Trauma Center Must Survive

Trauma centers save lives. Unfortunately, because of factors beyond their control, many lose money they cannot afford to lose if they are to survive.

The California Assembly Office of Research reports that 55 trauma centers in 13 counties lost more than $130 million in 1986. Until recently Orange County’s four trauma centers had managed to avoid that problem.

Unlike Los Angeles County, where five centers (three last year) withdrew from the trauma network, and San Diego County, where three of the trauma system’s six centers report losing an average of $1 million a year, Orange County’s centers generally have been breaking even.

But no system treating large numbers of indigent patients can long be immune from reduced state funding for medically indigent patients and the governor’s veto last summer of $29.9 million in bailout funds to help offset the trauma centers’ declining revenues.

Just before Christmas, the Fountain Valley Regional Hospital and Medical Center reported that it may have to withdraw if the county doesn’t begin subsidizing its operation. The hospital, one of the original emergency centers in the Orange County trauma network launched in June, 1980, didn’t disclose how much it is losing. It is saving that for inclusion in its formal request for county help, but it did say that the average payment from trauma patients is 30% below the average it collects from patients receiving other hospital services. It also said that its problems are similar to those in Los Angeles, where high trauma-care costs and inadequate reimbursements for treating medically indigent patients are creating the financial emergency.

If the hospital follows through as expected, it will be the first trauma center in the Orange County network to ask for county funds. The Los Angeles Board of Supervisors last month approved a $11.2-million emergency appropriation in an attempt to keep its trauma network from disintegrating even further.

Orange County’s network must be maintained too. Increasing charges won’t work. Too many patients can’t afford to pay the current rate. But they need the emergency care. And the community needs the centers open and operating to perform their proven life-saving functions for victims of heart attacks, auto accidents, shootings, explosions and other violent injuries that could befall anyone, rich or poor, insured or not, anyplace, any time. The closing of Fountain Valley would leave a strategic weakness in the system in the coastal and western area of the county.

Officials at the Fountain Valley center must document their operating losses and financially justify any government subsidy. But if operations can’t be streamlined to at least a break-even point, some government subsidy is in order to keep the emergency rooms in the county’s trauma network. Funds can always be replaced. Lost lives can’t.