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Trauma center financial woes aired

August 22, 2002|by LAURA ERNDE

laurae@herald-mail.com

Maryland lawmakers said they might propose a surcharge on traffic tickets or vehicle insurance premiums to raise an estimated $20 million to $30 million to subsidize trauma centers statewide.

Financial problems similar to the ones that led to the closing of Washington County Hospital's trauma center are plaguing trauma centers statewide, experts in the field told lawmakers Wednesday.

"There's no free lunch. There's no way this world-class trauma system is going to be able to keep world-class trauma specialists if we can't pay the market value," said House Speaker Casper R. Taylor Jr., D-Allegany.

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Taylor, who arranged the meeting, said he and other lawmakers will continue working to find the money either in the state budget or through new fees.

Last year, Del. Norman H. Conway, D-Eastern Shore, proposed a $20 surcharge on traffic tickets to pay for the trauma system. The bill never made it out of the House Judiciary Committee.

Del. Michael E. Busch, chairman of the House Economic Matters Committee, said another option would be to assess auto and motorcycle insurance premiums. About half of the trauma cases are due to highway accidents, he said.

Busch, D-Anne Arundel, said people would be willing to pay for access to the trauma system in case they were hurt in an accident.

Del. John F. Wood Jr., D-St. Mary's, who co-chairs a study panel on trauma centers, said he thinks the state should pay for the subsidy out of its general fund.

In order to make the state's trauma network complete, Taylor said, a Maryland State Police medevac helicopter should be added for Hagerstown. Right now, the closest helicopters are based in Cumberland and Frederick.

In addition to finding money for the trauma network, Taylor said a state agency such as the Maryland Health Care Commission or the Health Services Cost Review Commission should identify reasonable rates for surgeons to be reimbursed for their on-call time.

Another big problem is that trauma doctors do not get reimbursed for taking care of patients who don't have health insurance, said John Ashworth, director of the University of Maryland Shock Trauma Center.

Federal law prevents the state from paying doctors for the uncompensated care, although they can pay the hospital, lawmakers said.

Del. John Donoghue, D-Washington, said a bill he passed this year is looking at that issue.

At the same time, trauma doctors - who already have to pay higher rates because of the risky cases they handle - have seen their malpractice insurance rates increase, Ashworth said.

Surgeons also have to sacrifice time away from their more lucrative private practices to be on call for trauma cases, he said.

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