Excelsior College Medicines Dilemma Debate Cost in Iron Triangle Paper n his 1994 book Medicine’s Dilemma: Infinite Needs versus Finite Resources, Dr. Will

Excelsior College Medicines Dilemma Debate Cost in Iron Triangle Paper n 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.

Please remember to keep the debate civil and respectful. Please no personal attacks or debates that are unrelated to the topic at hand. You are encouraged to review the Excelsior College Guidelines for Online Interaction (a.k.a. Netiquette) (Links to an external site.)Links to an external site.. While you personally may not believe the aspect you were assigned is the most important, you are expected to write your posts as if you do. Please do not include comments in your post such as “I don’t really believe what I’m saying, but I have to do this so…” Your instructor will engage in the debate as a “devil’s advocate” throughout the week.

Consult the Discussion Posting Guide for information about writing your discussion posts. It is recommended that you write your post in a document first. Check your work and correct any spelling or grammatical errors. When you are ready to make your initial post, click on “Reply.” Then copy/paste the text into the message field, and click “Post Reply.”

To respond to a peer, click “Reply” beneath her or his post and continue as with an initial post.

Evaluation

This discussion will be graded using a rubric. Please review this rubric prior to beginning the discussion. You can view the rubric on the Course Rubrics page within the Start Here module. All discussions combined are worth 20% of your final course grade.