Saturday, November 25, 2017
Editorials

Editorial: A start on getting trauma fees under control

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A Senate committee took an important first step Tuesday toward protecting consumers from outrageous hospital trauma response fees. The Health Policy Committee voted to place a temporary $15,000 cap on the fees that are arbitrarily set by hospitals and have no connection to the cost of trauma services provided to seriously injured patients. The proposed cap is still too high, but it is a positive development and the concept can be refined as the bill moves through the Legislature.

The Tampa Bay Times reported earlier this month that hospitals in Florida that provide trauma care charge trauma patients an average of more than $10,800 — no matter what treatment patients receive or how long they stay. The trauma center response fees were intended to help hospitals recoup some of the cost for keeping specialized medical personnel available around the clock. But none of the trauma centers could tell the newspaper how the fees are set or how they relate to the actual costs of the centers. The six trauma centers operated by the for-profit Hospital Corporation of America, including Pasco County's Regional Medical Center Bayonet Point, charge an average trauma response fee of $28,000. Even legislators who are sympathetic to HCA's argument with the state over opening three controversial trauma centers recognize that fee is indefensible.

The Senate legislation, SB 1276, was amended by Sen. Denise Grimsley, R-Sebring, to include the $15,000 cap on trauma response fees until July 2015. A temporary cap is useful, but at that level it would only affect the HCA trauma centers and one other for-profit trauma center. One hospital, UF Health Shands in Gainesville, reduced its $10,000 fee to $4,000 after the Times started asking questions. A better approach would be for lawmakers to set a lower temporary cap, then direct the state to develop trauma center response fees that are tied to the severity of the patient's injury, the length of time spent in the trauma center and the actual cost of providing the service.

The Senate bill appears to be a compromise for HCA. In return for a cut in its trauma center response fees, the hospital company would get to keep open its three recently opened trauma centers, including Bayonet Point. Never mind that those three trauma centers are at the center of an ongoing legal dispute and have hurt existing trauma centers such as Bayfront Health St. Petersburg. Instead, there would be a one-year moratorium on opening new trauma centers while the state overhauls its approval process. That means HCA, with its army of lobbyists and mountains of campaign cash, could keep pushing to open more trauma centers in the future.

A stream of Ocala officials and residents sang the praises of the HCA trauma center in that city during the Senate committee hearing. Every community would like a trauma center. But expensive trauma centers cannot be on every corner like banks and gas stations, and the private competitive marketplace cannot be allowed to determine their locations and costs for patients. There is a compelling public interest in state review and approval of the location, performance and charges of trauma centers to ensure there is a sustainable statewide network.

The Senate bill is a reasonable start in establishing a temporary cap on trauma center response fees and a moratorium on new trauma centers. But there is more work to be done, and the Legislature should not inject itself in the legal fight over the three HCA trauma centers.

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