Even granted that the 16-county Region 1 Trauma Advisory Committee, of which Greater Rome is a part, will largely have to improve what it can using smoke, mirrors, computers and self-help, the result promises to be way better than the too-little now existing. Sadly, both state government and even the electorate have avoided facing up to this very fundamental issue.
Back in 2010, voters turned down a proposal to add $10 to the annual car tag fee (of $20) to create $80 million a year to improve/expand trauma care. Sadly, even Floyd County, the medical center of Northwest Georgia, opposed it. Before that the $200 “superspeeder” ticket surcharge was supposed to create $23 million a year for the same purpose. At last report it was generating about half that much (apparently a third of drivers never pay, probably simply stepping on the gas to get to the state line) and how it is actually being used in a state notorious for diverting such “dedicated” funds is largely unknown.
By the way, despite common notions only a bit more than half of traumatic injuries can be blamed upon driving ... if one counts not only cars/trucks but also motorcycles, ATVs and pedestrians. Falls account for 22 percent and shootings/stabbings/assaults about 15 percent. There’s also such a thing as a “golden hour” or the rule-of-thumb maximum time for getting to an emergency facility that can do all the right stuff.
THAT LAST is why the new region plan first concentrates on getting the patient to the right place and not necessarily the closest place. “Studies show there’s a 25-percent reduction in mortality to patients transported to the right facility,” according to Randy Pierson of Floyd Emergency Medical Services, who chairs the Region 1 EMS Council. Other target areas include pre-hospital response, hospital response, disaster response and pediatric response, the last apparently a particular weakness.
This is a volunteer effort by concerned agencies (emergency-service providers, hospitals, etc.) in a sprawling area empty of a top-level trauma center that can handle anything thrown at it, although Erlanger in Chattanooga is participating. There is no money to do the obvious, such as turn Floyd Medical Center (or Hamilton in Dalton), now Level II trauma centers, into a Level I ... or to build a LifeFlight helicopter fleet to bring patients in to them instead of hauling cases they can’t handle away.
A lot of the severity of the problem — involving speed in getting to the right facilities/physicians — depends on location. Region 1 is Floyd, Bartow, Chattooga, Catoosa, Cherokee, Dade, Fannin, Gilmer, Gordon, Haralson, Murray, Paulding, Pickens, Polk, Walker and Whitfield counties, although Georgia facilities often wind up with emergency cases from border areas of Alabama, Tennessee and North Carolina. Some locations are far closer to Erlanger — or the Atlanta Level I hospitals not in this region — than others.
GREATER ROME, for all its health-care blessings, is actually one of those most isolated from super-care delivered at great speed. Whether in an ambulance with siren blaring or in a helicopter, going 60 miles takes too many minutes, not to mention some injuries (such as burns) can’t be handled locally at all.
The cooperative plan to make what the region has work better, and perhaps a bit faster, is welcome. However, it once again amounts to locals trying to pick up a ball that the state — and nation for that matter — has dropped.
The problem is not now and never has been that what amounts to saving lives costs too much. No more taxes or superspeeder fines are required to provide all citizens, young and old and in-between, with the best odds of surviving whatever may befall them medically in a sudden and acute manner. What has happened is that trauma simply has not been given the priority it should have always had.
This nation, including this state, is the most expensive place for health care in the world — by a mile. The question, particularly when looking at the lack of support for trauma care, should be: Are we spending all this money on too many of the wrong things?
According to The World Bank, which keeps tabs on every dollar/Euro/peso/whatever on the globe and what it is being used for, puts U.S. expenditures (public and private) for health care at 17.6 percent of the GDP (gross domestic product) in the 2007-2011 timeframe. This is even before whatever percentage Obamacare will add.
THIS IS SO far more than what nations routinely criticized (by some Americans) for their “socialized medicine” pay as to be almost stunning. Not only that but many of those nations have health-care systems ranked higher in positive outcomes than the U.S. and also have far more sophisticated trauma systems (the World Health Organization says American health care is No. 37 globally in performance outcomes).
For example, the percentage of GDP in France, rated No. 1 in outcomes, going to health care is 11.9. Next-door Canada (only 30th best) is at 11.3.
Indeed, the only nation where GDP going to health care even comes close to the U.S. is Tuvalu, which plainly has a problem with access to trauma and most other care driving up the costs.
Tuvalu is a string of Polynesian islands and atolls that is the third smallest independent country in the world. Its population, strung out on those islands, is 10,000. It is known mostly for being the country soon expected to be entirely wiped out by a rising Pacific Ocean level caused by ice caps that are not melting from a global warming that is not occurring.
The country has one hospital and two doctors. For most things in which a doctor is desired, even childbirth or setting a broken leg, it takes considerable travel of up to 200 miles by sea or air. Anything at all serious, like major surgery or dealing with acute accident damage, requires being taken to Australia some 2,150 miles away. That’s probably why the GDP spent on health care there is 16.4 percent.
TUVALU’S GOT a pretty good excuse for trauma care being so difficult and distant to access, as well as for the huge percentage of all its spending being on health care.
What is ours, particularly when considering the voids in home turf trauma care?