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Fixing trauma center's woes will cost Marylanders more

August 19, 2002|by BOB MAGINNIS

In yesterday's Herald-Mail, members of the Maryland General Assembly's shock trauma task force outlined some possible ways to fix the problems ailing the state's system. From their remarks it seems clear if Maryland residents want state-of-the-art trauma care, they'll have to pay more for it.

The system, which was shaken when the Washington County Hospital closed its Level II trauma center, is laboring because cuts in Medicare and private insurance reimbursements have made it more difficult for trauma surgeons to provide free care and still maintain their private practices. New cash must be found, unless the state wants to see trauma surgeons' ranks shrink.

Since most trauma cases are vehicle-related, Del. Michael Busch, D-Anne Arundel, suggests a $1 or $2 assessment - a surcharge, really - on each auto or motorcycle insurance policy. A $2 charge would raise $8 million, but according to Del. John F. Wood, D-Charles, St. Mary's, it might take $20 million to fix the system because Hagerstown isn't the only center facing these problems.

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Other solutions are being studied under a bill introduced in the last session by Del. John Donoghue, D-Washington. They include changing the methods of payment and reimbursement and setting up a separate state fund for uncompensated care.

With these funds would come new controls, but the alternative is accepting fewer services locally, as trauma surgeons do as many obstetricians did some years ago and give up their practices or stop doing high-risk procedures.

The real answer to this dilemma will not come in the next Maryland General Assembly session, but when the U.S. Congress decides to look seriously at a system of national medical care.

What form that will take - or should take - we're not certain. We are sure that the present system, which pits the major players against each other in a mad scramble to ensure that no one pays too large a share of the costs, must be changed.

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