Health Care Focus Shifts From Doctors To Dollars Idaho Still Has Worst Ratio Of Doctors To Residents, But Lawmakers More Concerned With Cost Cutting

Idaho still has the worst ratio of doctors to residents of any state in the nation, but the health care debate that focused just four years ago on assuring everyone had access to medical services has shifted to cutting costs for those who do get to the doctor.

Idaho’s strong economy has been attracting doctors from other states, where the economies are weaker and the pressures more intense, and some of them are plugging gaps in the health delivery system in rural areas.

In fact, Senate President Pro Tem Jerry Twiggs of Blackfoot says there seems to be a perception, at least among some people, that the doctor shortage has abated.

But while the state is seeing 120 or more doctors move in each year, only half are the kind of primary care physician the state badly needs and only some of them relocate to the rural areas, Bob Seehusen of the Idaho Medical Association said.

“We may still be at the bottom, but we have more physicians than we had five years ago,” Seehusen said. “But we still have a problem out in the more rural areas.”

Four years ago, Democrats in the state Senate thought they had crystallized the debate over health care with their controversial IDAHEALTH proposal for universal health care in the state. While its radical approach was rejected by the full Senate - the only bill ever to fail to get even one favorable vote - the debate seemed to demonstrate a commitment by leaders in both parties to finding a way to assure every Idahoan had access to health care and a way to pay for it.

At the time, a study indicated about 16 percent, or 160,000 people, many children, were without health insurance.

The focus on access to both doctors and insurance, however, seemed to fade quickly.

And the balloon lost what little air it had left after 1994’s national debate over health care reform - a debate that magnified both the fear and the cost of change.

The national debate spotlighted cost as a major problem and convinced any number of state and local policy makers that the price of care had to be brought down before they would ever be able to afford making sure everybody had access to it.

Another survey last year found that about 15 percent of Idahoans still do not have health insurance. But with his self-declared tightwad philosophy, Gov. Phil Batt took office with little inclination to begin pouring more cash into government programs aimed at making insurance more affordable or putting more doctors into rural areas.

That has left a number of lawmakers frustrated, but some continue to search for ways to make care more available.