Why hike license fee? To save lives

March 12, 2003|by BOB MAGINNIS

Yesterday I got the first letter complaining about the proposal to fund Maryland's trauma system by raising the cost of renewing your driver's license every five years from $30 to $40. Just what is the state doing with all our money, the letter-writer asked.

The answer: Saving lives. The $9 million it should raise will prop up a system that was in danger of collapse last summer. The Washington County Hospital's trauma center was closed for four months, forcing the transport of some critically injured patients out of the area.

Outside the big cities, there aren't enough trauma cases to keep trauma surgeons on staff full time. But under the rules of a Level II trauma center, surgeons have to be in the hospital in case of an emergency, so they can't schedule other surgeries to pay the overhead of their private practices.

To cope, they worked 80 to 100 hours per week, some not seeing their children for days at a time. Add to that the increasing difficulty of getting reimbursed by Medicare, Medicaid and the insurers and doctors here decided something had to give.


After a lot of wrangling, the local hospital was dropped to a Level III Center, which means doctors can be "on call" as opposed to requiring them to be in the hospital for many hours during which nothing might happen.

But to do that, the hospital agreed to pay the doctors $1.7 million a year for being on call, a cost that can't be recovered through the normal rate-setting mechanism.

A number of solutions were proposed by the Maryland General Assembly's shock trauma task force, including adding a $1 or $2 assessment to each auto insurance policy.

According to Del. Michael Busch, who later became Speaker of the House, that would have raised $8 million, perhaps not enough to cover all the costs, according to Del. John F. Wood, who said that as much as $20 million might be needed.

Busch was personally committed to finding a solution, because after a horrific 2002 crash in Delaware that killed four of his family members, a 7-year-old niece was saved by a surgeon who trained in the Maryland trauma system.

And so when it came time to introduce legislation, Busch made the bill HB 1, a number reserved for each session's top priority. And according to Mark Wasserman, a vice president with the University of Maryland Medical System, local Del. John Donoghue, D-Washington, was the one who shepherded the bill through the House Health and Government Operations Committee.

"As the bill was considered by the committee, John was tapped to play a leadership role," Wasserman said.

Reached in Annapolis, Donoghue said there were some who didn't feel raising the driver's license fee was the right way to go.

Some members wanted to raise the amount of traffic citations, Donoghue said, but were eventually convinced driver's licenses were the way to go.

Raising the fee, which is paid only every five years, will cost drivers just pennies a day, Donoghue said. It certainly will be easier to calculate the amount received from driver's license renewals than from fines, which would depend on how many traffic stops were made.

And so, yes, the state is asking for more of your money. It may be painful to write the check, but not as painful as it would be if your son or daughter were injured in a car wreck and there were no trauma doctor available to take care of them.

After this past Sunday's column on the CSL sports league's quests to get the use of the old gymnasium at the former Fort Ritchie, I got a call from Gary Muller, a member of the One Mountain Foundation and that group's liaison to Pen Mar Development Corporation, which is redeveloping the old fort.

Muller said his group has been working with Pen Mar for a year to get the gym reopened so the community can use it. But he said One Mountain determined that it would be difficult for an all-volunteer group with no staff to operate it.

That's why One Mountain is working with the Waynesboro YMCA task force studying the feasibility of offering programs there. In addition to the basketball gym, there are also racquetball/handball courts and a room full of Nautilus fitness machines.

Muller agreed that having a fitness center on site would be attractive to those businesses considering locating there. He urged CSL to join the Y task force, to which I say, it couldn't hurt. If the Y decides not to operate it, there'd at least be a report advising PMDC what it would take to do the job.

I do differ with Y officials on one item: Given that Washington County government has already studied the repairs needed and estimated costs for them, it shouldn't take another six months to decide whether or not this is a viable project.

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