Iron Triangle

The Iron Triangle of Health Care is a concept developed by William Kissick, the father of Medicare, in his 1994 book, “Medicine’s Dilemmas: Infinite Needs Versus Finite Resources”. In his book Kissick describes three health care issues which are the primary concerns of all health care systems and that operate in a dynamic and complex relationship: Cost, Quality, and Access. The Triangle is Iron because it is generally difficult to have a low-cost, high quality, wide access health care system, Kissick (1994). Within the triangle it is generally assumed that if quality increases, then costs must increase as well, Kissick (1994). In this paper I will discuss this triangle and the relationship of the three aspects. Also I will discuss how each one dramatically

Bashshur evaluating the development of Telemedicine. The major purpose of Bashshur’s study was to provide a contextual and conceptual framework for the analysis of the potential effects of telemedicine on the health care system with special emphasis on cost. Bashshur also briefly reviews the results of the experience with telemedicine to date, describing the framework for a valid assessment of telemedicine effects on the health care system, discussing the rationale concerning the expected telemedicine effects on cost, quality, and accessibility to care. Bashshur proposes ways to resolve telemedicine issues related to cost, access, and quality.

In regard to Telemedicine, Bashshur (1995) stated the target populations and the major beneficiaries of telemedicine are the geographically remote, the institutionally confined, and those otherwise medically underserved, including inner city residents and the elderly. The substitution of telemedicine for person- to-person encounters should reduce the need for travel and the related opportunity costs and other inconveniences encountered in the process of obtaining