Rural areas in the Northwest constantly struggle to attract and keep doctors, and that's true even here where there is beautiful scenery, plus good recreational and cultural opportunities.

As the old saying goes, you can't eat pretty scenery, and most doctors are saddled with daunting educational debts and operating expenses. Even those who might want to establish old-fashioned roots in a community may find it financially impossible to do so.

The National Health Service Corps makes an effort to address this issue by providing up to $25,000 a year in public assistance to physicians who come to places experiencing doctor shortages. This and immigration rules that encourage foreign doctors to practice several years in underserved communities provide at least a stopgap answer to this perennial problem.

Unfortunately, when it comes to the NHSC, what the government gives with one hand, it takes away with the other by taxing corps grants at a rate of 40 percent. Considering many recipients are new doctors who use the funds in part to repay enormous student loans, this taxation represents a silly misdirection of government resources.

A partial answer has been proposed by U.S. Sen. Maria Cantwell, D-Wash., in the form of a tax exemption for NHSC grants. Though some may squawk at giving any tax break to "wealthy" doctors, this idea makes good sense as a mechanism to help communities recruit physicians under the program and keep them for at least the full term of the grant.

As it is, new physicians who may really want to help struggling rural people may find it simply unaffordable to do so. It behooves our nation to do all we can to facilitate these somewhat altruistic urges, before the rude realities of the modern health care system have a chance to sour the idealism of recent graduates.

Beyond this Band-Aid, the United States still must turn its attention to solving the deeper problems of our health care system, starting with Medicare and Medicaid reimbursements. The federal government and many states, including Washington, are cutting the amounts paid to doctors, pharmacies and other providers, unleashing real hardships on some of society's most vulnerable members.

For far too long, we've let lobbyists for insurance and drug companies set the national agenda on health care. It's way past time for the United States to begin putting patients first.

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