Introduction
Cost, access, and quality have long been considered the primary elements of the healthcare system. They are the main indicators of how well care is supplied to patients. These three measurements are incorporated into the “Iron Triangle” introduced by William Kissick in 1994. There was a time when care costs, accessibility, and quality were not static and caused adverse health outcomes (Vogenburg, 2019). Hence, it was necessary to balance these factors to make healthcare delivery more accessible and better by all means. Even though the elements seem to be functioning separately, they are interrelated in every sense.
Cost
A medical service, like any product, has a value, a monetary expression, which is the price. Prices for services consist of two main elements: costs and profits. Healthcare services are not ordinary commodities, the production, and consumption of which are determined by the effective supply and demand ratio. The price is formed based on the cost of providing paid medical services, taking into account the need for medical services and requirements for the quality of paid services. The fees for healthcare services are rapidly rising due to several factors. These are the growing population, aging generations, service prices and their distribution, pandemic, the spread of chronic diseases, and others. Considering the growth of costs, the services may be inaccessible to some groups.
Access
Accessibility to medical care is free to access medical services regardless of geographical, economic, social, cultural, organizational, or linguistic barriers. This is a multidimensional concept that includes a balance of many factors within the strict practical limitations caused by the peculiarities of the country’s resources and capabilities (Shi & Singh, 2019). These factors include human resources, financing, vehicles, freedom of choice, public education, and quality and distribution of technical resources. The general criteria for the quality of medical care are the correctness of the introduction of medical technologies, risk reduction for the condition of patients, optimal use of resources, and satisfaction of consumers of medical care.
Quality
The quality of medical care is the degree to which medical services provided to individuals and groups of the population increase the likelihood of achieving desired health outcomes and correspond to evidence-based professional knowledge. This definition of the quality of medical care extends to health promotion, prevention, treatment, rehabilitation, and palliative care and proceeds from the fact that the quality of medical care can be measured and continuously improved. It is possible because medical care is provided based on evidence and taking into account the needs and preferences of service users – patients, families, and local communities. However, quality is difficult to measure and define for the standards of care are not static, and the system itself fluctuates.
Interrelation of Cost, Access, and Quality
Cost, access, and quality affect each other in the structure of the healthcare system. Access defines the population groups that may use the medical services, costs determine the prices for these services and products, while quality stands for patient health outcomes. These indicators must be balanced to reach stability in the system. Numerous fluctuations are occurring because these criteria fluctuate. For instance, when the costs grow, the level of accessibility drops because some groups can barely afford the services; the rise in price does not guarantee an increase in quality. The other situation is when the costs remain on the same level, the access soars up, and the quality lowers. It happens because healthcare professionals do not manage to serve many patients at once and have to reduce treatment time.
On the other hand, there is an opportunity to improve the situation in the healthcare system by equating the indicators. The ideal circumstances are the following: cost reduction which guarantees more access to medical care for patients; this causes quality increase. Even though expanding access increases health care costs, it allows for the amelioration of services’ quality. However, the model still lacks validity because, with the rapid changes in the economy and the spread of technologies, numerous threats can disrupt this triangle. Nonetheless, the system’s flexibility makes it possible to adjust to the new requirements. Healthcare policymakers would be able to stabilize the costs in case the crisis occurs and ensure equal access to the majority of the population. The quality is the most controversial indicator because the system lacks statics and can alter at any time.
Critical Policy Issues
There have been numerous attempts to equate cost, access, and quality to reach a perfect balance in healthcare. Governmental and commercial organizations, health professionals, and individuals aimed to implement policies related to these three constituents. The primary critical policy issue is cost containment because as the economy grows, the expenses of healthcare soar. The problem here is to maintain the same level of expenditures and unnecessary spending without any risks and damage to the company or other stakeholders. The access-associated policy issue relates to the insurance and its eligibility criteria. It is still troublesome for some groups to obtain a plan that would cover their healthcare expenses. Finally, a quality-related policy issue is establishing communication between a health professional and a patient. It is especially difficult to provide comprehensible care if a patient speaks a different language.
Conclusion
In conclusion, the healthcare system is highly dependent on three constituents: cost, access, and quality. These determinants have proven to be interrelated and interdependent to a certain degree. Even though the elements affect each other, the perfect balance cannot be reached because cost, access, and quality cannot be improved simultaneously. Considering that these indicators are vital for issuing a policy, it was necessary to elaborate on critical issues. Cost containment, insurance eligibility, and medical worker-patient communication are the main issues within the specified framework. As a result, by eliminating at least one of the problems, it is possible to solve the other one partially.
References
Shi, L. & Singh, D.A. (2019). Delivering healthcare in America: A systems approach (7th Ed.). Jones and Bartlett Learning.
Vogenburg, F.R. (2019). U.S. healthcare trends and contradictions for 2019. American Health and Drug Benefits, 12(1), 40-47.