The Idaho Spending Index examines appropriation bills on several fronts to add important context to lawmakers’ discussions as they are considered on the floor of the House and Senate. Among the issues we look at in drawing a conclusion about a budget:
Does the agency requesting these funds serve a proper role of government? Has wasteful or duplicative spending been identified within the agency, and if so, has that spending been eliminated or corrected? Does the budget examine existing spending to look for opportunities to contain spending, e.g., through a base reduction? If there is a maintenance budget, is that maintenance budget appropriate? Are the line items appropriate in type and size, and are they absolutely necessary for serving the public? Does the budget contemplate the addition of new employees or programs? Does the appropriation increase dependency on the federal government?
Our analysis is intended to provide lawmakers and their constituents with a frame of reference for conservative budgeting, by summarizing whether appropriation measures contain items that are sincerely objectionable or sincerely supportable.
Bill Description: Senate Bill 1418 appropriates $25,200,800 and 42.65 full-time positions to the Division for Health Education Programs for fiscal year 2023.
Senate Bill 1418 expands the number of medical residencies far above what the agency and the governor requested to be appropriated for the 2023 fiscal year. Notably, this budget seeks to add three full-time positions to the Idaho State University Family Medical Resident program and creates five more line items for residency programs than was requested. These extra programs would be in addition to the original 7 programs designed to add 14 residency positions throughout the state. The total cost of these new residency appropriations will cost more than $1.2 million.
The evidence for the effectiveness of physician retention through residency programs is not very promising. According to the Legislative Budget Book, Idaho’s 5-year physician retention rate post-residency is only between 58.5% and 73.3%. It would be improper to assume that simply adding more residencies alone would improve the physician shortage in the state.
Nearly all the 2023 funds for medical residencies come from the General Fund. Meaning that when physicians leave the state after their residency, the constituents’ tax investments are lost for the benefit of other states, not for that of Idahoans. This is not a responsible use of taxpayer funds.
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