Business Insight presented by Arlington Dermatology Cost of Healthcare I know some of my readers will be upset reading these words. It seems like our society is divided in many ways and access to healthcare is one of the most challenging divisions. First of all, we are divided into three groups of major access: fully insured, underinsured, and uninsured. Secondly, we are divided into two groups of healthcare needs: people who do not really use their healthcare plans, because they are healthy and people who use it very frequently. Third, we are separated by the finances in healthcare: people who can pay for their costs, and people who must make a choice whether to pay for healthcare or for food. There are more examples of additional divisions related to healthcare, but let's just stop here. What I listed above is drastic enough and enough transparency to show that people from each of the groups in those three conceptual divisions would never understand each other or agree with each other. Individuals who have good insurances and are healthy, and have money to pay for occasional needs do not really know how it feels not to have money to pay $2,000 for a CT scan or buy a prescription drug for $900. These are not made-up numbers. These are real prices seen every day. Some time ago, I gave an example of a totally ironic case of a lab test that I have done periodically. It lists 4 different individual tests and is priced at $700. My insurance processes it and applies contractual fee schedules, and, even with my deductible, I end up paying $54.00, because that is what the contract between insurance and the lab calls for. However, if an uninsured person has the same test done, there is no contract involved, so that person has to pay the full price of $700. The lab may be 'kind' to put it on a payment plan, but this does not change the irony of the situation. I am not guilty of this irony and I happen to realize how unfair this whole system is. I am in the middle of it. As a provider, I am a subject of contract and fee schedules. I can come up with a charge of $1,000 for a visit, but the insurance can pay me $90 and I have to adjust the rest, if the contract calls for it. If I were a lawyer, I could charge anything I want, but as a doctor I cannot unless I stop taking or accepting insurances. Many doctors have done just that. But this is not a solution fair for patients either. I cannot even count the calls from patients and pharmacies telling us that a prescription is too expensive to buy and patients just do not follow my directions. It is not their fault but it is not mine either. The problem is bigger than any group in our divided society. Bigger than doctors and hospitals. Definitely bigger than patient's needs. We need a huge revamp of our healthcare system and we need it very soon. What we have is not sustainable. And it is not fair. There is one more division I want to mention. We have basic healthcare and we have boutique healthcare. Basic healthcare is a matter of human right. Boutique healthcare is a matter of human choice. In basic healthcare, patients do not pick to be sick or healthy. They need help to live. In boutique healthcare, patients make choices to have a brand drug or generic. Our society needs a full and free access to basic healthcare. We can have an expense of boutique for those individuals who make a choice to pay more because they can. Michael Bukhalo, MD Arlington Dermatology 5301 Keystone Court Rolling Meadows, IL 60008 Tel. 847 392 5440 | www.arlingtondermatology.net Business Insight presented by Arlington Dermatology Cost of Healthcare I know some of my readers will be upset reading these words . It seems like our society is divided in many ways and access to healthcare is one of the most challenging divisions . First of all , we are divided into three groups of major access : fully insured , underinsured , and uninsured . Secondly , we are divided into two groups of healthcare needs : people who do not really use their healthcare plans , because they are healthy and people who use it very frequently . Third , we are separated by the finances in healthcare : people who can pay for their costs , and people who must make a choice whether to pay for healthcare or for food . There are more examples of additional divisions related to healthcare , but let's just stop here . What I listed above is drastic enough and enough transparency to show that people from each of the groups in those three conceptual divisions would never understand each other or agree with each other . Individuals who have good insurances and are healthy , and have money to pay for occasional needs do not really know how it feels not to have money to pay $ 2,000 for a CT scan or buy a prescription drug for $ 900 . These are not made - up numbers . These are real prices seen every day . Some time ago , I gave an example of a totally ironic case of a lab test that I have done periodically . It lists 4 different individual tests and is priced at $ 700 . My insurance processes it and applies contractual fee schedules , and , even with my deductible , I end up paying $ 54.00 , because that is what the contract between insurance and the lab calls for . However , if an uninsured person has the same test done , there is no contract involved , so that person has to pay the full price of $ 700 . The lab may be ' kind ' to put it on a payment plan , but this does not change the irony of the situation . I am not guilty of this irony and I happen to realize how unfair this whole system is . I am in the middle of it . As a provider , I am a subject of contract and fee schedules . I can come up with a charge of $ 1,000 for a visit , but the insurance can pay me $ 90 and I have to adjust the rest , if the contract calls for it . If I were a lawyer , I could charge anything I want , but as a doctor I cannot unless I stop taking or accepting insurances . Many doctors have done just that . But this is not a solution fair for patients either . I cannot even count the calls from patients and pharmacies telling us that a prescription is too expensive to buy and patients just do not follow my directions . It is not their fault but it is not mine either . The problem is bigger than any group in our divided society . Bigger than doctors and hospitals . Definitely bigger than patient's needs . We need a huge revamp of our healthcare system and we need it very soon . What we have is not sustainable . And it is not fair . There is one more division I want to mention . We have basic healthcare and we have boutique healthcare . Basic healthcare is a matter of human right . Boutique healthcare is a matter of human choice . In basic healthcare , patients do not pick to be sick or healthy . They need help to live . In boutique healthcare , patients make choices to have a brand drug or generic . Our society needs a full and free access to basic healthcare . We can have an expense of boutique for those individuals who make a choice to pay more because they can . Michael Bukhalo , MD Arlington Dermatology 5301 Keystone Court Rolling Meadows , IL 60008 Tel . 847 392 5440 | www.arlingtondermatology.net