The main reason Georgia's trauma network hospitals are in financial trouble is that too many patients have no insurance and can't pay their bills. In 2006, Grady Memorial Hospital in Atlanta alone had to write off about $42 million in uncompensated care for providing North Georgia's only Level I trauma center, a facility that saves scores of lives every year.

To ease that financial pressure, the Georgia Senate voted Monday to approve a $10 vehicle registration fee that would generate about $75 million a year for trauma care. Yet that same bill prohibits the network's 15 hospitals from using the money to cover their losses in providing this lifesaving service.

If that mistake is not remedied by House and Senate conferees, the long-sought program could be crippled before it even gets off the ground.

Last year, a legislative study commission wisely recommended that an independent state trauma commission, not the Legislature, be charged with monitoring the performance —- medical and financial —- of all hospitals in the network.

The Senate provision ignores that recommendation. Lt. Gov. Casey Cagle and other Senate leaders say they fear setting up an "entitlement" system if hospitals are allowed to tap a pool of trauma money each year to help offset their unpaid bills.

In a sense, that entitlement already exists. Federal law says that every trauma patient who comes through the doors of an emergency room —- regardless of insurance or citizenship status —- is entitled to the full range of necessary services. Nobody, including the Senate, argues with that requirement, but year after year the state continues to stick trauma network hospitals with the cost of providing that care without putting up a single dime to help.

Death rates from traumatic injury are already 20 percent higher in Georgia than the average of other states —- amounting to about 700 needless deaths per year —- because of the state's inadequate trauma network. The Senate's provision would make it more difficult to improve that performance.

Instead of covering uncompensated care, the Senate measure demands the money be spent on "readiness" —- better communications systems, air and ground ambulances, and paying medical specialists to be on standby. It also attempts to expand the network into rural areas that have virtually no service now. These are worthy long-range goals, but the more immediate goal should be to stabilize the existing network and protect it against the bills run up by the 1.7 million Georgians with no health insurance coverage who are hurt in serious motor vehicle accidents and need specialized trauma care.

The Senate also made the funding contingent on voter approval of the plan in a referendum on the November ballot. That approach may be unconstitutional —- Georgia has no real mechanism for voter approval of taxes, other than an amendment to the state constitution —- and choosing that course indicates cowardice.

"We're not imposing a $10 fee," Sen. Eric Johnson (R-Savannah) said of the provision. "We are allowing voters to impose one on themselves." Not what you would consider a profile in political courage.

Even if it passes the Legislature, is signed by the governor, is approved by voters in November and is deemed constitutional, the bill does nothing to require that money raised by the new car fee is actually spent on trauma care. Future legislatures would be free to spend that money any way they wanted, and in tight financial years you can easily see such a scenario being played out.

House and Senate conferees still have a chance to find a permanent, reliable funding mechanism for trauma care that helps offset the losses hospitals face and allows the network to better serve Georgians.