Gov. C.L. "Butch" Otter wants to expand the number of slots provided for Idaho students at medical schools in neighboring states through a state-sponsored program that reserves seats for Idaho residents and then encourages them to come back and practice in Idaho.

While Idaho's doctor shortage is a problem acknowledged by everyone, including the governor, at his post-State of the State news conference Otter rejected the idea that the shortage of primary care physicians could stop the implementation of a proposal to extend primary care coverage to the uninsured.

Otter spent a few paragraphs in his annual message on doctor recruitment, saying he wants to add five seats to the state's medical school partnership with the University of Washington, bringing it up to 40. In a separate budget presentation to the Joint Finance Appropriations Committee Tuesday morning, Division of Financial Management Administrator Jani Revier said Idaho also wants to add two more slots to a similar program it runs in partnership with the University of Utah, which would bring it up from eight to 10.

Idaho doesn't have a medical school of its own. In both cases, Idaho sponsors slots at these medical schools and then helps the graduates repay their loans if they return to Idaho to practice, with the money coming from fees paid by the medical students.

In his speech, Otter called this "a great investment in our students and an important step toward addressing our community needs," but acknowledged that it is "also a pipeline from which it takes years to realize benefits."

"There are quicker ways to address our shortage of primary care physicians," Otter said. "So I encourage you to keep funding our physician residency slots. And we must keep attracting health care professionals by providing medical loan reimbursement incentives for primary care doctors who agree to serve our rural communities. In the meantime, I'm asking the Board of Education to work with our medical communities and higher education institutions to develop a new plan for addressing future demand for health care providers."

John Ness, the CEO of Kootenai Health, told lawmakers last week that Idaho would probably need several hundred more primary care doctors to implement a $30 million plan to extend primary care coverage to the estimated 78,000 Idahoans who don't qualify either for Medicaid or for tax credits to buy insurance on the state exchange.

Otter, though, said after his speech Monday that the state's doctor shortage wouldn't be such an obstacle to implementing the Primary Care Access Program. Otter said many of the uninsured who would get coverage through the program are already going to the community clinics that would take part in the program. DHW officials said the same thing last week when I asked them about it.

"We're prepared for the 78,000," Otter said.

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