Key Issues In Primary Care

Bringing primary care to everyone in your community requires addressing many issues, from different models of primary care delivery and workforce shortages to how primary care is paid for and corporate exploitation of our nation’s health care for their profit. Explore the topics below to understand the context of the fight for primary care for all.

The United States spends twice as much per person on health care as the average wealthy nation and has the worst outcomes. We rank 49th in the world in life expectancy. The bulk of our health care spending is on hospitalizations, surgeries, procedures, expensive specialists, and medications. Healthier nations spend far more of their health care budgets on primary care, which keeps people out of emergency rooms and hospitals and helps them have healthier lives.

• Mirror, Mirror 2024: A Portrait of the Failing U.S. Health System
• Implementing High-Quality Primary Care in 2025: Key Policy Priorities
• Increasing Investment in Primary Care—Lessons from States
• Strengthening Primary Care to Improve Health Outcomes in the US

Health care in the United States has been taken over by vampiric insurance companies, heartless corporations, and inhuman private equity firms. They spend our money on procedures that generate profit for themselves, rather than focussing on keeping us healthy. In fact, it is better for their shareholders if we are sick and need to spend money to get well. Corporations invest in health care where they can make a profit by charging high prices and cutting costs by compromising our care. The people who make big money from healthcare want to keep making that money. They pay hundreds of millions of dollars every year to lobby politicians to make sure things stay the way they are.

Primary care puts people first. It is affordable and effective, delivered by teams of doctors, nurses, nurse practitioners, physicians’ assistants, physical therapists, and other clinicians who develop strong relationships over time with patients, families, and communities.

• Insurance company ownership of primary care practices
• Primary care physicians as employees of hospitals and networks
• Defining Health Care “Corporatization”
• Corporate Giants Buy Up Primary Care Practices at Rapid Pace
• 5 Consequences of Private Equity’s Expansion in Health Care Services
• Private Equity And The Monopolization Of Medical Care
• Nearly 80% of docs employed by hospitals, corporate entities in continued shift away from independent practice

The United States hasn’t adequately nor strategically invested in ensuring we have a strong health care workforce. There aren’t enough doctors, nurses, or other health care professionals. And the problem is getting worse. To guarantee access to advanced primary care to everyone, we will need as many as 87,150 more primary care physicians by 2037. The percent of medical school grads going into primary care drops every year because primary care is one of the lowest-paying specialties. As for-profit corporations, hospitals, and insurance companies buy up primary care practices and the focus moves from the patient to the bottom line, the hours get longer and time with patients gets shorter, making primary care less attractive to future doctors.

The tools we can use to solve the primary care workforce shortage include building new medical and nursing schools, lowering the cost of graduate education, supporting trainees through scholarships and loan repayment in exchange for their commitment to practice primary care, increasing the number of federally and state funded residencies, targeted visas for foreign health care workers, cracking down on corporate exploitation, changing the formulas that determine Medicare and Medicaid’s physician fees so they pay primary care clinicians more, and raising the minimum wage for health care workers (or everyone). The list goes on.

• State of the Primary Care Workforce
• AMA examines decade of change in physician practice ownership and organization
• Compensation Is Key to Fixing Primary Care Shortage
• What to Know About How Medicare Pays Physicians
• Why student-loan forgiveness is making primary care more attractive

There is no one right way to deliver or pay for primary care. Different models work in different situations. In most cases, a mix of different models will help to provide the best care for the most people.

• What Is a Federally Qualified Health Center? A Comprehensive Guide
• Community Health Center Patients, Financing, and Services
• Community Health Centers’ Progress and Challenges in Meeting Patients’ Essential Primary Care Needs
• Defining the Medical Home
• Fee-for-service vs. value-based care: What is the difference?
• Hybrid Payments: A Way to Make Primary Care More Patient Centered
• Why a Hybrid Payment Model Offers Hope for Primary Care as Medicare Turns 60
• ACO vs PCMH: What is the difference?
• Accountable Care and Accountable Care Organizations
• What is direct primary care (DPC)?
• What Is Concierge Medicine?
• Proposed Changes to How Medicare Pays Can Help Primary Care’s Chronic Condition