Business Insight presented by Arlington Dermatology Cost of Healthcare All of us read and hear news about astronomic increases in insurance premiums, hospital bills, and healthcare delivery in general. Granted, with newer technology and complex testing, diagnostic medical science has been growing in cost for years. It does help us live longer and better, improves quality of treatments, and resolution to many problems. Medical science has also come up with hundreds of new medications. They allow for safer and more effective treatments and cures. All of it comes at a cost. That cost is transferred to us, the customers of the system. When we get sick, we just want to get better. Often, people spend all of their savings to get more effective treatment. Also often, people get into high debt and sometimes cannot afford to pay for the treatment. I am not even mentioning those who are uninsured or underinsured, and then, they simply do not get proper medical care or treatment. On the other hand, there are many trends that make that medical care even more difficult to obtain due to the complexity and burden of the insurance system. All over the country, smaller and larger medical facilities are acquired by private equity financial companies, focused on making profit by cutting the costs. This means less direct care, less services, cutting staff, eliminating higher educated and experienced staff, and replacing it with less costly but inexperienced individuals. Doctors often sell their practices because they cannot make ends meet with the overhead of growing prices, prices often unjustified by production costs or imports. Still, despite so many complaints, medical supplies are manufactured in China at a very low cost and brought to our country by numerous dealers who charge us, customers, 500% over the cost. The fee schedules for doctors are based on Medicare rates and hardly ever go up. As a matter of fact, in 2024, dermatology had a cut of over 3% in reimbursement by insurances. It turns out that some of those insurances are actually owned by private equity as well. So simply, they pay doctors less and drive them out of business, they buy out their practices, cut the costs by cutting the quality of care and ultimately, patients pay the price of higher premiums for lesser care. A very good example from my field is so frequently conducted skin cancer surgery called Mohs surgery. As we all know, skin cancer has been increasingly present in our lives. If it is identified in the anatomical areas visible to an eye, like face, chest, neck, it can be treated by a progressive removal of cancerous skin, without a risk of a deep excision. The surgery requires a couple of hours, is under very limited local anesthetic, must be done by a doctor skilled in reading pathologic cells under a microscope, but can be done in a doctor's office with proper equipment. If done in the office, the cost to Medicare is limited and patients pay less as well. However, if the same surgery is moved to an outpatient hospital based facility, the facility fee alone can go up to several thousand dollars. Is there a need for that fee? No, there is no need and it should not be done. But, if medical decisions are made by financial people, profits are the focus and they can be achieved by conducting procedures at a higher cost. I recently read and analyzed several investigative articles of financial market taking over healthcare. I truly get upset over those trends and I worry that our system will become unavailable to thousands of patients who simply will not be able to pay for treatments. And this brings us to this ironic paradox: we will have better tools, drugs, treatments, but we will have a sicker society, because only a few will be able to use the progress we achieved. Is this where we are heading? 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 All of us read and hear news about astronomic increases in insurance premiums , hospital bills , and healthcare delivery in general . Granted , with newer technology and complex testing , diagnostic medical science has been growing in cost for years . It does help us live longer and better , improves quality of treatments , and resolution to many problems . Medical science has also come up with hundreds of new medications . They allow for safer and more effective treatments and cures . All of it comes at a cost . That cost is transferred to us , the customers of the system . When we get sick , we just want to get better . Often , people spend all of their savings to get more effective treatment . Also often , people get into high debt and sometimes cannot afford to pay for the treatment . I am not even mentioning those who are uninsured or underinsured , and then , they simply do not get proper medical care or treatment . On the other hand , there are many trends that make that medical care even more difficult to obtain due to the complexity and burden of the insurance system . All over the country , smaller and larger medical facilities are acquired by private equity financial companies , focused on making profit by cutting the costs . This means less direct care , less services , cutting staff , eliminating higher educated and experienced staff , and replacing it with less costly but inexperienced individuals . Doctors often sell their practices because they cannot make ends meet with the overhead of growing prices , prices often unjustified by production costs or imports . Still , despite so many complaints , medical supplies are manufactured in China at a very low cost and brought to our country by numerous dealers who charge us , customers , 500 % over the cost . The fee schedules for doctors are based on Medicare rates and hardly ever go up . As a matter of fact , in 2024 , dermatology had a cut of over 3 % in reimbursement by insurances . It turns out that some of those insurances are actually owned by private equity as well . So simply , they pay doctors less and drive them out of business , they buy out their practices , cut the costs by cutting the quality of care and ultimately , patients pay the price of higher premiums for lesser care . A very good example from my field is so frequently conducted skin cancer surgery called Mohs surgery . As we all know , skin cancer has been increasingly present in our lives . If it is identified in the anatomical areas visible to an eye , like face , chest , neck , it can be treated by a progressive removal of cancerous skin , without a risk of a deep excision . The surgery requires a couple of hours , is under very limited local anesthetic , must be done by a doctor skilled in reading pathologic cells under a microscope , but can be done in a doctor's office with proper equipment . If done in the office , the cost to Medicare is limited and patients pay less as well . However , if the same surgery is moved to an outpatient hospital based facility , the facility fee alone can go up to several thousand dollars . Is there a need for that fee ? No , there is no need and it should not be done . But , if medical decisions are made by financial people , profits are the focus and they can be achieved by conducting procedures at a higher cost . I recently read and analyzed several investigative articles of financial market taking over healthcare . I truly get upset over those trends and I worry that our system will become unavailable to thousands of patients who simply will not be able to pay for treatments . And this brings us to this ironic paradox : we will have better tools , drugs , treatments , but we will have a sicker society , because only a few will be able to use the progress we achieved . Is this where we are heading ? Michael Bukhalo , MD Arlington Dermatology 5301 Keystone Court Rolling Meadows , IL 60008 Tel . 847 392 5440 | www.arlingtondermatology.net