Cigarette tax hike could restore class size

By Lana Groves, Asst. News Editor

A tobacco tax increase could help the U School of Medicine restore its class size back to 102.

U administrators said the medical school, which decreased the 2009-2010 incoming class size by 20 students in the face of a 40 percent budget drop, could receive an additional revenue source if Utah legislators reintroduced a bill that would increase taxes on cigarettes to one cent above the national average.

The bill, House Bill 219, was substituted and held in the Utah Legislature’s 2009 General Session, but U administrators say it could be introduced if Gov. Jon Huntsman Jr. calls a special session to handle budget deficits.

One of the things they’ll have to deal with is a reduction in the Medicaid budget.””We talked to the governor and legislators over the session,” said Kim Wirthlin, vice president for government relations at the U. “They understand what we’re going through and will help us look for a solution. A special session will be called if there’s a reason to.

The state cut payment for in-patient hospital care for Medicaid patients by 20 percent for Utah hospitals, which equals an almost $12 million cut for the U Hospitals and Clinics.

Wirthlin said legislators have been debating about whether to hold a special session, which would occur during the summer if Huntsman calls one.

An increase on tobacco taxes would be the only way to restore revenue sources to the U medical school, which lost $10 million in funds when the Centers for Medicaid and Medicare discontinued a funding source to the Utah Department of Health last September.

“We really don’t have any other sources to cover our educational costs,” said Lorris Betz, vice president for health sciences. “We’re not requesting anywhere near the reduction in our educational budget and we’re already cross-subsidizing, using revenue that’s generated when our faculty take care of patients, to support their teaching.”

The medical school increased tuition by about $3,000 for in-state students to offset budget problems, but administrators say tuition only covers one-fourth of costs to train a medical student every year.

The tobacco tax bill could substitute the lost annual revenue source, as it would bring in a projected $26 million for the 2010 fiscal year, said Rep. Paul Ray, R-Clearfield.

Ray said the purpose of the bill is to pay for smokers on Medicare, whose medical bills the state would eventually pay for, and the negative impacts of secondhand smoking.

“We had been in discussions with the staff at the University of Utah, and I’m certainly amenable,” Ray said. “I want to keep all the revenues from the cigarette tax to health-related items, but I don’t have a preference as to where to direct the money.”

During the spring legislative session, Wirthlin said legislators considered a motor vehicle bill, Senate Bill 239, which increased vehicle registration fees, and a grocery tax, House Bill 403, which would have increased sales taxes on food, as possible ways to alleviate the medical school’s budget losses.

“We knew we were going to have some more budget shortfalls, so didn’t want to use up everything at once,” Ray said. “We kept it as an arrow in the quiver to fall back on8212;something to pull more revenues with if we had to.”

If it is brought up in a special session, the tobacco tax could solve current problems for the medical school, which has a potential impact on the national physician shortage for primary care.

The Association of American Medical Colleges is calling for a 30 percent increase in the number of medical students enrolled by 2015, a feat the U medical school was trying to back until the unexpected funding problem hit.

“We are not happy that we’ve had to reduce our class size, considering the physician workforce needs in Utah, but we don’t want to compromise the quality of education,” Betz said. “We just can’t teach as many students as we did before.”

The medical school teaches at a 1:2 teacher-to-student ratio in some upper level courses. If the school kept class sizes the same without offsetting budget losses, students would be receiving a lower-quality education, Betz said.

“It comes down to: how do we preserve the quality of education?” said Chris Nelson, spokesperson for U health sciences. “Making up for the budget shortfall would be ideal.”

Although some medical students at the U appreciate keeping the value of education high, they wish tuition had been further increased instead of decreasing the numbers of incoming students.

David Mabey, a fourth-year medical student, said he mostly supports what the U medical school did to offset costs but thinks students could afford higher tuition.

“The University of Utah medical school is already very inexpensive compared to other medical schools for in-state tuition8212;it’s why I decided to come here,” Mabey said.

Yet others, such as second-year medical student Elisabeth Jacques, said the physician shortage makes this the worst time to decrease class sizes.

“It will have a really deleterious effect on health care in the U.S.,” Jacques said.

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Tyler Cobb

An organic chemistry class remains full despite the U reducing its medical school incoming class size by 20 students for the next school year.