Is It Worth $10 to Save a Life?
By Benjamin Nanes
This November, Georgians will vote on adding a $10 fee to vehicle registrations, to be directed toward trauma care. Or is it a tax? If you listen to the pundits and politicians, the fee versus tax debate defines the referendum. But they’re wrong; nothing could be less relevant. Georgia needs dedicated funding for a trauma care system that will save lives and help the state’s economy, not a petty debate over what constitutes a “fee” or a “tax.” The question is simple. Is it worth $10 to save a life? The answer should be simple too.
Not all hospitals are prepared to treat trauma, the kinds of injuries associated with car wrecks and industrial accidents and the number one killer of Americans between the ages of one and forty-four. Hospitals that do have the necessary specialized staff and facilities are designated as trauma centers, and patients who reach a trauma center quickly – within the “golden hour” following their injury – are more likely to survive than those who do not. However, there are only sixteen trauma centers in Georgia, and just four are designated as “Level I” centers, able to treat the most serious injuries. Large areas of the state have no trauma coverage at all. As a result, too many injured Georgians are unable to reach a trauma center quickly enough; the likelihood of surviving a traumatic injury in Georgia is twenty-percent lower than the national average. Increasing access to trauma care in Georgia could save 700 lives each year.
Trauma death rates are high in Georgia because of inadequate access to trauma care. Access to trauma care is limited because we don’t pay for it. The specialized staff and facilities trauma centers need are expensive, and the money hospitals collect from patients, insurance companies, Medicare, and Medicaid rarely covers the cost. That’s why so few hospitals provide trauma care, and they loose about $275 million a year doing so. Many hospitals can’t keep up; in the past ten years, six Georgia hospitals lost their trauma center designations. The trauma tag fee, which could raise $80 million a year, won’t make trauma care profitable, but it will help more hospitals become trauma centers and ease the burden on those that currently exist.
Though the need for trauma care funding is clear, some have sought to use the referendum to enhance their Washington reputations by suggesting they support trauma funding, just so long as it doesn’t come from anything that might be called a tax. That sort of political posturing ignores the real reasons why a vehicle registration fee is one of the best ways to fund trauma care. First, hospitals are unlikely to make the investments needed to establish new trauma centers without the stability provided by dedicated, sustainable funding. A tag fee does this, but an uncertain appropriation by the legislature, subject to sudden and arbitrary cuts, does not. Second, nearly half of trauma cases are caused by accidents involving motor vehicles, so it makes sense to fund trauma care with a vehicle-related fee. Perhaps most importantly, given the state of the economy, Georgia needs to do all it can to create jobs. But limited access to trauma care can convince employers worried about the safety of their workers to move elsewhere. Dedicated trauma funding is crucial to ensure that Georgia remains a competitive business environment, especially for manufacturing. That’s why the Georgia Chamber of Commerce supports the trauma tag fee.
Whether it’s called a fee or a tax is irrelevant. Georgia needs a dedicated source of trauma funding. The vehicle registration fee on the ballot this November will save lives and help Georgia’s economy. Don’t be distracted by the political bluster of those who only want to talk about semantics. That’s not what this referendum is about. That’s not what matters. Is it worth $10 to save a life? To save 700 lives? The answer is simple. Yes, it is.
Benjamin Nanes is a MD/PhD student at the Emory University School of Medicine and is a member of HealthSTAT’s Board of Directors.
Here are some additional resources on the issue:
http://www.ajc.com/news/georgia-politics-elections/bill-to-expand-access-506505.html
http://www.ajc.com/news/georgia-politics-elections/trauma-funding-vote-must-562789.html
http://georgiaitsabouttime.com/
http://www.ciclt.net/ul/dhrtn/B_FAQ.pdf
http://www.ciclt.net/ul/dhrtn/P_Traumaeightpg.pdf
http://www.ciclt.net/ul/dhrtn/Health%20Voices_Feb_2008.pdf
