Igelhart, "The American Health Care System: Introduction" NEJM 1992;326:962-967

• Low Taxes and High Expectations
• The Government’s Growing Role
• The Spectrum of Health Care Financing Systems
• Supplements to Market-Based Insurance
• Medical Care for Veterans
• The Unisured
• The Price of Conflict

Iglehart, "THe American Health Care System: Medicare" NEJM 1992;327:1467

• Benefits
• Financing
• Payment
• Quality
• The Future

Igelhart, "The American Health Care System: Medicade" NEJM 1994;330;498

• The Evolution of the Program
• The Expansion of Medicaid
• The Explosion in Costs
• Donations by Providers and Taxes
• Access and Quality of Care
• Managed Care
• Conclusiosn

Light DW, "Life and Death and the insurance companies." NEJM 1994;330:498

Mick, S. Moscovice, " I. Health Care Professionals," ch 10 in Williams &Torrens, 269-274; 278-281; 291

• Employment Trends in the Health Care Sector
• The Expanding Supply of Physicians

Davids-Floyd, R. "Obstetric Training As a Rite of Passage" Medical Anthropology Quarterly, V. 1, N3

• Methods
• Obstetrical Gnosis: The Technological Model of Birth
• Processing of Psychological Transformatin: Medical School and Obstetrical Training
• The Future of the Technological Model

Wennberg, et. al. "Hospital Use and Mortality among Medicare beneficiaries in Boston and New Haven." NEJM 1989;3321:1168

• Results

Numbers, "The Third Party: Health Insurance in America," Leavitt & Numbers, 133-247

Reinhardt, "Reorganizing the financial flows in American health care," Health Affairs, 1993l12 Suppl:172-93

• Two Facets of Health Care Financing
• Financing the Collective Insurance Fund
• Disbursing Funds to Providers
• Conclusion: On the Vertiue of HIPCs

Casalino LP. "Balancing Incentives: How should physicians be reimbursed?" JAMA 1992;267:403

• Current Payment Methods: Incentives to do too much or too little
• Primary Care Physician Reimbursement
• Specialist Reimbursement
• One Payer or Many?

Igelhart, "Medicare begins prospective payment of hospitals." NEJM 1983;308:1428

Fuchs VR, "No Pain no Gain: Perspectives on cost containment." JAMA 1993;269:631

• Two Bad Reasons
• Three Good Reasons
• Why Pain is Inevitable

"Total Hip Replacement" NIH consensus conference, JAMA 1995; 273:24: 1950-1956

• 1. What ar ethe Current Indications for Total Hip Replacement (THR)?
• 2. What ar the Design and Surgical Considerations Relating to a Replacement Prosthesis?
• 3. What are the Responses of the Biological Environment?
• 4. What are the Expected Outcomes?
• 5. What are the Accepted Approaches and Outcomes for Revision of THR?
• 6. What are the most Productive Directions for Future Research?
• Conclusions

Mayor & Collier, "The Technology of hip replacement" Scientific American Science & Medicine, May/June 1994 vol 1 n 2:58-67

• Hip Arthroplasty Has a Long History
• The Charnley Total Hip Is the Standard
• Techincal Problems Limit Implant Longevity
• Implant Materials Have Evolved
• Modifications in Use of Cement Reduce the Rate of Failure
• Computers and Robots are Coming into Use

Relman AS. The new medical-industrial complex." NEJM 1980;303:963

• The New Medical-Industrial Complex
• Income and Profitablility
• Why Have private Businesses in Health Care?
• Some Issues
• The Role of the Medical Profession
• Other Problems
• Some Proposals

Luce, B. "Medical Technology and its Assesment." Chapter 9, in Williams and Torrens, 245-251; 254-268

• Innovation, Development, and Diffusion
• Organizing for Technology Assesment
• Methods for Assesment
• Challenges for Technology Asessment

Koenig, Barbara, "The Technological Imperative in Medical Practice: The Social Creation of a ‘Routine’ Treatment," in "Biomeddicine Examined, Mararet Lock and Deborah Gordon, eds., pp. 465-496.

• Introduction
• Social Studies of Medical Technology
• The Routinization of Technology Use
• A Case Study of Therpautic Plasma Exchange (TPE)

Locarlio AR et al. "Relation between malpractice claims and adverse events due to negligence." NEJM 1991;325:245

• Results
• Discussion

Leape, L. "Error in Medicine." JAMA, 1994, 272: 1851-57

• Why is the Error Rate in the Practice of Medicine so High
• The Medical Approach to Error Prevention
• Lessons from Psychological and Human Factors Research
• A Theory of Cognition
• Mechanisms of Congintve Erros
• Latent Errors
• Prevention of Accidents
• The Aviation Model
• The Medical Model
• Hospital Changes to Reduce Hosptial Injuries
• Institutionalization of Saftey
• Implementing System Changes

Singer, "Euthanasia-a critique," NEJM, 1990;322:1881-1888

• Critique of the Case for Euthanasia
• The Case Agasint Ethanasia
• Conclusions

Quill, "Doctor, I want to die. Will you help?" JAMA 993;270:870-873

• The Wish to Die
• The Request for Help in Dying
• What do Dying Persons Want Most from their Physicians

Quill, "Death and dignity: a case of individualized decision making" NEJM 1991; 324: 691-694

Pellegrino, "Compassion needs reason too" JAMA 1993;270:874-875

Young, "Patent Medicines and the Self-Help Syndrome," Leavitt & Numbers, 71-78

Bartecchi et al. "The human costs of tobacco use." NEJM 1994;330:907;975

• The Human Costs of Tobacco Use
• Cardiovascular Disease
• Cancer
• Lung Disease
• Children and Adolescents
• Women
• Minorities
• The Elderly
• Economic Costs of Tobacco Use
• The Tobacco Industry
• The Campaign to Prevent Tobacco Use

Bartecchi et al. "The human costs of tobacco use." NEJM 1994;330:907;975

• Tobacco 400,000 19%
• Diet/activity patterns 300,000 14%
• Alcohol 100,000 5%
• Microbial agents 90,000 4%
• Toxic agents 60,000 3%
• Firearms 35,000 2%
• Sexual behavior 30,000 1%
• Motor vehicles 25,000 1%
• Ilicit use of drucs 20,000 <1%
• Total preventable causes: 1,060,000 50% of deaths
• Comments and Conclusions

Eisenberg, et al. "Unconventional medicine in the United States" NEJM, 1993; 328: 246-252

• Discussion

Reinhardt "Reforming the health care system: the universal dilemma" American Jouranl of Law and Medicine, 1993; 19(1-2):21-36

• Introduction
• Controling the Transfer of GNP to Providers
• The Economic Footprints of these Approaches
• The Convergence of Health Care Systems
• Conclusion

Relman AS "Controlling costs by managed competition: Would it work?" NEJM 1993;328:133

Igelhart, "The American Helath Care System: Manged Care" NEJM 1992;327:742-747

• Evolution
• Types of Manged Care Plans
• Costs
• Selecting Physicians and Influencing their Behavior
• The Future

Kassirer, "Managed Care adn the mortality of the Marketplace" NEJM 1995;333(1) 50-52