Funding is at issue in measure to pay trauma doctors better

Bills seeks $2 surcharge on automobile insurance

January 31, 2003|By Andrea K. Walker | Andrea K. Walker,SUN STAFF

Nearly everyone testifying at a House of Delegates committee hearing agreed yesterday that a fund should be created to help better pay doctors at Maryland's hospital trauma centers.

Disagreement came over the source of the money.

House Speaker Michael E. Busch, who has made trauma centers a priority this legislative session, has introduced a bill that would raise the money through a $2 annual fee on automobile insurance policies. He predicts that it could bring $8 million to $9 million a year.

Busch, an Anne Arundel County Democrat, said he chose the charge because more than 50 percent of all traumas are caused by automobile or motorcycle accidents, and 90 percent of households have at least one automobile. "We want to make it cost-relative," he said.

But several executives and lobbyists from the insurance industry said the charge puts the burden on too few people.

The state collects $49.6 million a year from an $11 surcharge on motor vehicle registrations to support the trauma system.

"We recognize the seriousness of the problem, but you're putting this problem on the backs of your constituents who have auto insurance, and it is not fair and equitable," said D. Robert Enten, a lobbyist for the National Association of Independent Insurers.

The funding issue came to light in June, when the trauma center at Washington County Hospital in Hagerstown closed because it couldn't pay enough doctors to work round-the-clock shifts. The center re-opened in June -- at lower staffing levels -- after coming up with $1 million to give the doctors standby pay.

The closing prompted legislators to conduct a study on the issue last year. The study concluded that the state should contribute $15 million a year to the trauma system to avoid another shutdown.

Yesterday, Washington County Hospital's president and chief executive officer came out in support of Busch's bill, saying that the state's 11 trauma centers need a better solution.

"We have been incurring all of the expense up to this point, and we're operating in the red largely because of this problem," said CEO James P. Hamill.

While a few hospitals, such as the Maryland Shock Trauma Center, have full-time medical staffs, most of the trauma centers depend on surgeons and other specialists to take turns being on call around the clock.

Doctors testified yesterday that they lose money by agreeing to work at trauma centers because they can't see other patients while on call. Many of the trauma patients that come in are not insured, they said.

"None of you could run a business if you lost money from 54 percent of the people who walked in the door," said Dr. Thomas M. Scalea, director of the Program in Trauma at the Maryland Shock Trauma Center in Baltimore. "All we're asking is that you give us the stuff we need to do our job."

Several insurance lobbyists said Busch's bill largely overestimates the money that can be raised through the annual charge. They said many of the state's 4.3 million registered vehicles are self-insured or uninsured and wouldn't be liable for the fee. Buses and taxis would be exempt because the state doesn't consider them motor vehicles, they said.

"You need something that will capture a broader number of people," said Lawrence A. Richardson Jr., director of government affairs for State Farm Insurance Cos. in Maryland and Washington.

Del. James W. Hubbard, a Prince George's County Democrat, said he was concerned that the surcharge wouldn't cover the trauma program as health costs continue to rise.

Busch said he would take other funding options into consideration.

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