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THE PASSAGE BY the Massachusetts Senate of S-3116 at the end of June marks a milestone in efforts to strengthen Massachusetts’s vital but fragile primary care sector. The bill’s detractors are now furrowing their brows and defending the status quo. Their arguments should not carry the day.

I know because I confronted and refuted those same arguments 15 years ago as Rhode Island’s health insurance commissioner when we started down the same path.

Primary care is essential to a high-performing health system. It is the only health care service where an increased supply results in longer lives and more equitable outcomes. Hospitals, specialists, and the pharmaceutical industry cannot say the same thing. Yet because of political power and explicit public policy, we have funneled more and more money into those services, resulting in an ever-weakening primary care system, in Massachusetts and the country.

The solution is clear but requires persistence. We must spend a greater portion of our health care dollar on primary care and pay for it in ways that allow primary care teams to improve access and coordination. This is exactly what S-3116 would do.

The bill would require increasing the share of health care spending directed to primary care from the current level of less than 7 percent to at least 15 percent. It would phase in this shift over three years, starting in 2028, and require that the change have no net impact on health care spending, insurance premium prices, or cost sharing paid by patients.

It recognizes that the current model of private rate negotiation between health insurers and providers advantages large systems, which use their size to negotiate high rates for their profitable medical services, leaving primary care clinicians with crumbs and patients without access.

Faced with the prospect of change, insurers and health care providers have started wringing their hands. Insurers raise the prospect of increased insurance premiums. Providers, seeing a threat to their revenues, point to increases in the number of uninsured resulting from Medicaid cuts stretching their budgets.

I have heard these arguments before, and they need to be recognized for what they are — a defense by entities invested in the current ways of doing things. This is the status quo that created this mess.

In Rhode Island, 15 years ago, we saw the value and the impoverished state of primary care. Confronted with the evidence, a consumer and business advisory council told the Office of the Health Insurance Commissioner, which I led, to increase primary care spending for commercial health insurance without adding to premiums. We used the annual rate review process to do just that, holding insurers accountable for increasing primary care spending without contributing to premium increases.

And insurers did their part. It turns out when only 5 percent of health care dollars goes to primary care, to increase that portion you don’t have to take money away from anybody. You just have to give everybody else lower increases each year than they might like. After some initial resistance, insurers liked having a bad guy they could point to when they offered lower increases to specialists and hospitals.

As for the costs of uninsured, those expenses are indeed significant for large health systems, but only as they are currently configured. While Massachusetts needs to continue its nation-leading efforts to keep everybody covered, it must also find cheaper ways to pay for that coverage.

That means these large health systems — as the state Health Policy Commission has regularly articulated — must rebalance themselves to be more primary-care-oriented, so that uninsured people need not wait for expensive and wasteful emergency room care.

With employer support and comprehensive rate review, provider and insurer handwringing did not carry the day in Rhode Island, and enforceable primary care spend targets were implemented. Subsequent premium increases have been significantly lower than in Massachusetts, and hospitals somehow managed to stay in business. However, overall primary care spending in the Ocean State has not increased in the last 15 years, and the state of primary care is no better than in Massachusetts.

There were three major reasons for this: 1) our measures only affected commercial insurance — a small portion of the health care dollar — not Medicaid or large employers who self-insure and are not subject to state regulation; 2) we did not address how primary care got paid; and 3) we did not follow through with monitoring and oversight.

The bill passed by the Massachusetts Senate — informed by the deliberations of the Primary Care Task Force established last year by the Legislature — learns from our efforts in Rhode Island and addresses all those shortcomings. It holds large health systems as well as insurers accountable for increasing primary care spending, thus covering the self-insured population. It prepares for a change in how primary care gets paid by facilitating the broad adoption of MassHealth’s highly acclaimed primary care payment model, where they have defied insurers’ concerns and raised primary care spending without contributing to increased overall Medicaid costs. And it establishes an office of primary care policy in the Health Policy Commission to keep the state’s collective eye on the ball.

The bill’s architect, Sen. Cindy Friedman, and Senate President Karen Spilka have done the Commonwealth a great service in advancing this legislation. Attention now turns to the House, where “the assassins of progress,” as one Rhode Island advisory council participant memorably labeled industry soothsayers, will no doubt focus their efforts to defeat the bill. Those calls need to be ignored.

High-quality primary care must be a common good for all Massachusetts residents. It is the most important part of a health care system, and it needs to be treated as such.

Christopher Koller was the country’s first health insurance commissioner, serving in Rhode Island from 2005 to 2013. He is now a senior advisor at Ariadne Labs in Boston.