LANSING, Mich. — A bipartisan group of Michigan House lawmakers introduced an eight-bill package Wednesday designed to bring more primary care doctors to the state and place them where the need is greatest, as a growing shortage stretches the health care system thinner.

According to MiDOCS, there is a primary care shortage in 74 of Michigan's 83 counties. Nearly one in three people lacks regular access to primary care, and the gap is most acute in rural communities.

Doctors joined lawmakers for a press conference in Lansing to unveil the package, arguing that primary care is the foundation of a functional health care system and that foundation is eroding.

"Patients are waiting longer and longer to get the appointments that they need," said Rep. Matt Longjohn (D-Portage), who is also a physician. "Health care professionals are stretched thin, and educational debt and burnout are real problems."

Longjohn pointed to a funding gap at the heart of the problem. He said less than six cents of every dollar in the state's roughly $27 billion in annual medical spending goes to primary care.

"We have to change that equation," Longjohn said.

What the bills would do

The eight-bill package would:

  • Set a 12 percent investment target for state-contracted health plans;
  • Establish a state commission on primary care access and an office of primary care within the Michigan Department of Health and Human Services;
  • Codify a program to recruit and retain doctors in underserved communities and expand it to cover nurses;
  • Provide tax credits to primary care trainers;
  • Create grants for Michigan medical schools; and
  • Create a state-backed loan for medical students.

"Research has shown consistently that better access to and use of primary care improves chronic disease management and is associated with longer life expectancy," said Dr. Herbert Smitherman of Detroit Medical Center.

Supporters say the funding shortfall comes alongside low pay, high medical school debt, and limited career opportunities for physicians in training.

"Students who should be asking what kind of physician they hope to become are instead being forced to ask whether they can afford to become a physician at all," said Donya Ahmadian, MS, MPH, of ASMSA National.

Bipartisan reception

The effort is being led by Democrats but already has some Republican sponsors. House Health Policy Committee Chair Rep. Curt VanderWall (R-Ludington) has not yet sponsored the bills but said he welcomes the push.

"We've heard so many things from our constituents: 'I wait forever to find a primary care doctor,' 'nobody's left in my area,' 'the cost has gotten very expensive,' 'what can we do to make sure that we have better access?'," VanderWall said. "You know what? We're hearing them. We're going to work hard to make sure that we address those situations and work with everybody on the floor to get them done."

Supporters cautioned that this will be a long effort. With only a few months left in the legislative session, they expect to keep working on the package even after lawmakers leave Lansing in December.