If you buy a car in Washington you contribute $4 to the state trauma fund. If you get a traffic ticket driving it home, you chip in another $5. Although the fund grows by about $1 million a month, however, it makes only a symbolic dent in the overall cost of treating one of health care’s most demanding challenges.
Some providers are stepping back, Spokane’s Deaconess Medical Center being one of the latest. The South Hill institution hasn’t given the state formal notice, but it has acknowledged locally that it no longer wants Level II trauma center status, neither jointly with Providence Sacred Heart Medical Center, as at present, nor individually, as it had indicated to the state Department of Health it did. Deaconess follows hospitals in Walla Walla, Wenatchee and Bellingham in that decision.
That means that Sacred Heart will be the only remaining Level II trauma center in Eastern Washington. (The state’s only Level I trauma center is Harborview in Seattle.)
At the state level, there is reason to be concerned, not that the exodus is hard to understand. Being a trauma center means having a battery of pricey specialists on hand, or on call, around the clock, every day, whether seriously injured patients are coming through the door or not. That can be a problem when neurosurgeons are in short supply and half of the trauma residencies in the nation went unfilled last year.
The economy isn’t helping. The Legislature just hit the state’s hospitals with $300 million in direct funding cuts. The number of employers who provide their workers with health care is dropping sharply. Unemployment is high, and the state is trimming 40,000 people from the Basic Health Plan. In this climate, uncompensated care, a traditional budgetary woe for hospitals, can only get worse.
In Spokane, Sacred Heart’s CEO, Dr. Andrew Agwunobi, is undaunted by the extra traffic and overhead coming his way. In fact, he points out, consolidating the trauma load in one location instead of two will improve efficiency.
But from a statewide perspective, the picture is worrisome. The trauma-care system is designed to speed victims of bad falls, car wrecks, gunshots and other serious injuries to the place best suited to repair them. Spreading the resources too thin will defeat the purpose, and reducing the number of qualified facilities will risk bottlenecks and overcrowding.
U.S. Sen. Patty Murray, D-Wash., is trying to get a modest amount of trauma funding into the federal health care reform legislation that Congress will address this year. Traumatic injury doesn’t get the attention other health problems can claim, but it is the leading cause of death for Americans under 44. Policymakers owe it a full measure of attention.
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