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Research ArticleResearch Briefs

The General Public Vastly Overestimates Primary Care Spending in the United States

Melissa Ma, Rebecca Etz, Andrew Bazemore and Kevin Grumbach
The Annals of Family Medicine March 2025, 23 (2) 165-167; DOI: https://doi.org/10.1370/afm.240413
Melissa Ma
1School of Medicine, University of California, San Francisco, San Francisco, California
BS
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  • ORCID record for Melissa Ma
  • For correspondence: Melissa.Ma@ucsf.edu
Rebecca Etz
2The Larry A. Green Center, Department of Family Medicine and Population Health, Virginia Commonwealth University
PhD
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Andrew Bazemore
3The American Board of Family Medicine, Lexington, Kentucky
MD, MPH
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Kevin Grumbach
4Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California
MD
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    Figure 1.

    Comparison of the Public’s Estimated Health Care Needs Addressed by Primary Care and Estimated PC Spend vs Actual PC Utilization and Expenditure in the United States

    PC = primary care.

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    Table 1.

    Characteristics of Survey Respondents

    CharacteristicsRespondents No. (%) (n = 1,135)US Census Data (%)a,8
    Sex
    Male511 (45.0)49.0
    Female607 (53.5)51.0
    Unknown17 (1.5)
    Age, y
    18-29218 (19.2)21.6
    30-44292 (25.7)25.4
    45-60325 (28.6)23.0
    ≥ 60283 (24.9)30.0
    Unknown17 (1.5)
    Major geographic region
    Northeast276 (24.3)17.0
    Midwest190 (16.7)20.6
    West240 (21.1)23.6
    South386 (34.0)38.9
    Unknown43 (3.8)
    Household income, USD
    0-24,999192 (16.9)14.1
    25,000-49,999219 (19.3)17.2
    50,000-74,999174 (15.3)15.7
    75,000-99,999144 (12.7)12.1
    100,000-149,999190 (16.7)17.0
    150,000 and up138 (12.2)23.9
    Unknown78 (6.9)
    Self-identified race
    American Indian/Indigenous or Alaska Native28 (2.5)2.1
    Asian132 (11.6)7.3
    Black or African American84 (7.4)14.6
    Native Hawaiian or Pacific Islander9 (0.8)0.5
    White789 (69.5)75.5
    Other36 (3.2)
    Unknown57 (5.0)
    Hispanic or Latinx
    Yes203 (17.9)19.5
    No895 (78.9)80.5
    Unknown37 (3.3)
    Education levelb
    Some high school36 (3.2)7.4
    High school degree247 (21.8)35.9
    Associate degree128 (11.3)7.2
    Bachelor’s degree351 (30.9)27.9
    Graduate or professional degree272 (24.0)16.3
    Trade school/technical college degree56 (4.9)5.3
    Other28 (2.5)
    Unknown17 (1.5)
    • US = United States; USD = United States dollars.

    • ↵a All categories derived from 2023 US Census data, except education level.

    • ↵b Education level derived from 2022 US Census data.

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  • PLAIN-LANGUAGE SUMMARY

    Research Brief

    The General Public Vastly Overestimates Primary Care Spending in the U.S. by More Than Tenfold, Study Finds

    Background and Goal: Despite its foundational importance to health outcomes, primary care in the United States accounts for only 4.7% of total health care expenditures. This study, based on an online survey of 1,135 adults demographically representative of the U.S. population, aimed to measure public perceptions of primary care spending.

    Key Insights: Respondents estimated that primary care addresses 58.7% of U.S. health care needs. However, participants believed that 51.8% of overall health care spending goes to primary care—more than 10 times the documented share of 4.7%.

    Why It Matters: Chronic underinvestment in primary care has resulted in workforce shortages, physician burnout, reduced access, and suboptimal care. Access to high-quality primary care has been associated with better population health and more equitable outcomes. The substantial overestimation of primary care spending by the public highlights the need for increased patient and public engagement and education to rally additional state and national support for policy changes that affirm the essential role of primary care in the health care system.

    The General Public Vastly Overestimates Primary Care Spending in the United States

    Melissa Ma, BS, et al

    School of Medicine, University of California, San Francisco, San Francisco, California

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The Annals of Family Medicine: 23 (2)
The Annals of Family Medicine: 23 (2)
Vol. 23, Issue 2
Mar/April 2025
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The General Public Vastly Overestimates Primary Care Spending in the United States
Melissa Ma, Rebecca Etz, Andrew Bazemore, Kevin Grumbach
The Annals of Family Medicine Mar 2025, 23 (2) 165-167; DOI: 10.1370/afm.240413

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The General Public Vastly Overestimates Primary Care Spending in the United States
Melissa Ma, Rebecca Etz, Andrew Bazemore, Kevin Grumbach
The Annals of Family Medicine Mar 2025, 23 (2) 165-167; DOI: 10.1370/afm.240413
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