Monday, December 20, 2004

The Trauma Tax...
From the Atlanta Business Chronicle: New driver fines may help state's 14 trauma centers
People who are caught driving unsafely would have to pay extra fees to help fund trauma centers if the CEO of Grady Health System gets his way.

In the face of rising medical costs and Medicaid cutbacks, Grady CEO Dr. Andy Agwunobi said he plans to ask the General Assembly to consider a new plan to help fund the state's 14 trauma centers. Agwunobi suggests Georgia adopt legislation that would fine people who are caught driving without seat belts or under the influence of drugs or alcohol, and use the money for a trauma center fund. He said the program has been used successfully in Texas. New Jersey also has a similar program.

"There is some harmony in the idea of -- instead of a fee charged to everybody -- having it charged to people who drive up the costs," Agwunobi said.

Trauma centers typically carry a heavy responsibility for caring for the uninsured, especially at Grady, where only 7 percent of patients have commercial insurance and many are covered by Medicaid. Agwunobi said proposed Medicaid cutbacks could hit the hospital hard overall, having a negative financial impact of $15 million to $39 million.

In Georgia, unreimbursed trauma care costs hospitals $200 million a year, and costs Grady alone at least $30 million a year, Agwunobi said. However, he said those costs often are invisible to the public.

"Unless you have a family member who gets in an accident, you don't think about it," Agwunobi said. "But we'll keep fighting for this; it's really about the 16-year-old boy who lives in Cordele, Ga., and gets in an accident and needs help."

Nationwide, as many as 35 percent of trauma patients who die do so because optimal care is not available, according to a 2004 study from the Centers for Disease Control and Prevention.

A "trauma fund" would be beneficial because the money could be used to induce more of the specialists such as orthopedists and neurosurgeons to participate in the trauma system. It could also induce more hospitals to participate, as wide areas of the state are uncovered. The full listing of the trauma centers is here. The geographical distribution is illustrated here:

The level I centers are red, the level II's are blue, level III's green and the sole level IV is gray. As you can see there are wide areas of the state that are uncovered, especially in the northeast, south, and southeast. Patients in these areas aren't turned away, but the care may not be as ideal as in a trauma center. While usually against new taxes, these strike me more as user's fees.
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