One-third of North Dakota’s physicians are between 55 and 64, meaning a depletion of our medical ranks in the near future.

Our increasing population, particularly in the booming western part of the state, will require 500 more doctors by the time the state reaches 800,000.

As a major source of diabetes and heart disease, obesity is adding new pressure for medical care. Obesity increased by 80 percent in the last 15 years. Around two-thirds of our citizens have already reached obesity.

The Affordable Care Act (Obamacare) will add the 60,000 uninsured North Dakotans to the medical load in the state.

North Dakota is the second highest state in the number of people over 84 and we have plenty of folks between 75 and 84. The elderly require the lion’s share of medical time and expense. In fact, they are breaking Medicare.

The statistics tell us that we are approaching a medical crisis for which we do not have the infrastructure. Seventeen of North Dakota’s 53 counties do not have practicing physicians.

All of these factors will challenge the foresight of the 2013 legislative session because they call for new investment in training more medical practitioners. Fortunately, the oil boom revenue has made it possible to consider options that would have been unthinkable 10 years ago.

In order to meet the shortage, the UND Medical School will require expansion in facilities and students. Three proposals have been offered for consideration by the upcoming legislature session.

1. First, there is a bare bones $38 million addition to the present facility in Grand Forks. This is really a short-term stop-gap proposal that won’t stand the test of time.

2. A second option calls for a $68 million 5-story addition to the present facility with 170,000 square feet of new space.

3. The third possibility is construction of a $134 million new building with 370,000 square feet.

In his budget message to the Legislature, Governor Jack Dalrymple endorsed the $68 million addition to the existing structure. The governor is to be commended for this step forward.

However, it should not preclude a careful analysis by the Legislature of the long term implications of adding to an old structure. Perhaps the proposal for a new building would be a more plausible choice in the context of a 50-year perspective.

Another consideration in opting for the new building is recruitment of quality personnel to teach the enlarged student classes and to share in medical research. After all, North Dakota’s image is not the greatest in the outside world. That means working conditions become a major consideration for professionals looking to build a long-term career somewhere.

An expanded medical school will offer more opportunities for North Dakota young people to become professionals in their home communities. Around 80 percent of the new classes are North Dakota students. And, according to the matriculation records, more qualified students are waiting in line.

As state policymakers consider their choices, it should be pointed out that this is not a University of North Dakota institution even though it is located in Grand Forks.

The whole state is facing this medical challenge. Because the school is meeting a critical statewide need from east to west, it is a North Dakota medical school. Hopefully, legislators will recognize the statewide importance of the right decision.