Published in RINewsToday on May 4, 2026

In 2023, Primary Care for All Americans (PC4AA) was launched as a national initiative to raise primary care as a public policy priority and advocate for payment reform to promote universal access to high-quality primary care. Primary care physician and former Rhode Island Health Director Dr. Michael Fine is the driving force and co-founder of PC4AA. He is also the author of several books, including “Healthcare Revolt” and “On Medicine as Colonialism.”

When asked why PC4AA was needed, Dr. Fine responded:  “ We wondered about that ourselves.  Physician groups tend to focus on pocketbook issues.  Public health folks focus on health outcomes.  But no one was putting it all together.  And no one was specifically involving communities or showing them how they could provide primary care to everyone, in part because primary care is so affordable,” he said.

Dr. Fine explains the organization’s focus, stating: “Our mission is very clear. We exist to help communities figure out how to provide primary care to everyone, learning from the experience we gained in Scituate, Rhode Island.” In Scituate, the community locally funded a voucher program that successfully provided primary care to all uninsured residents for over two decades. “It’s the only place that we know of that assures everyone has access to primary medical and dental care,” he says, highlighting a replicable model.

Dr. Fine maintains that comprehensive primary care is a surprisingly affordable essential service, with its per-person cost comparable to municipal services such as police, fire, and road maintenance.

PC4AA’s influence and policy impact derive from the scale of its collaboration rather than from formal enrollment numbers alone. By uniting primary care physicians, health policy experts, patient advocates, academic leaders, and public health professionals, the coalition helps build nationwide consensus for health care reform—especially in making primary care accessible to all Americans, says Dr. Fine.

The coalition’s community-building efforts are apparent in its active workgroups. “We have over a thousand people in local or state workgroups who clicked ‘Join Us’ on our website, and they participate in some way,” says Dr. Fine. He further stresses that their growth is tracked by the number of these workgroups joining monthly online meetings and through the passage of primary care legislation at the state level.

Dr. Fine notes that the difficulty of accessing primary care inspired the creation of PC4AA. He notes that primary care uniquely improves public health while reducing costs, and that an adequate number of primary care doctors is essential to making healthcare affordable.

According to Dr. Fine, less than 43 percent of Americans have meaningful primary care relationships, a figure that is falling as fewer medical students choose primary care. Internationally, effective, affordable health care systems have at least 50 percent of physicians in primary care, he says.

Responding to these primary care workforce trends, PC4AA’s top priority is to expand access to primary care nationwide. “We need  thousands of new primary care clinicians,” says Dr. Fine, explaining that this can be accomplished by establishing new medical and physician assistant schools and by increasing residency programs.

PC4AA also advocates for reducing primary care doctors’ workloads, eliminating preauthorization and cutting administrative duties, and improving reimbursement. Although accounting for less than 4 percent of health spending, primary care accounts for half of all patient visits, costing about $575 per person annually, out of an average total of $15,000.

Having operated for over three years Dr. Fine acknowledges a major challenge the group faces: a “feeling of impotence.” Although healthcare may seem “too big and scary for some” and many believe that “only the big guys can fix it,” Dr. Fine insists that the power to make systemic changes actually lies with communities. He points out, “Look at how Newport fought successfully to keep their birthing center open, or what Scituate did.”

While these may be viewed like temporary strategic challenges, Dr. Fine reframes these obstacles as chances for growth and community empowerment.

Fine argues that fixing the healthcare system requires a broad-based social movement, similar to past movements for abolition and suffrage, to restore community agency and build a system that serves people ahead of profit.

Communities can take forward-thinking actions to solve their own healthcare problems, says Dr. Fine, by creating local primary care reports, passing city council resolutions, and building scholarship programs to grow their own healthcare workforce.

“Get started, have a conversation, understand that you can do this because you can,” states Fine. He challenges readers to actively join the movement—by connecting with local efforts, attending on-line meetings, and spreading the message in their communities. “Take concrete steps, unite others, and turn awareness into real progress. Together, we can build the future of primary care from the ground up.”

PC4AA Welcomes First Executive Director

According to its March 31 newsletter, PC4AA announced the hiring of Neda Ashtari, MD, MPP, as its first Executive Director.  This appointment arrives at a time when the nation is fiercely debating how to expand access to health care and reduce spiraling costs.

 In the newsletter, PC4AA writes: “Dr. Ashtari brings to PC4AA something rare and deeply needed—a combination of lived experience, clinical insight, policy expertise, and movement-building leadership. As a physician serving in the safety net in Los Angeles during residency, she cared for patients managing a broken system where access too often depended on income and coverage status. She watched as patients were lost in the system due to insurance gaps or delayed medical care because of costs. These were not abstract policies; they were daily realities.”

 The newsletter also highlights Dr. Ashtari’s own perspective: “I keep coming back to a simple conclusion,” she writes. “Lasting reform starts with universal access to primary care.” It notes that this conviction has guided her work for more than a decade across organizing, policy, and clinical care.

PC4AA further points out in the newsletter that Dr. Ashtari has led national advocacy campaigns, including the American Medical Student Association’s Lower Drug Prices Now initiative, coordinating organizing efforts across more than 30 chapters nationwide. Through her leadership with Universities Allied for Essential Medicines, she helped build coalitions that expanded access to lifesaving medications globally—work recognized in the documentary White Coat Rebels.

The newsletter emphasizes that she co-founded Protect US, a public health nonprofit focused on expanding access, strengthening public health infrastructure, and combating misinformation. After serving as Associate Director of Health Policy at the Center for American Progress, Dr. Ashtari recently assumed a new role as Director of Federal Affairs at the American Medical Association, where she advocates on behalf of clinicians and patients on Medicare Advantage policy.

Looking forward, Dr. Ashtari outlines her vision for the role in the newsletter: “As PC4AA’s Executive Director, I will work to translate the organization’s grassroots energy into a durable national movement—one capable of changing how primary care is valued, funded, and delivered across the country.”

The newsletter closes by emphasizing a consistent theme across her work: Dr. Ashtari is “not only a thinker, but a builder,” noting that she understands policy alone is not enough—lasting change requires organizing and translating values into durable systems that people can rely on.

 Mark Your Calendar

The organization is convening the “Health Care Renaissance Summit,” its inaugural gathering to build a coordinated national movement for primary care reform.  The summit, scheduled for May 20, 2026, at the Le Méridien Hotel in Cambridge, MA, brings together an eclectic group of stakeholders—including clinicians, community organizers, medical students, policymakers, and advocates—reflecting PC4AA’s strategy of linking grassroots organizing with policy change.

“According to PC4AA, this one-day national summit is designed to be interactive and results-driven. The event features keynote speaker Dr. Jonathan Fitzsimons—a family physician and Medical Lead of the Renfrew County Virtual Triage and Assessment Centre—along with talks from national leaders, skill-building workshops, and “table talks.” These joint sessions allow participants to share strategies and unique experiences. Core discussions focus on practical approaches, such as advancing local policy resolutions, launching student-driven initiatives, and strengthening state- and community-based coalitions.”

Organizers hope attendees leave the summit with practical tools for local organizing and real-world examples to bring home to their communities. The event connects people to a national support network and advances PC4AA’s mission to expand primary care access through community-led work that creates lasting change.

Ticket Pricing is $50 for students and $250 for general admission. Register now at https://pc4aasummit.netlify.app/# to be part of this movement for healthcare reform and help drive change in primary care in your community.

Summit sponsors include: New Bedford Community Health (New Bedford, Massachusetts); City of Pawtucket (Pawtucket, Rhode Island); Tufts University School of Medicine, Department of Family Medicine; The Meyers-Keller Fund for Good Works (Denver, Colorado); Elation Health (San Francisco, California); and Michael Kaplan, MD(Lenox, Massachusetts).

To visit PC4AA’s website, go to https://primarycareforallamericans.org/

Listen to Dave Chase’s Relocalizing Health podcast interview with Dr. Michael Fine, “How Primary Care and Community Agency Can Transform Healthcare from Extraction to Empowerment,” at: https://relocalizinghealth.com/episode/how-primary-care-and-community-agency-can-transform-healthcare-from-extraction-to-empowerment