Modern Healthcare: The future of fixing healthcare starts with direct primary care

By Rep. Dan Crenshaw

A few years ago, I met a Houston doctor who introduced me to the concept of direct primary care. The idea is simple: you should have an affordable monthly fee for a primary-care doctor, without extra charges for visits and without third-party insurance. You can find a doctor near you by simply going to a website and typing in your ZIP code (

So why isn’t this convenient and personalized model more prevalent, I wondered. It seems to be exactly what Americans want in their healthcare: control over their healthcare decisions with a trusted doctor of their choice.

And yet, many Democratic politicians in Congress and on the campaign trail are pushing for the exact opposite: Medicare for All or the “public option,” both of which run counter to the principles of choice, control and quality. This takeover of healthcare would put the government in the middle of every decision that should be made by patients and their families.

Now, this doesn’t mean we ignore the need to do a better job of providing Americans with access to high-quality healthcare that keeps our citizens healthy and in control.

It’s time for a modern approach to personalized healthcare. That is where direct primary care comes in.

Perhaps most relevant to the COVID-19 pandemic, adequate access to primary care is key to reducing comorbidities that we know contribute to higher rates of COVID fatalities. Based on data from the Centers for Disease Control and Prevention, we know that 76.4% of COVID-19 deaths had at least one serious underlying condition–most of which are preventable diseases like diabetes, chronic lung disease, heart disease, liver disease and even obesity [1].

And we know that primary-care providers play a large role in reducing the seriousness of these comorbidities. It’s well accepted that primary-care providers reduce emergency room utilization, improve outcomes, and even possibly reduce overall healthcare spending. And studies have found that higher continuity of primary care–a continuous relationship with a primary care doctor–is associated with lower hospital admissions.

But primary care–especially for at-need communities in rural, low-income areas–is sparse at best. The patient-to-physician ratio in rural areas is only 39.8 physicians per 100,000 people, compared with 53.3 physicians per 100,000 in urban areas.[2] And we’re expected to have a shortage of as many as 55,200 primary-care doctors by 2032.[3].

We must address this, which is why I am introducing the Direct Primary Care for America Act.

My bill is a few small, simple steps toward expanding and normalizing access to the already hugely successful model of direct primary care.

First, it includes a bipartisan proposal to allow people to use their health savings account for direct primary care.

For at-need communities, my bill gives states the flexibility to provide direct primary care to low-income Medicaid recipients.

And to address the shortage of direct primary care in rural areas, my bill includes direct primary-care clinics as approved sites for the National Health Service Corps’ Loan Repayment program in areas that have a shortage of primary-care providers. This will ensure that your access to high-quality primary care is not determined by your ZIP code.

This is just one step to answer the call for personalized healthcare from the American people. We still have a long way to go to increase the transparency, choice, affordability, and accessibility that patients desire when it comes to their care.

But empowering Americans with the freedom to choose a doctor they know and trust to provide them with high-quality care will lead to a healthier citizenry and put us on the path to modernized, personal healthcare for all.

Rep. Dan Crenshaw