In the power struggle between the House and Senate over tax cuts, there's a genuine risk that the 2008 General Assembly will again end without finding a way to fund the state's troubled trauma-care network.

Legislative leaders went into the session promising to create a mechanism that would channel $80 million to $100 million a year into the 14-hospital network, including Atlanta's Grady Memorial Hospital, the only Level I trauma center in North Georgia.

Trauma care is an expensive service. Grady alone lost $43 million providing trauma care in 2006, which is one of the major reasons the hospital is insolvent. Other hospitals have also warned they may not be able to keep their trauma units open without financial help from the state.

House and Senate budget negotiators have at least agreed to appropriate $58 million to sustain the network through the rest of the fiscal year, which ends in July. But plans for a permanent, dedicated funding source are in jeopardy.

Each year, Georgia's still-primitive trauma-care network costs an estimated 700 lives a year that might otherwise have been saved. The few Georgia hospitals that provide trauma care do so as a community service, but in today's medical marketplace —- with 1.7 million Georgians uninsured —- hospitals can't keep writing off millions in unpaid bills for such an expensive service.

House Speaker Glenn Richardson has proposed to fund trauma care through an annual $10 fee on automobiles. However, that approach is linked to Richardson's controversial plan to eliminate ad valorem taxes on cars and trucks, which seems unlikely to become law. If it dies, the $10 fee for trauma care is likely to die with it.

The Senate hasn't taken up any of a half-dozen bills that would directly fund trauma programs. And unfortunately, neither the Richardson plan nor any of the Senate proposals would guarantee funding for trauma care.

Instead, revenue from those sources would flow directly to the state's general fund and would have to be appropriated for trauma care each year by the Legislature. In a tight budget year —- and we may have several in our future —- the Legislature could choose to spend the money elsewhere. A similar funding mechanism was supposed to fix financing problems in the state's indigent criminal defense program, but it has been chronically underfunded since it was created four years ago.

Georgia needs a dedicated source of funds to shore up its existing trauma network and eventually expand it to more hospitals. Air and ground ambulance programs also need to be better coordinated on a regional basis, especially in rural areas.

That can't be accomplished if trauma-care advocates are forced to fight the same budget battles every year. Other states, including Florida, Virginia and Maryland, understand that trauma care is an essential, lifesaving service that must be maintained.

The General Assembly should move quickly to create a mechanism that will secure the network now and in the future.