For educational purposes only

http://www.latimes.com/news/comment/20010613/t000049102.html

Wounded Trauma Centers

No one wakes up in the morning planning to have a car accident. The closest most of us come to thinking about emergency care is watching an episode of "ER." If the worst were to happen, we assume that we too would be whisked to a hospital equipped with the latest gadgets and staffed by doctors trained to handle life-and-death emergencies. But this is an assumption we can no longer automatically make. If we want them to be there when we need them, California's ailing trauma centers need help before they reach the lights-out equivalent of the energy crisis. Assembly bills 686 and 687, sponsored by Assembly Speaker Bob Hertzberg (D-Sherman Oaks) and Assembly Health Committee Chairwoman Helen Thomson (D-Davis) and now before the legislative conference committee, are a start. Injuries, mostly caused by car accidents, are the leading cause of death for people under 35. Trauma centers are emergency rooms on steroids, equipped and staffed to treat the most serious, life-threatening cases. It's an expensive undertaking. And after years of reduced payments from managed-care companies and government programs, combined with the state's large number of residents without any insurance, hospitals that staff trauma centers are hemorrhaging money. In Los Angeles County, the 10 private hospitals that contract with the county to help its three public hospitals provide trauma care lost $17 million last year. There is talk that some will drop out when their contracts with the county are up June 30. Whatever responsibility the crisis-prone county government may bear for this particular crisis, there's no denying that it--like counties throughout the state--is being asked to do more and more with less and less money. In 1988, voter-approved Proposition 99 earmarked a portion of state tobacco tax revenues for health care programs for the indigent. In 1990-91, Los Angeles County received $9.2 million from this fund and used the money to reimburse private trauma hospitals for their losses. But a decline in smoking has cut tobacco tax revenues by about 30% over the past decade, and the Legislature over the years has tapped the dwindling pool to pay for new programs for the poor. Los Angeles County will receive a mere $800,000 for the upcoming fiscal year, hardly a salve for the hospitals' losses. L.A. County's share of the $50-million appropriation called for in AB 686 would probably be about $17 million--enough to keep its fragile safety net stitched together for another year. AB 687, a companion bill, would create a statewide plan for providing trauma care; earlier this year, a study funded by the U.S. Centers for Disease Control and Prevention chastised the state for not having one. Some legislators are saying that, because of the energy crisis and the strain it is putting on the 2001-02 budget, this is not the year for big new programs. If only there were a big new plan to fix California's health care problems in their entirety. These measures would just keep the lights on in trauma centers across the state. Californians surely expect no less.

-- K (infosurf@yahoo.com), June 14, 2001