Navigating the Iron Triangle: Understanding Healthcare Policy in the U.S.
In the case of the US healthcare policy system, William Kissick’s iron triangle concept is quite valuable. In his 1994 book, “Medicine’s Dilemmas: Infinite Needs Versus Finite Resources,” Kissick mentions a triangle which has three major components: cost, quality, and access. It is called “iron” because of the great challenges that are associated with attaining one of these points in the triangle, which assists in clarifying the trade-off that is made by the policymakers and the mangle of the healthcare provision (Brunello, 2021).
Understanding the Interrelation
Balancing Cost, Quality and Access in Health Care Policy
For the purposes of this model, Maneuvering between cost, quality and access is placed in the center of the golden triangle, which is the iron triangle. Changes in one dimension of the triangle result in changes in the other two dimensions. Consider, for example, policymakers who implement legislation to expand Medicaid eligibility. This new law, while improving the population’s access to a greater scope of healthcare services, does so at the cost of heightened public expenditure because the government now needs to provide healthcare to a larger portion of the population.
Exploring Healthcare Policies: A Case Study
To jump further into the tangible impact of healthcare policy on the iron triangle, we should examine the Affordable Care Act (ACA), a landmark legislation aimed at overhauling the U.S. healthcare system (Wiegmann et al., 2021).
The ACA: A Balancing Act
Obamacare, or The Affordable Care Act, arguably sets the precedent of executing healthcare policies. With its wide ranging provisions, ACA attempts to increase the accessibility of healthcare services, improve their quality, and control costs.
Impact on Cost
The ACA affects healthcare expenses remarkably, and as with everything, it has features that are both positive and negative. As an example, the introduction of subsidies and Medicaids has resulted in the coverage of a greater population, therefore, the issue of considering uninsured citizens has also significantly improved. These elements have mitigated the economic cost for providers because of the unpaid care (Wilmoth et al., 2022). On the contrary, there has been an increase in government expenditure on healthcare subsidies which has emerged from more people flowing into the insured bracket, this trend has severely affected the government’s financial position.
Quality of Care
In terms of quality, the new regulations issued under the ACA do impact the provision of health care services specifically positively. The clauses in the ACA that focus on qualitatively centered care or accountable care organizations strongly incentivized the providers to increase their efforts on primary healthcare and introduced measures to improve the delivery of care services. But it is also accompanied by other difficulties which are mainly structural issues in provider networks and the vertical integration of healthcare services to different socio economic groups.
Conclusion
In summary, the most important aspects of the issue healthcare policy iron triangle has to offer is understanding relationships that exist within this context. Consider, for example, an analysis of an aspect of the Iron Triangle that was done in HS230 M2 Assignment. The initiative with the Affordable Care Act has increased scope and quality, however, issues still seem to abound with meeting these objectives in the face of increasing costs.
Now, with regard to the cost issues, policy makers need to ensure that equity, efficiency, and patient centered care are integrated with data analysis and policies that emerge from stakeholder participation. While trying to understand most pressing issues in healthcare policy one of the factors that is forgotten is the iron triangle, which is crucial to trying to guarantee that all citizens of America are served in an optimal, affordable, and high quality manner.
References
Boxall, A.-M. (2022). What Does the State Innovation Model Experiment Tell Us About States’ Capacity to Implement Complex Health Reforms? The Milbank Quarterly, 100(2), 525–561.
Brunello, G. <1997>. (2021). The provision of Healthcare in the United States before and after the introduction of the Affordable Care Act. A comparative institutional analysis of OECD countries.
http://dspace.unive.it/handle/10579/19801
Wiegmann, A. L., Young, E. I., Baker, K. E., Khalid, S. I., Seu, M., Shenaq, D. S., Dorafshar, A. H., & Schechter, L. S. (2021). The Affordable Care Act and Its Impact on Plastic and Gender-Affirmation Surgery. Plastic and Reconstructive Surgery, 147(1), 135e.
Wilmoth, M., Muthoni, C., & Tarr-Whelan, L. (2022). 14 – Mentoring in health policy: Moving more nurses into the arena. In D. Seibert, B. Malone, & P. DeLeon (Eds.), Shaping Nursing Healthcare Policy (pp. 167–180). Academic Press.