The following editorial appeared Tuesday in the Idaho Statesman.

No generic equivalents here. Idaho isn’t going to cure its health care problems on the cheap. The recommendations from Gov. Butch Otter’s health care summit make that point painfully clear.

The task force’s recommendations serve up a generous dose of hard reality:

“Comprehensive statewide health coverage could reduce serious illnesses and save money down the road, but it may cost money at the outset. As a result, the state may have to explore sales or cigarette tax increases.

This was probably the task force’s boldest recommendation, but this kind of thinking is long overdue in a state with more than 220,000 uninsured people, including 42,000 children. And Otter deserves credit as well: On Friday, he put pressure on the Legislature by voicing support for public-private partnerships to cover all uninsured or underinsured Idahoans.

“Idaho will need 5,000 additional nurses by 2020 – a challenging goal in a state that has about 18,000 licensed nurses, according to a 2006 report commissioned by then-Gov. Jim Risch. To meet demand, the state will have to double the number of nursing seats at its colleges and universities. On top of that, says the task force, “nursing faculty salaries must be raised to be competitive with hospital wages.” Idaho has no choice. It simply has to grow its own next generation of nurses – by continuing to invest in the state’s nursing programs.

“The task force doesn’t rule out creating an Idaho medical school, perhaps five to 15 years in the future. The group recommends building on Idaho’s partnerships with neighboring states – by increasing the number of medical school spots available for Idaho students.

Unfortunately, the task force seems to view this only as a short-term answer, when in fact these partnerships could provide Idaho a long-term supply of new doctors at an affordable price. The state is spending more than $4.75 million this year for 28 medical school seats at the University of Washington and the University of Utah – while avoiding the huge costs of building and maintaining its own medical school.

Remedies – from incentives for “wellness behaviors” to creating a statewide health database – are going to cost us all some money.

A dysfunctional health care system is costly, as well. When people are uninsured, we all wind up paying the difference – through inflated medical bills or taxpayer-funded catastrophic care. Uninsured people sometimes skip basic preventive care, allowing diseases to go undiagnosed and untreated. A shortage of doctors and nurses will make it more difficult, and more expensive, for all of us to get the health care we need. And as Idaho grows, our population grows older, placing more strain on a broken system.

Otter’s health care task force got off to a disappointingly secret start, meeting behind closed doors for two days in August. Ultimately, the task force took a broad look at the problems, and offered up some no-nonsense recommendations. Let the discussion begin – in public.