Disc one to three

M2D2: Cost, Quality, and Access

No unread replies.No replies.

In his 1994 book Medicine's Dilemma: Infinite Needs versus Finite Resources, Dr. William Kissick describes what he refers to as health care's "iron triangle". His discussion is based on three key aspects of health care - cost, quality, and access - and the inherent tension between them. His argument, one that is still widely agreed upon (though still hotly debated) over 20 years later, is that it is impossible to have all three of these things at the same time. That is, a health system cannot be low cost, provide high quality care, and allow full access to all people at the same time. Therefore, a health care system must choose which of these three characteristics to prioritize. The question is, which of these three is the most important and how does a health care system decide how to make that decision.

Kissick, W. L. (1994). Medicine's dilemmas: Infinite needs versus finite resources. New Haven: Yale University Press.

For this discussion, you will engage in a modified form of a debate with your classmates regarding which of the three “iron triangle” characteristics is the most important. You will be assigned one of the three aspects (see the instructor’s announcement for your assignment), which you should advocate for as the most important characteristic of a health system to focus on. Your initial post should “stump” for your assigned side by using thoughtful arguments, supported by our readings or other scholarly sources as appropriate. You will then respond to two of your classmates who focused on a different aspect and debate why your assigned aspect is more important than the one they discussed. You should also respond to all of the people who responded to your initial post to refute their arguments.

In your initial post:

· Describe the aspect of "iron triangle" of health care you were assigned.

· Justify why your assigned aspect is more important than the other two.

In your peer responses:

· Compare and contrast your assigned aspect with the aspect discussed by your classmate.

· Refute your classmate's claims that his/her described aspect is the most important.

· Summarize why your assigned aspect is most important to focus on.

· Determine if there is a way to balance the aspects without sacrificing in one area.

· Refute the arguments of your classmates who posted a rebuttal to your initial post.