Across the country, more than 30 Trauma Centers have been forced to eliminate services or downgrade to a lower level of care. Unless improved funding is established, others will face the same fate. When services are eliminated, seriously injured patients have to be transported farther at a time when minutes can make the difference between life and death.
The 14 designated Trauma Centers in Virginia lose over 44 million dollars in a single year simply by treating the more than 20,000 residents who required trauma care. These kinds of losses force hospitals to continually evaluate their ability to keep Trauma Centers operational.
The State of Virginia Joint Legislative Review Commission's report on Trauma Care highlights these issues.
As the only Trauma Center on the Virginia Peninsula, Riverside provided trauma services for more than a thousand residents last year and sustained a loss of 5 million dollars in un-reimbursed or inadequately compensated care. Even greater losses, over $8 million, are incurred when the additional cost of constant 24/7 readiness is factored in. Changes in trauma status at Riverside would affect victims of motor vehicle crashes, falls, assaults, burns, recreational accidents and other serious injuries.
Imagine what it would be like, what kind of safety concerns you would have, if a fire department or a police station suddenly discontinued providing protection and security to families in our community. The fact is, there is another vital service that is threatened across the nation, in our state and on the Peninsula.
Hospital-based Trauma Centers are in crisis because of a complete open door policy-their commitment to providing care to everyone who needs it, regardless of ability to pay. The result has been escalating reimbursement costs not covered by insurance or public funding. While this crisis does not affect the exceptionally high quality emergency departments in our region, the advanced care that Trauma Centers provide for seriously injured people-care that is proven to save lives and reduce disability-is endangered.
Because of its specialized nature, trauma care is expensive. To receive a trauma designation, hospitals and their emergency facilities require additional surgeons, anesthesiologists and other highly trained staff ready to meet incoming patients as they arrive at the door. Plus a high level of technology and areas dedicated specifically to trauma patients. And most costly of all, trauma care only saves lives if it is always ready to respond, 24 hours a day, 7 days a week.
The problem is, a high percentage of patients who benefit from this advanced care do not have insurance. For others who are covered, private and public health insurance often reimburse only a fraction of the actual cost of Trauma Centers.
An increasing number of states are fighting back to save trauma care. Programs in Michigan, California, Maryland and other states are creating funding sources based on motor vehicle-related fees, an approach that makes sense given the fact that vehicle collisions create the greatest need for trauma care. Virginia lawmakers have moved ahead in a similar direction. Texas, which leads the nation in speed and alcohol related vehicular fatalities, has confronted its Trauma Center crisis with a tough but effective strategy that targets dangerous driving behaviors.
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