help during library hours.
  • Email us at
  • or COME IN! The Reference Desk is on the main floor, North.

Updated January 8, 2009 . Please send comments to Megan Davis
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