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Opinion >  Editorial

Editorial: Washington needs doctors; funding delays are senseless

UPDATED: Fri., March 15, 2019

Every now and then, Spokane Democrat Timm Ormsby should step back from the budget process he leads as chairman of the Washington Legislature’s House Appropriations Committee and say to himself, “This is nuts.”

It’s nuts that a fresh appropriation of $10.8 million will be required to support students’ final two years at Washington State University’s Elson S. Floyd College of Medicine in Spokane. The money wasn’t included in projections for the 2019-21 budget, as if half of a four-year medical education can be regarded as optional.

And it’s nuts that the Legislature is balking at an expenditure of $3.6 million to expand enrollment at WSU’s medical school to 80 students per year from the current class size of 60, as has always been planned.

Now the first nutty situation might affect the second, providing an excuse to skip the new students. Senate Majority Leader Andy Billig, D-Spokane, says the Legislature’s top priority is to ensure continued funding for the medical school’s current students. Once that obligation is met, lawmakers could clap themselves on the back and conclude they’ve done their bit for medical education in Spokane.

They won’t have. The $10.8 million isn’t new money, only the ongoing expenditure the state committed to when it opened the medical school.

Further contributing to a maybe-later mindset is the fact that the University of Washington’s medical school in Spokane, operated in partnership with Gonzaga University, also hopes to increase its enrollment to 80 students per class from the current 60. Space constraints, however, prevent that expansion from occurring immediately. Legislators might persuade themselves to believe they’re being evenhanded by deferring growth at both WSU and UW.

But a delay would prevent the WSU medical school from reaching the optimum size envisioned when the inaugural class began its studies in 2017. And the fact that UW isn’t prepared to enlarge its Spokane medical program makes it even more urgent to move forward with the WSU expansion.

It’s not WSU that needs greater medical-school capacity – it’s the state of Washington. John Tomkowiak, dean of the WSU medical school, says that even if every one of his graduates practices in Washington, the state would still need an additional 100 to 150 doctors a year.

The need is especially acute in rural Washington – a need that WSU’s medical education program is designed to address. The program sends third- and fourth-year medical students to study and train at WSU’s campuses in Everett, the Tri-Cities and Vancouver, with only a quarter of them remaining in Spokane. WSU’s dispersed curriculum promises to scatter newly trained doctors widely.

That ought to make WSU’s medical school expansion a priority not just for Spokane’s delegation, but for legislators throughout the state. Yet lawmakers appear wary of making any financial commitments in advance of the state’s next revenue forecast, due March 20.

While wariness in matters of public finance is welcome, perspective is also required. The Legislature expects $4billion in increased revenue during the 2019-21 biennium; the March 20 forecast will bring a minor adjustment in that amount. A $3.6 million appropriation allowing WSU to train more doctors would soak up less than one one-thousandth of the new money sluicing through the corridors of the Capitol.

What’s more, the appropriation would be an investment, not an expenditure. A 2010 analysis by the consulting firm Tripp Umbach – confirmed by an independent 2014 study commissioned by UW – projected that medical education would add $1.6 billion and 9,000 jobs to Spokane’s economy over a 20-year period. Even if only half of Tripp Umbach’s projected gain materializes, and even if only one dollar in 10 lands in state and local government coffers, the result is an $80 million increase in tax revenue.

A far more important benefit, of course, would come in terms of public health. WSU-trained physicians will focus on family medicine, mental health, addiction treatment and rural practice – all of which Washington desperately needs. Lawmakers from Spokane and throughout the state should do what they can to support and expand WSU’s new medical school. Uncertainties, hesitations and delays are just plain nuts.

Note to readers: The sixth paragraph has been edited. Originally, it called the University of Washington’s medical school “new”; the medical school started in Pullman in 1972 and was expanded to the Spokane campus in 2006.

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