Healthcare in the US: Cost, Access or Quality? Which one is most important to Americans?

According to a Gallup Poll most Americans continue to see healthcare costs in the U.S. as a major issue which is a continued trend since 2001. These results are from Gallup's annual Healthcare survey from November 2018. Americans continue to be pleased with quality - 55% rate quality as either excellent (17%) or good (38%). 31% state it is only fair and 14% say quality is poor.

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. It is considered an "iron" triangle because it is difficult to have a low cost, high quality, wide access health system - at best you can have two of the three. In recent years there has been the addition of "choice" as an important healthcare factor as we move towards patient-centered care. Patient centered care asks that the healthcare system meet patients in the context of their social worlds and involve them in their care.

Why should this matter to medical school applicants? Because these are the core issues of a healthcare system. If you state you are interested in health policy, social justice, or the under served this is an important concept to understand. Learning more about how these interact in healthcare systems will be allow you to speak intelligently about the state of our current healthcare system.

In case you are curious these are the most urgent global issues according to the United Nations' public health agency: