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Business Insight presented by Arlington Dermatology Do You Know How to Get Medical Care? Most Americans receive medical care when they get sick. 83% of all Americans carry some sort of medical insurance and they can access our healthcare system through their insurance. 17% are uninsured and, often, their medical care is delivered through emergency room when they get really sick.. Otherwise, they do not have financial means to visit a doctor earlier than for emergency. Let me surprise you further: 45% of those with insurance coverage are not happy with their insurance and healthcare delivery. On average, they must wait 21 days to see their primary care doctor and 3-4 months to see a specialist. In other words, if you feel weak and have some breathing problems, you may wait for 3 weeks to see your regular doctor and, if he/she decides that you need to see cardiologist for some more careful cardiac evaluation, it will take several months to accomplish that. As a result, you may have to end up in the emergency room as well. American healthcare is very expensive. More expensive than anywhere in the world. There are several reasons for it. No doubts, we have great technology and most sophisticated drugs. The price of a CT scan or MRI goes into thousands of dollars. We also deliver many new medicines. I do not think I need to mention their price. Every time we get another drug approved through the clinical research, I am shocked by the price tag on it. A small tube of cream for psoriasis can cost over $1000! But we need these drugs and they do make our lives better. So, how could we balance what is discovered with what is realistically available? Insurance policies come to help get answers. Right? Not so much. Insurance companies do not rush to cover new medicines. It takes sometimes several years to get the new drug on the list of formularies for coverage. Patients and doctors must meet many criterias and factors to get that coverage. Otherwise, substitutes for the new drugs are offered, often much less expensive but also less beneficial. Diagnostic testing is another reason for the price of healthcare going higher every year. Like with the new drugs, new testing is developed every year too. And similarly, insurance companies do not hurry to cover them. Many tests are offered but their quality could be questioned as there isn't much data available to compare to establish some quality benchmark. But they exist and they are utilized. Healthcare providers do not communicate. No central medical file for patients exist. Thus, very often testing is duplicated, because, when attending several doctors, patients cannot verify what and by whom they were tested for. While it may deliver proper medical information to a doctor, the cost of duplicated testing is high. And it may not be totally paid by insurance either. And finally, only about 14% of Americans understand their insurance and its language. That leaves 86% of our population guessing how to utilize their insurance. Why is it happening? Well, insurance companies produce policies that are very complex, have limited coverage, and use the language protecting insurance from being sued for any liabilities. In other words, they prefer not to pay for services but pay for the lawyers who develop that super confusing language. The ironic thing is that many administrative employees of the insurance industry do not know how to use their insurance either. I invite you to a discussion. Let's talk about your own experience. 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 Do You Know How to Get Medical Care ? Most Americans receive medical care when they get sick . 83 % of all Americans carry some sort of medical insurance and they can access our healthcare system through their insurance . 17 % are uninsured and , often , their medical care is delivered through emergency room when they get really sick .. Otherwise , they do not have financial means to visit a doctor earlier than for emergency . Let me surprise you further : 45 % of those with insurance coverage are not happy with their insurance and healthcare delivery . On average , they must wait 21 days to see their primary care doctor and 3-4 months to see a specialist . In other words , if you feel weak and have some breathing problems , you may wait for 3 weeks to see your regular doctor and , if he / she decides that you need to see cardiologist for some more careful cardiac evaluation , it will take several months to accomplish that . As a result , you may have to end up in the emergency room as well . American healthcare is very expensive . More expensive than anywhere in the world . There are several reasons for it . No doubts , we have great technology and most sophisticated drugs . The price of a CT scan or MRI goes into thousands of dollars . We also deliver many new medicines . I do not think I need to mention their price . Every time we get another drug approved through the clinical research , I am shocked by the price tag on it . A small tube of cream for psoriasis can cost over $ 1000 ! But we need these drugs and they do make our lives better . So , how could we balance what is discovered with what is realistically available ? Insurance policies come to help get answers . Right ? Not so much . Insurance companies do not rush to cover new medicines . It takes sometimes several years to get the new drug on the list of formularies for coverage . Patients and doctors must meet many criterias and factors to get that coverage . Otherwise , substitutes for the new drugs are offered , often much less expensive but also less beneficial . Diagnostic testing is another reason for the price of healthcare going higher every year . Like with the new drugs , new testing is developed every year too . And similarly , insurance companies do not hurry to cover them . Many tests are offered but their quality could be questioned as there isn't much data available to compare to establish some quality benchmark . But they exist and they are utilized . Healthcare providers do not communicate . No central medical file for patients exist . Thus , very often testing is duplicated , because , when attending several doctors , patients cannot verify what and by whom they were tested for . While it may deliver proper medical information to a doctor , the cost of duplicated testing is high . And it may not be totally paid by insurance either . And finally , only about 14 % of Americans understand their insurance and its language . That leaves 86 % of our population guessing how to utilize their insurance . Why is it happening ? Well , insurance companies produce policies that are very complex , have limited coverage , and use the language protecting insurance from being sued for any liabilities . In other words , they prefer not to pay for services but pay for the lawyers who develop that super confusing language . The ironic thing is that many administrative employees of the insurance industry do not know how to use their insurance either . I invite you to a discussion . Let's talk about your own experience . Michael Bukhalo , MD Arlington Dermatology 5301 Keystone Court Rolling Meadows , IL 60008 Tel . 847 392 5440 | www.arlingtondermatology.net