Do no harm to medical care

Doctors, when taking the Hippocratic Oath, swear to “First, do no harm.” It’s an oath Washington legislators might do well to repeat to themselves as they consider health-care funding issues in the state’s operating budget.

Groups representing the various aspects of health care, specifically the Washington Healthcare Forum, are watching with some anxiety as education and transportation needs garner the greatest share of attention at the start of the legislative session. While the state constitution calls the funding of education the state’s “paramount duty,” “paramount” doesn’t mean “only.” Driving at least some of that anxiety is the fact that funding for most health-care programs in the state isn’t mandatory under the constitution and is vulnerable to cuts.

The Washington Healthcare Forum, a coalition that represents hospitals, doctors, insurance providers and related state associations, since 1999 has brought together chief executive officers from those groups, represented locally by the CEOs at Everett Clinic, Providence Health and Services and Premera Blue Cross. The forum’s funding concerns have grown as reforms in health care continue, both undertaken by government and the market itself and at a time when the patient population is growing and aging.

Among the forum’s chief concerns, said Everett Clinic CEO Rick Cooper, is the double hit that programs, including Medicaid, could take in a budget cut. “If the funding level drops, those programs lose access to federal (matching) dollars,” he said in a recent meeting with the Herald Editorial Board. Beyond that, the cuts can have even greater ill effects resulting from lost efficiencies and, if preventive care is limited, increased costs and poor patient health.

The forum has taken no position on the competition between the University of Washington and Washington State University as to which school should add medical school capacity, though Providence’s Preston Simmons noted that the state risks a shortage of 1,700 primary care physicians by 2030. Currently there aren’t enough resident training positions in the state to meet the demand for care. Likewise there is current and growing need for nurse practitioners and physician’s assistants.

We earlier encouraged the Legislature to continue to provide funding, joined with support from the private sector, for the Washington State Opportunity Scholarship program, which provides grants to college students entering health care and STEM career fields. The scholarship aims to keep those students in the state after college, which would help fill the need for medical professionals noted by the Washington Healthcare Forum.

Funding of health care programs may not be the state’s paramount duty, but it should be a priority.

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