TribTalk | Robert Hendler, M.D. | February 19, 2019
When most of us think of trauma events, we think of mass casualty events like school shootings, natural disasters or terror attacks. But every day, in communities big and small across our state, Texans fall, have car crashes, experience household and industrial accidents and are assaulted. Each year, more than 130,000 Texans experience trauma injuries requiring hospitalization. Often these hospitalizations require medical care of the highest specialization — neurosurgery, orthopedics, burn care — as well as long-term physical rehabilitation services.
Trauma care is where the almost impossible becomes possible, the piecing together of what looks to be irreparable. Today, across Texas, this lifesaving care takes place at 283 designated trauma hospitals. Many of these are in our rural communities and are absolutely essential to stabilizing trauma patients and a link to getting them to higher acuity level of care.
However, a substantial amount of trauma care is not paid for, in part because Texas has such a large number of residents without health insurance. All Texas trauma hospitals provide lifesaving care without question and without regard to whether a patient can pay. This unpaid care exceeded $320 million for Texas trauma hospitals in 2016. That amount is in addition to the significant annual costs of maintaining the highly trained staff, services and equipment required for trauma designation. One estimate puts the average annual cost of supporting a Level I trauma center at more than $20 million.
Since 2003, the Texas Legislature has provided dedicated state funding for the state's trauma hospitals. This funding, combined with federal matching funds, provides approximately $176 million to 283 hospitals. That’s just over half of that unpaid care amount. But without these funds, fewer hospitals would be able to maintain their trauma services, and fewer Texans in fewer communities would have access to lifesaving trauma care when and where they need it.
Right now, in Austin, the Legislature is debating the future of this trauma hospital funding. Its future is caught up in the fate of the Driver Responsibility Program and the fines and penalties it imposes on reckless and irresponsible drivers. Some of the DRP’s revenue goes to Texas trauma hospitals. Some goes to state general revenue.
Texas hospitals understand the challenges associated with the DRP and have for several legislative sessions provided both alternative suggestions for funding trauma hospitals and ways to address the inequities in the DRP while preserving trauma hospital funding. We do the same this legislative session.
Lawmakers have tough choices to make when crafting a budget and deciding what merits state funding. But for Texas trauma hospitals and the thousands of Texans who depend on them each year, the question to ask our lawmakers is, ‘Will there be a trauma hospital near me when I need it?’
Texas trauma hospitals are committed to making sure that every trauma patient, without exception, has the opportunity for a second chance — for the seemingly impossible to become possible. Keeping that promise requires that the state keep its commitment to funding.