Thread by @AugieLindmark

I’ve been a doctor for two days.

I’ve now cared for two patients who can’t afford a needed medication due to high copays.

Is this a daily thing or...?

For those interested, some studies suggest copay spending may in fact be shrinking.

But the rise of cost shifting overall, via deductibles and other mechanisms, is horribly out of control. healthsystemtracker.org/brief/payments…

Thank you to all who shared personal accounts and unpacked the various inequities embedded in America's health system. I'm not sure whether to express gratitude for the stories shared, or indignation that we again have to witness such hardship. Perhaps both are needed.

For those curious about medical education (#meded). Rarely are costs mentioned in curriculum, but if they are, "cost-effectiveness" is taught. Essentially this means ordering less tests and it's couched within narrow interests of a hospital or health system.

Rarely does medical education breach the incredible costs borne by patients. This is a tragedy, as many have rightly mentioned.

Students must learn this on their own. And many do. Thankfully, the next generation of health professionals is, in my biased opinion, quite thoughtful.

I first learned this lesson when I was 18 years old.

Before I started college, an unknown mass was found in my throat. There was a tumor in my body, and neither my family or my doctor knew if it was benign or malignant. I would need surgery.

The first question my mother asked was: "Before we consider surgery, what's our deductible at?"

In the end, I got lucky because the tumor was benign. The medical bills stopped there.

Luck, as many of you have mentioned, is a crap way to design a health system.

Preaching to the choir here, but here it goes. Those Medicare for All bills? They tackle cost sharing and out of pocket spending.

If you're a student, check out @snahp_national and @uaem. These movements need you. If you're a physician, find some good humans in @PNHP.

If you're an activist hero, support and follow groups like @CPDAction, @popdemoc, and @housingworks to rally support behind the CARE Act, win equitable drug pricing legislation, and save our health care.

If you need to yell into a book, read An American Sickness.

And above all else, there's power in community. The same power that can overcome decades of political lethargy and health care commodification. Thank you for that reminder. Onward!