Dear @olgakhazan, You write: "the AAPS doesn’t seem to offer a solution for the fact that these days, a single 'How can we help you?' from a doctor can result in a five-figure bill." (thread) 1/12
You're right. We don't offer "a solution." We advocate for *many* solutions — solutions that are already successfully driving down the cost of high-quality medical care in the real world. 2/12
One solution is Direct Primary Care. DPC offers patients nearly unlimited access to primary care, from a physician, for a monthly fee that is most often in the mid two digits. See for instance: greenhillsdirectfamilycare.com/pricing-fees/ 3/12
These practices also offer access to lab tests and imaging at prices significantly lower than other options. Here's an example of how a DPC practice slashed a patient's 5-figure hospital bill down to low 3-figures. (Source: help.senate.gov/imo/media/doc/…) 4/12 
In addition these direct pay medical practices are cutting patients' Rx costs from 4 figures to 3 figures or even lower. When abusive Pharmacy-Benefit-Manager-driven pricing schemes are bypassed, prices plummet. Here's a real-life example of a patient's Rx savings/month. 5/12
In fact, "Physician Point-of-Care Dispensing Could Save Seniors and Taxpayers $20 Billion on Generic Drug Costs in Medicare" aapsonline.org/physician-poin… 6/12
And direct-pay surgery centers are cutting the cost of surgery by as much as 90%. A $30,000 hernia procedure is available at @SurgeryCenterOK for "just over $3,000," reports @CBSNews. cbsnews.com/news/man-drive… 7/12
Instead of marginalizing physicians who are sacrificing to LOWER the cost of care for patients, we would respectfully suggest you focus on ways the middlemen who provide no actual care themselves are gaming the system to the tune of hundreds of billions of dollars per year. 8/12
For example, legalized kickbacks to Pharmacy Benefit Managers and hospital Group Purchasing Organizations are lining the pockets of middlemen, at the expense of patients. Addressing this issue is long overdue. krisheldmd.wordpress.com/2019/02/16/dra… 9/12
The vertical integration being pursued by health insurers, as they purchase PBMs, facilities, practitioners, and pharmacies, are also driving up costs, and limiting patients' options, without adding meaningful value. aapsonline.org/comments-on-do… 10/12
So while a "deep" (skin deep?) piece attacking AAPS using cherry-picked quotes, concerning complicated issues, often from decades old articles and statements that are easily taken out of context or misconstrued, to make us appear "fringe," may generate clicks... 11/12
... it does not accurately represent who we actually are and what we are fighting for on a daily basis, nor does it contribute to offering actual solutions that patients desperately want. Patients deserve better. 12/12
