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Higher education proposals get high profile at 2015 legislative session

MinnPost photo by Briana Bierschbach
Gov. Mark Dayton, surrounded by University of Minnesota medical students at the campus cancer research center on Wednesday, said he wanted to invest $30 million in the medical school over the next two years.

Long before he ever got involved in politics, Gov. Mark Dayton wanted to be a doctor. 

In the fall of 1968, Dayton sent out a slew of applications to the “best medical schools” in the nation, he said, including the University of Minnesota‘s. 

Dayton never went to med school, of course. He got sidetracked protesting the Vietnam War and eventually became active in politics. But his enthusiasm for medicine never went away, something he made clear on Wednesday, when he rolled out a budget proposal that would pump $30 million over the next two years into the University of Minnesota Medical School. The goal: to restore the prominence the school enjoyed when Dayton applied to it more than 40 years ago. Over the last 20 years, the university’s ranking when it comes to funding from the National Institutes of Health (NIH) has slipped from the 15th to 30th, hurting the school’s reputation and its ability to tap other research grants and funding.

Dayton’s proposal is just one of a slew of higher education-related bills proposed this session by lawmakers, who are looking to postsecondary education as a way to help address everything from gaps in health care between metro and outstate areas to a massive wave of baby boomer retirements. 

“It’s the debt issue, the work-force issue, and it’s people’s sense that [higher education] is the mechanism for social mobility,” said Dayton’s higher education commissioner, Larry Pogemiller, who sensed a renewed focus on postsecondary education this year. “I think both Democrats and Republicans are saying, we’ve got to invest here. Families are investing heavily here and we have to help them.” 

But there’s some disagreement over whether those investments should be focused on two- or four-year colleges, a not-insubstantial question since all of the funding requests are competing for a highly sought-after $1 billion budget surplus.

“I think everybody is going to be surprised,” Pogemiller said. “The resources are a bit tighter than it looks.”

Dayton envisions ‘The Brain Power State’

On top of $30 million for the medical school this biennium, Dayton wants the university and the Legislature to make a verbal commitment to invest another $50 million in the school each biennium for the next decade.

Higher Education Commissioner Larry Pogemiller
Commissioner Larry Pogemiller

The funding would pay for 50 research faculty members who would form “medical discovery teams” that would specialize in studying areas that have a wide reach, like diabetes and cancer. Medical School Dean Brooks Jackson said the goal is for their work to move the medical school from 30th in the NIH rankings up to 20th in just five years. Among public medical schools, Minnesota currently ranks 12th. 

“If we can demonstrate success with this model … then I think we will come back to the state and ask for more money and get literally in the top five or 10,” Jackson said.

The school’s rankings started slipping after 1995, when a federal grand jury indicted Dr. John Najarian, a renowned transplant surgeon, on charges of fraud, theft and tax evasion. The school paid $32 million in fines, and the NIH placed severe restrictions on the university’s ability to use research money. As a result, both current and former medical school leaders say, the program lost 90 top faculty members between 1995 and 2001.

Medical School Dean Brooks Jackson
Medical School Dean Brooks Jackson

In addition to restoring the medical school, Dayton sees the proposal as having immeasurable economic benefits across the state. It would attract the top researchers and medical professionals to live and stay in Minnesota, he said, which would in turn benefit the state’s already successful medical device industry. It will also help address the expected shortage of doctors the state will face in the coming decades. “It’s going back to what Governor Perpich called ‘The Brain Power State,’ ” Dayton said.

Dayton also hinted he will make additional investments in higher education in his budget, which will be fully unveiled next week. That will include bonding dollars for infrastructure improvements on college campuses across the state. “The university is underfunded, as is the [Minnesota State Colleges and Universities] system,” Dayton said. “We need to address that long term.” 

Legislators eyeing two-year schools, outstate programs

State Sen. LeRoy Stumpf
MinnPost photo by Briana Bierschbach
State Sen. LeRoy Stumpf

But some Senate Democrats, who control the upper chamber, want the focus to be more on the state’s two-year institutions. One of their first bills this session would provide free tuition for certain students at the state’s community and technical colleges in the Minnesota State Colleges and Universities (MNSCU) system. Ideally, that would cut down on the high costs of college education and get more students into the vocational and technical training that can lead quickly to jobs, said DFL Sen. LeRoy Stumpf, the author of the bill. President Barack Obama used his State of the Union speech Tuesday night to pitch a similar plan to make community college free for some students.

The plan will likely cost somewhere between $100 and $150 million over the next two years, but Republican House Higher Education Policy and Finance Chairman Bud Nornes said he’s concerned about the cost and the mechanics of the proposal.

State Rep. Bud Nornes
State Rep. Bud Nornes

“I know certain career paths that need a shot in the arm, but it’s not as simple as it sounds,” Nornes said. “I also personally feel to get a good education you have to have a little investment in it yourself. Free education might not be the best solution.” 

Nornes is generally supportive of some kind of a plan to deal with the doctor shortage in the state, but he’d like to see more balance in Dayton’s proposal. In particular, he’d like to explore putting investment into agriculture programs on University of Minnesota campuses across the state. “That’s also an important part of our economy and we don’t want that to slip,” he said.

DFL senators also want to offer loan college forgiveness to medical professionals who agree to work in greater Minnesota or other underserved communities in the state, an idea Dayton says he supports.

Colleges and universities seek more funding

The Senate’s community college proposal has also received some pushback from University of Minnesota President Eric Kaler, who said four-year colleges also have job-training programs for students. Instead, Kaler would like to see nearly $130 million put into the university next biennium to keep the cost of college low for students and — sensing a renewed focus on rural parts of the state — invest in university programs in Greater Minnesota.

In the university’s budget proposal, Kaler pitched a plan to extend a tuition freeze for undergraduate students for two more years. He would also like to add all graduate students to the freeze, for a total cost of about $65 million for the biennium. The university predicts tuition would go up 3 percent for undergraduates without the freeze. 

Sen Terri BonoffSen. Terri Bonoff

But Senate Higher Education Finance Chairwoman Terri Bonoff said she’s never been a fan of simply freezing tuition for college campuses. “I will do all I can to invest in the university and make sure they remain a premier institution, but how they handle their tuition is up to them,” she said. “I don’t think it’s the best use of taxpayer dollars.”

Bonoff would also like to revisit a proposal that ties 5 percent of the University of Minnesota’s funding to its meeting performance goals, like cutting administrative costs and increasing graduation rates for low-income students. “We will have to go back and say, ‘What is our performance metric for funding for the next two years?’” Bonoff said. “It’s about employing best practices to move the dial on the things we know make a difference.”

In addition to a tuition freeze, the university wants $35 million for health care, which would help open a handful of clinics in greater Minnesota and other underserved communities. The university also wants funds to study and help improve water quality from mine discharges in northern Minnesota. 

MNSCU is going a different route with its request: The system plans to ask for $142 million from the state over the next two years to cover increasing inflationary and personnel costs. That will help avoid a tuition increase for the system’s 400,000 students, according to budget documents, as well as bring the division between state and student costs closer to a 50:50 split.

“Inflationary increases must be addressed to keep education at the lowest possible cost for the students who often need financial assistance the most,” reads a MNSCU budget proposal. “State funds are not being requested to fund new initiatives. We will fund new investments internally by prioritization based on the needs of the students, employers and communities.” 

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Comments (4)

  1. Submitted by Ray Schoch on 01/22/2015 - 01:39 pm.

    Off-the-cuff suggestions

    When I graduated from high school, I didn’t have a clear idea of what I wanted to do with my life. I did, however, have a clear idea of what I did NOT want to do. The cliché is that you can work with your back or your brains, and I already knew I had a bad back, so decades of manual labor had little appeal.

    Accordingly, I borrowed money from the government (via a long-defunct National Defense Education Act) to attend a state teacher’s college. This wasn’t because I’d already decided teaching was my calling. It was because that state teacher’s college was the least expensive 4-year college in the state, and I wanted to keep any loans as small as possible. One pleasant surprise of the NDEA program was that, for every year I taught in a public school after getting my degree and teaching certificate, 10% of the loan would be forgiven, up to 5 years and 50%. It was an equation even a mathematically-challenged history major could understand, and it turned into a career.

    Allow me tol toss out a pair of ideas…

    One would have a portion of med school tuition and fees waived by the state – on the order of that long-ago 10% for each year of service – for each year, up to 5 years, that a med school graduate worked in an underserved and/or low-income area, whether in the Twin Cities, or, more likely, in greater Minnesota. Who knows? After 5 years, a doctor might decide he kind of likes the rural setting. I stayed in teaching for 25 more years after I’d paid off my loan.

    A second possibility takes that idea further, based on what is often done in Europe, where they have better, and less expensive health care than we do here. That second possibility would have medical school tuition and fees paid by the state. Totally. No loan to repay, no worry about interest rates, defaults, etc. In return, the physician would be, by contract, a state employee, with wages paid by the state, for a reasonable length of time after graduation and the granting of a medical license from the U of M. Just to start the conversation, let’s say 10 years. We pay for your med school, you repay us by working for us at a location of our choice, at a state-established civil service pay grade, for a decade. Assuming satisfactory performance on your part, when the decade is over, if you want to form your own practice, join a hospital staff, or join a group practice, you’re free to do so, and at whatever wage you can negotiate.

    Frankly, these strike me as approaches that might be used in a number of professional fields (including education) deemed important to the state’s overall well-being or economic prosperity, but that are, for whatever reason(s), not attracting enough in the way of college enrollment or after-graduation talent to meet the state’s needs.

    • Submitted by Robert Gauthier on 01/22/2015 - 06:15 pm.

      Not bad ideas

      I made a similar proposal to legislators thirty years ago in a conversation, there was interest.

      However, I think the issues are a bit more nuanced than in the past. Since Reagan’s assault on higher education and the middle class in the early 80’s, cost for medical education have spiraled out of control. Changes in repayment policies and demanding payment during residencies have intensified the crunch on new physicians.

      Today, we are looking at a maldistribution of providers and need, with rural areas suffering a lack of specialists, surgery services, and easy access to primary care. As the population ages it tends to each more in rural areas than in urban areas.

      I have often wondered if a solution might be a little bit simple. Take a look at the old model of the rotating internship, offer an opportunity for people after one year of residency to go practice, with supervision, in rural areas or underserved areas, for 1 to 2 years. In return for the service, debt from 1 to 2 years of medical school education would be forgiven or paid for by the state.

      Don’t make it obligatory for all medical students and residents, rather allow those who are interested in public service or primary care to be incentivize to pursue care in such areas. For someone interested in serving in rural areas, financially it would be a better deal to get half of your debt forgiven then go into residency immediately and try to pay off that debt with accrual of interest.

      For some they would find that they don’t really like primary care as much as they thought they would percent of all. Others would be inspired and become more motivated. Finally, younger physicians look at issues and community problems in a different fashion than more senior physicians.we might find that are younger physicians people might have ideas that help serve their communities more innovative and cost-effective ways.

      Physicians after one year of residency have a state license and can prescribe medications without supervision. In addition, they would probably be cheaper and better trained than most nurse practitioners in rural areas. This is not knock a nurse practitioners but rather is the difference in the educational paths, they could learn the tricks of the trade from the ortho girl physicians and nurse practitioners they work with in these underserved areas.

      All in all a win-win situation for everyone.

    • Submitted by Steve Titterud on 01/23/2015 - 08:40 am.

      Great idea – but 10 years is just too long. Start with 5,…

      …and let’s see if modifications are needed.

      I remember, too, the NDEA days – when our national legislators were SUPPORTERS of education and felt it was a fundamentally sound investment in the nation’s future !! It was a patriotic issue in its own way. Sputnik scared the pants off our national legislature.

      Ray’s example illustrates that this NDEA funding wasn’t just for engineers and doctors – it funded a huge number of education degrees, as well as language studies. This money is widely thought to be very well spent, yielding a wonderful ROI – for the nation.

      Nowadays, we’ve got people like John Kline, who sees the students as the targets or lawful prey of his campaign donors. It’s become purely a question of profit for his “friends” – how much can we get, and who do we have to screw over to get it ??

  2. Submitted by Bill Gleason on 01/23/2015 - 09:57 am.

    The University of Minnesota Medical School and Its Problems

    This topic seems currently to be on the front burner with the governor’s visit to the U to push for more funding.

    I’ve nothing against the medical school getting more funding, but hope that the way the money is used gives more concrete results than in the past.

    The governor must also have visited the Star-Tribune because an editorial there just the other day also mentioned funding for the medical school and I commented there. One of the folks in the comment section ask me for suggestions. Here, with a little editing, are some suggestions:

    1. We need to turn out more medical doctors. Northwestern has had a six year medical program (2 undergrad + 4 medical school) for many years. Some medical schools are three years. Interestingly, when St. Thomas proposed to start a new medical school, one of the U of M deans claimed that there was not a doctor shortage. The answer to this question from the university administration seems to depend on who gets the money to solve the doctor shortage problem. .

    2. The cost of medical school has to be cut. The enormous debt at graduation adversely affects the choice of medical practice and specialty.There are plenty of good suggestions about how to solve this problem.

    3. Turnover in the Dean’s office at the U of M over the last twenty years has been ridiculous. And the almost unanimous call of medical school faculty for a full-time dean has been ignored by the university administration.

    4. We have to face the fact that more NIH funding is not the answer to our problems. Nor is spending absurd sums to hire new faculty to get more NIH funding. Remember the so-called “biomedical discovery district” that was supposed to attract many new faculty and up our performance in the NIH derby? How has that worked out?

    5. To talk about the U without talking about Mayo is foolish. If we are going to spend a billion dollars or so in Rochester as well as probably light rail, then the interaction between the U and Mayo is critical. I don’t see much of that happening.

    6. The College of St. Scholastica has just announced pans for a Physician’s Assistant program to start in 2016. Augsburg already has one and one of my U of M students has graduated from it. She was of medical school caliber, but was unable to assume the debt that the MD path would have led to. The U of M should also have a PA program.

    These ideas are just a few examples. I’m sure current faculty members at the U have more, but the medical school administration doesn’t seem to be very interested in what faculty members have to say. Perhaps that is why so many have left?

    Bill Gleason
    U of M medical school faculty member
    retired

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