Primary Care as a Public Utility: The Case for a Common Fund.

Area of Science:

• Health Services Research
• Public Health Policy
• Health Economics

Background:

• Over one-third of US adults lack primary care access, transforming it into a commodity.
• State primary care investments face federalism, insurance fragmentation, and administrative hurdles.
• Current state investments often exclude significant populations like Medicare beneficiaries and self-insured individuals.

Purpose of the Study:

• To address challenges states face in bolstering primary care access.
• To propose a primary care common fund as a solution to improve investment and access.
• To align primary care financing with the vision of primary care as a public utility and common good.

Main Methods:

• Analysis of state-level challenges in primary care investment.
• Description of a primary care common fund model.
• Examination of potential advantages and precedents for a common fund approach.

Main Results:

• State investments are limited by insurance structures, affecting equity.
• A primary care common fund can pool public and private spending.
• This model offers flexibility in payment and reduces administrative burden without system disruption.

Conclusions:

• A primary care common fund can help states overcome investment barriers.
• This approach treats primary care as a public utility, enhancing access.
• The model is feasible and supported by existing precedents.