Georgia election | Failed amendment leaves trauma fix unclear

By Carrie Teegardin

The Atlanta Journal-Constitution

Georgians will continue to post high death rates from car crashes and work accidents as a result of Tuesday's defeat of a ballot measure to improve trauma care, according to medical providers who supported the measure.

Those pushing the amendment viewed the vote as their best shot to bring faster and better care to injured Georgians, many of whom live 50 miles or more from a hospital designated as a trauma center.

But even rural Georgians who are especially vulnerable rejected the measure to add $10 to annual vehicle registrations. The amendment faced an electorate dominated by voters who are already weary of taxes and who have little trust in the government's ability to wisely handle public money.

Advocates said the defeat makes it unlikely that the state will upgrade trauma services anytime soon.

"We're headed into an era of uncertainty as far as the trauma system goes," said Kevin Bloye, a spokesman for the Georgia Hospital Association. "The state budget is in crisis and as much as we remain committed to bolstering the trauma system, we're not optimistic."

Georgia has 17 hospitals designated as trauma centers, short of the 25 to 30 centers that public health officials say the state needs. Georgia's death rate from traumas -- usually the result of car crashes, work accidents and falls -- is 20 percent above the national average. If Georgia was at the national average it would have 700 fewer trauma deaths a year, according to the Georgia Trauma Care Network Commission.

Chad Black, a paramedic who lives in Gainesville, said he became more and more disappointed Tuesday night as votes came in. The measure failed with 52.6 percent of Georgians opposed.

"It was a $10 tax and people have in their minds that they're tired of being taxed and it really does't matter what it's for -- they're against it," said Black, who had campaigned for the measure.

Black blamed a widespread distrust of government. "When you have a campaign that is for something that saves lives, I know it's important to the people," Black said. "But you can't convince people the right thing is going to be done with that money."

Voters in Fulton and DeKalb counties, who have close access to top-level trauma centers, showed more support, according to county-by-county vote totals. The $80 million generated each year would have been used to pay for a statewide network to coordinate the response to traumatic injuries, increase the number of hospitals that can handle traumas and improve the fleet of emergency service vehicles that respond to accidents.

Currently, vast stretches of south Georgia are 50 miles or more from the nearest trauma center, making it unlikely that injured people from those areas could reach a trauma center within an hour of the injury. Chances of survival and recovery increase dramatically for many injuries if care is administered with an hour.

About one in seven fatal car crashes in Georgia took place at least 50 miles away from the closest trauma center in 2008, according to the Governor's Office of Highway Safety.

Bob Dallas, director of the Governor's Office of Highway Safety said the amendment offered a good financial deal for residents of rural Georgia, since drivers in densely populated urban areas would have subsidized an increase in trauma centers in more remote areas.

"The need is there, it will remain and we need to address it," Dallas said.

In 2007, the General Assembly created the Georgia Trauma Care Network Commission to help improve Georgia's trauma services, and the state authorized $58.9 million in 2008 for the commission to distribute to trauma care providers. Because the state's tight budget may make it difficult to get another large allotment,  advocates now worry about a worsening of trauma services.

Hospitals can lose money on their trauma operations because the required staffing and equipment is expensive and patients often are uninsured.

Bloye, of the Georgia Hospital Association, said several distinguished Georgia trauma center have threatened to leave the system or downgrade services if they did not get help covering costs.

"I fear that could happen," he said, "but we're going to do our best to make sure it doesn't. We're talking about a life and death issue."