Iron Triangle In Healthcare

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Cost, access, and quality – these three components can be described as an “Iron Triangle” of public healthcare. These components are highly intertwined, as changing one of the component will have a substantial effect on others, e.g., improving the quality of healthcare may result in an increment of cost or reduction of access, and similarly, increasing access may hamper the quality or increase the healthcare cost significantly. Cost, access, and quality determine the type of delivery of health care. The delivery of mental health care, especially the treatment of depression, should be considered as an important aspect of public health care, as depression is the leading cause of medical disability for people aged between 14 and 44 years (Stewart, …show more content…
According to the centers for disease control and prevention, 41149 individuals committed suicide in the U.S. in 2013 (Centers for Disease Control and Prevention, 2014). However, the dangers of depression and general public health do not get much attention in general media, and in many cases, treatment for mental illness including depression is not covered by many private and public insurance plans. As the cost of mental health treatment is very expensive and is increasing day by day, a large portion of patients with mental illness and depression do not seek professional help. Moreover, there is no significant increase in state or federal budget in dealing with mental health, rather in most cases, there are significant cuts from mental health budget in past few years. For instance, States cumulatively cut more than 1.8 billion dollars from their budget for services regarding metal health illness between 2009 and 2010 (Honberg Ron, Diehl Sita, Kimball Angela, Gruttadaro Darcy, 2011). Even in 2015, North Carolina cuts 110 million dollars from regional mental health budget (Bonner, 2015). According to WHO, US only spends 6% of its overall health spending on mental health issues (World Health Organization, …show more content…
Unfortunately, the complex US health care system does not provide an equal access to proper treatment for all. This discrimination is much bigger in delivery of mental health care. For instance, approximately 60 percent of adults and almost one-half of youth aged from 8 to 15 years with mental illness received no mental health services in 2013 (Duckworth, 2013; Friedman, 2012). According to Health Resources and Services Administration in 2010, almost 89.3 million Americans live in federally designated metal health professional shortage areas in comparison with 55.3 million in primary care shortage areas (Kaiser Health News, 2014). As a result, access to professional help for patients with depression or other mental illness conditions becomes very difficult. Although affordable care act (ACA) makes mental and behavioral health treatment one of 10 essential benefits in federal insurance policies, it still cannot assure proper coverage of care for mental disorders, including schizophrenia, depression, bipolar disorder, childhood behavioral disorders and addiction for all Americans mainly because of state to state disparities regarding the mental health care coverage (Brink, 2014; US Department of Health and Human Services, 2016). Other factors, i.e., social attitude towards mental illness and depression, poverty, illiteracy and unawareness of the harmful effects of mental illness significantly hampers the
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