It’s getting harder to find a primary care provider, not just in Eugene and Springfield, but nationwide. The National Center for Health Workforce Analysis projects that there will be a shortage of 87,150 full-time primary care providers by 2037. These shortages are projected to impact rural areas more than metropolitan ones.
According to America’s Health Rankings, there are approximately 280 active primary care providers per 100,000 people in Oregon. That puts Oregon at number 31 in the country for PCPS.
In July, President Donald Trump signed the “One Big Beautiful Bill Act” into law, which could cut approximately $536 billion from Medicare over the next nine years, according to the Congressional Budget Office. This could leave many Americans without adequate health care coverage, putting them at risk of losing their primary care provider, as more practices stop accepting Medicare programs.
Advocates say that as we face this historic health care shortage, it’s time for Oregonians to consider more radical approaches that haven’t been tried before in the U.S., like universal health care.
Dr. Nicholas Jones, who has a private practice in Eugene, says there’s a couple of factors that contribute to the lack of PCPs in the area. Primary care isn’t very profitable, and the federal government is cutting Medicare reimbursements to providers. When primary care isn’t profitable, physicians seek employment elsewhere in high-paying specialties that reduce the number of general practitioners.
Cutting reimbursements to providers lowers the incentive for clinics to accept Medicare and Medicaid. This, combined with a general lack of physicians, has made parts of Oregon into a health care desert, with many being unable to find a PCP that’s accepting new patients.
Jones says one solution to some of the issues is a direct primary care model, where patients pay a flat-rate reimbursement to clinics. This fee would cover most services a PCP can provide — avoiding skyrocketing insurance costs.
He says this method could help clinics reduce overhead and maintain financial stability even as reimbursements get lower. He also suggests that reforms could be made to broaden the scope of what insurance will cover, but with Medicaid and Medicare cuts — that might be more difficult. “That can reduce ER utilization, and see patients the same day, next day, and offer after hours advice and services,” Jones says.
Oregon is a full practice state, meaning nurse practitioners and physician assistants can operate in a full capacity as a primary care physician, but Jones says more nurse practitioners and physician assistants isn’t a solve-all solution.
“If a physician is going to become a cardiologist, they need over a decade of specialized training, whereas a nurse practitioner can do just two years and apply for cardiology positions.” Jones says that while nurse practitioners can absolutely provide adequate care, it’s important that they have a medical director who has the necessary experience to handle more complex cases.
Even with an increase in nurse practitioners and physician assistants, barriers to care like decreasing reimbursements and high insurance deductibles still exist.
Healthcare For All Oregon is a nonprofit organization dedicated to advocating for universal health care for all Oregonians, regardless of income. Collin Stackhouse, chair of HCAO Portland chapter, says one solution to the declining number of PCPs is “having a stable, state based universal health care system that actually properly compensates primary care providers.”
He adds that it “could entice providers to move to Oregon and start fulfilling the need that we obviously have.”
In one year, Oregon’s Universal Health Care Governance Board will present a proposal to adopt universal health care to the Oregon Legislature as a result of Senate Bill 1089, which passed in 2023. The nine-member board appointed by the governor is charged with developing a comprehensive plan to finance and administer a universal health plan.
Stackhouse and Lane County HCAO chapter chair Lou Sinniger say they’re hopeful that within the next three years, Oregon can set an example by implementing the nation’s first ever universal health care program. “Oregon has a history of being the first state to do things,” Sinniger says. “We became the first state three years ago to make it a constitutional right to have access to affordable health care. We’re the only state in the nation that has that in our constitution. So if we can do it there, we can, we can do the next step.”
Having a universal health care program could increase access to primary care services by providing adequate reimbursement to physicians and reducing patient financial barriers. “I hope that people really pay attention to a way out of this costly, failing medical system and look at universal care as an option — as a way out of it and as a way to make things better, not only for themselves, but everybody else.”
The HCAO Lane County Chapter holds monthly meetings every first Tuesday of the month at 7 pm at the United Methodist Church in Eugene. The meetings are also available via Zoom. Visit Hcao.org/chapters/lane-county for more details.