Kevin Richert's  aptly titled editorial, State Board needs to refocus on higher ed  (April 13, 2009), scored a bulls-eye, but his dismissal of Idaho State University President Arthur Vailas's medical education vision for the State of Idaho as ill-conceived, missed the mark altogether.

The fact is,  President Vailas's call for a statewide, distributive model  for medical education is an exercise in sorely-needed leadership.  Idaho suffers from a paucity of practicing physicians. Consequently,  it ranks at the bottom of the nation in the delivery of health care to its citizens, and it is on the brink of  crisis as the physician work force ages, with too few replacements in sight.  Vailas has offered a sound and cost-effective remedy.

It is little wonder that President Vailas's proposal has been embraced by many legislators, business leaders  and physicians across the state, that it has found favor with Governor Butch Otter, and that it has been backed by GMT, a national firm commissioned by the Idaho Legislature, to evaluate the health care needs of the state and its capacity to establish a medical program.

Idaho's continued enrollment in  WWAMI the outsourcing of medical educationdeprives Idahoans of the opportunity to shape and determine our own medical education standards, needs and priorities, along with the many health care and economic benefits that flow from medical education. It is assumed, for example, that medical students educated in Idaho, and who fulfill their residency training here, are more likely to practice medicine in Idaho. Greater numbers of physicians promise greater access to health care. Other  important medical benefits flow from the presence of a medical program, including access to clinical trials and the impact of medical research.

The economic benefits, moreover, can be dramatic.  Conservative estimates show that the medical school business volume multiplier effect is 2.3, meaning that every $1 spent by a medical school generates an additional $1.30, for a total impact of $2.30.  The medical program will  attract new industries and businesses which, in turn, will create jobs and generate revenue. The economic boom is undeniable.

Why should Idaho outsource  medical education ? To save money ?   If that's the driver, then why not outsource other programs, including legal education and engineering ? We retain those programs, and initiate others, precisely because of their value to our state. When it comes to the health and welfare of Idaho, medical education is indispensable.

If the goal is to  provide and expand medical education in the most cost-efficient manner, then Vailas's plan deserves to be embraced.  WWAMI costs our state  $48,210 per seat, per year. So, four classes of 20 seats per year will cost $3, 856, 800.  Under Vailas's proposal, students could bear the full cost of annual tuition in Idaho by paying $46,952.  Of course, that cost could be offset by state support, or other resources, but the bottom line, which often matters to pragmatic Idahoans, is that the proposed medical education program would cost less and produce greater numbers of graduates.  That's getting a bang for your buck.

The case for a medical education program in Idaho is compelling.  Why should Idaho rent medical education when it can own it ?

The Center for Advance Energy Studies (CASE), located at University Place in Idaho Falls, affords  a striking illustration of the capacity of the state universities to cooperate  in providing highly specialized education and promoting solutions to the global need for energy. Health care represents an area of surpassing importance to Idahoans.  If we can collaborate in the vital field of  energy research, then surely we can do it when the issue involves the quality and length of life for our citizens.

David Adler is a Professor of Political Science at Idaho State University.