Centers in Trauma

After three years of operation, San Diego County’s trauma system is having much the same experience its older siblings in Orange and Los Angeles counties had before it. Medically, it is working well and saving many lives. But financially, the strain of the expense, especially the bills that too many people cannot afford to pay, is taking its toll on the hospitals.

At least three of the six hospitals in the San Diego system complain that they each are losing an average of $1 million a year on their trauma centers. Palomar Hospital says it lost $2.6 million last year and just announced that it will temporarily double its trauma center charges in an effort to reduce its losses. Hospital officials say they will consider dropping out of the program if it does not at least come close to breaking even. The other hospitals that have openly expressed concern about their losses are Children’s and Scripps Memorial.

This is a far cry from the days in 1983 when hospitals were jockeying to be included among those designated by the county Board of Supervisors for the trauma system. Back then, hospitals figured the prestige that came from having the state-of-the-art emergency centers would account for enough additional business to offset any shortfall they caused. That has proved not to be the case. Grossmont Hospital was the first to leave the system, citing $11,000-a-month losses.

Proposals for easing the financial burden on the hospitals have been floated at local, state and national levels. Gov. George Deukmejian last month vetoed legislation to spend $30 million to supplement trauma programs around the state. Sen. Pete Wilson (R-Calif.) last week said he would push to use three sources of federal funding to support the state’s trauma networks.

Locally, the trauma hospitals themselves have proposed that the supervisors consider going to the voters next June with a proposal to levy a tax to support the system. As worthy an idea as this might appear, it does not seem politically practical. To begin with, only one of the hospitals involved is a public institution.

Furthermore, voters are being asked this fall to approve spending measures for transportation and for improving Balboa and Mission Bay parks. Regardless of how those proposals fare, getting a two-thirds’ vote for trauma care funds next June seems unrealistic.

The supervisors should support Wilson’s proposal, apply pressure to Deukmejian to free state funds and plan now to find money within the county budget to help keep the system working. It has done too good a job to let it wither by the attrition of more hospitals, especially Palomar, the only North County hospital in the network.