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Dr. Stange's piece was brilliant and articulate, and his proposed solution had a compelling ring to it. I am concerned however that if lots of primary care providers were to move to the (admittedly appealing) direct care model, the eventual result might be a more functional system, but the near term result would be a great many patients unable to access primary care. I wonder if a more practical approach might be for those of us who believe in a system more equitable, accessible, and responsive to patient's needs, to lend strong support to the movement for "Improved Medicare for All." A single payer, publicly funded, publicly accountable health care system that covers everyone, could choose to make the much needed greater investment in primary care (among other improvements) that we are unlikely to see in our current hopelessly fragmented and profit-driven system.