Supporting the Concept of the Iron Triangle of Healthcare for patients, government, and healthcare providers

Supporting the Concept of the Iron Triangle of Healthcare for patients, government, and healthcare providers
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December 8, 2020
Supporting the Concept of the Iron Triangle of Healthcare for patients, government, and healthcare providers
The “Iron Triangle” of health, as introduced by William Kissick in 1994, postulates that its fundamental components comprising access, cost, and quality cannot be enhanced simultaneously. The proposition is based on the observations that an improvement in one component of the iron triangle causes a decline of at least one of the other two. There has been simmering talk about healthcare as a system comprised of various components. The iron triangle of health reflects one of the approaches to understanding the healthcare system. The three fundamental elements that make up the iron triangle of health include access, cost, and quality. These three core items constitute the centrality of focus for the government, patients, and healthcare providers. The ideal healthcare system is marked by broad healthcare services accessibility, affordable and friendly costs, and high quality. The idealized situation where costs, quality, and access regarding health services are optimized is arguable utopian and is not alive to contemporary realities. Can the costs, access, and quality be at the highest level of performance at any given time? Can people seamlessly access quality healthcare at affordable costs? Equally, can the government facilitate the provision of quality healthcare services within reasonable costs and friendly budgetary allocation? Do healthcare providers have the capacity to offer quality health services accessible and affordable to the general population? These rhetorical questions illustrate the extent of controversy and contestations surrounding the concept of the iron triangle of health. This paper will argue and demonstrate that the iron triangle of health, as represented by costs, access, and quality, denotes a fierce clash of its core components and that there is a controversy and conflict when there are efforts to fine-tune the three elements.
Over recent times, there is raging discussion permeating public, political and scholarly discourses, with themes of cost, access, and quality, featuring prominently in discussions. The thought-provoking question in these debates revolves around nurturing a healthcare system marked by seamless accessibility, affordable costs, and high quality. Can these aspirations be achieved simultaneously within the overall healthcare system with engagements from the patients, healthcare providers, private sector stakeholders, and government? Or are they just mere fantasies? The contemporary healthcare environment demonstrates otherwise. Arguably, people lack seamless access to quality and affordable healthcare services. With the rising prevalence of chronic diseases, accompanied by coronavirus disease, with associated morbidities and mortality, it is clear that the healthcare system is highly constrained to offer accessible, quality, and affordable services.
More often, poor prognosis and adverse health outcomes constitute a testimony that a significant portion of the population cannot a...