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The U.S. health care delivery system is often described as a kaleidoscope, puzzle, or patchwork quilt to emphasize that health care delivery in this country involves multiple, loosely coordinated components, and does not function through one integrated system. The organization and structure of this system have a tremendous impact on the delivery of services. As such, health care professionals, consumers, advocates, and policy makers face tough choices with regard to health care costs, quality, and access.
Review the information in the Learning Resources, and think about how the structure and organization of the U.S. health care system affect delivery of services. Also think about the interrelationships between and among health care costs, quality, and access in this country. Bring to mind a specific example that illustrates potential trade offs, using the following questions as a guide:
How could current and future efforts to contain costs affect quality and access?
How might measures to ensure the provision of high quality care influence costs and accessibility?
How could efforts to promote universal access to care impact cost and quality?
Describe a specific situation or issue that illustrates the trade offs involved in decisions related to cost, quality, and access.
Briefly explain how the structure and organization of the U.S. health care delivery system bring about or impact this type of situation or issue.

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