Life Update #3 - Legislative action

In January of 2008 I was asked by my friend and Harborview trauma surgeon Jerry Jurkovich, MD to be present with he and US Senator Patty Murray as she introduced her proposed Trauma Bill to the press and local TV stations.  It was certainly an honor to be asked to be a part of this effort, which will begin to help fund uncompensated trauma care.  This growing financial crisis for many critical "safety net" institutions, such now as Grady Hospital in Atlanta, has resulted in 20 US trauma centers closing since 2000.  Though efforts are being made to keep Grady, and other such institutions open, I believe some radical changes will soon be necessary in the way we deliver and pay for health care.

At the press conference during which Dr. Jurkovich and Senator Murray spoke, I was asked to share my personal experience as a physician/patient and to relate just how vital it is to each of us that centers like Harborview remain financial viable and open.  As I found out, you simply do not know when you too will need the services of your nearest trauma center.

Thankfully Harborview is not in a financial crisis mode as best I know.  Yet allow yourself to imagine for a brief time just what life in the NW would be like if Harborview had to close.  That would mean not a single level I trauma center between Alaska, Montana, Idaho and Washington.  Either critically injured patients would need to be taken care of as best as possible locally, or moved to trauma centers in Oregon or California.  In my case I would have been sent south to such facilities, out of reach with family, friends, church and others who were so very vital to my recovery process.

Though it may seem impossible that such an institution like Harborview would someday face closure, once you read the Grady Hospital story you can begin to see how it all could unravel.  Without outside funding from the state or federal government, or with only minimal funding at best, an institution must depend more and more on those with insurance.  Trauma is a disease of those generally under age 35, in fact the leading killer of those under that age.  With nearly 50 million uninsured in the US, and trauma striking most often at an age when those injured are least likely to have insurance, one can begin to see the economic burden placed not only on those injured, but also upon the facilities that care for them.  Yet in an institution like Grady with 33% of patients having no insurance and only 8% having private insurance (generally the best payor), eventually things begin to fail.  Costs must be controlled, which impacts staffing levels, equipment repair and purchase; working conditions deteriorate, staff including physicians become disenchanted and look for jobs elsewhere with better support, staffing, equipment and pay.  Once the exodus begins, it only seems a matter of time before closure will come and another hole in the safety net appears with no clear means to repair it at all.

That said, I would urge you to read more on this subject, beyond even the NY Times article I have linked to.  Certainly I support Senator Murray's Trauma Bill, yet this too may only be a brief stopgap or respite for many trauma centers who have otherwise entered the cycle leading to insolvency already.  I don't know the long term solution, beyond perhaps national healthcare.

I welcome your thoughts.