This year, the S.C. General Assembly took the first step toward ensuring gravely injured South Carolinians can continue to receive lifesaving emergency care. In April, Gov. Mark Sanford signed into law the unanimously passed Statewide Trauma System Act, creating a vehicle by which the state's 12 Level I and Level II trauma centers (the ones equipped to handle the most grievous injuries) could receive sufficient public money.

Today, in Charleston, the S.C. Hospital Association launches what members hope will be a successful campaign to persuade legislators and Sanford to take the next logical step in 2005: putting at least $28.6 million into the trauma system that legislators created this year.

Association members make a compelling case that absent this infusion of public money, the network of 24-hour hospital emergency rooms on which South Carolinians depend for live-saving care after dreadful accidents is in danger of collapse. In 2001, the most recent year for which data are available, the trauma hospitals, including Grand Strand Regional Medical Center, lost a combined $18.3 million on unreimbursed care. These same hospitals, according to the association, spent a combined $9.3 million to ensure trauma-trained doctors and support personnel were ready 24 hours per day to handle gravely injured patients.

Since 2001, says the association, these annual loss and expense numbers likely have grown, as an increasing number of trauma patients, one in four, have no health insurance. Legally (and morally) speaking, trauma hospitals can't turn them away, so these emergency-room losses get charged against paying customers or else written off - creating in some hospital administrators the temptation to get out of the trauma business.

Augmenting the problem are the absurdly high malpractice premiums trauma surgeons must pay - not because they're incompetent but because their specialties make them especially vulnerable to liability lawsuits. Rather than put up with the aggravation, some trauma-trained doctors and newcomer physicians with trauma potential turn to less risky specialties.

Under the association proposal, the desired $28.6 million would indemnify S.C. trauma centers against losses, giving host hospitals a greater incentive to stay in the trauma business. Coupled with malpractice reform that made trauma physicians and other high-risk specialists less vulnerable to high insurance premiums, as Sanford reportedly wants to do, the money would buy South Carolinians something they don't have now: insurance that if some terrible accident befalls them any time of day or night, there will continue to exist a regional trauma center equipped and staffed to give them a chance to survive and recuperate. Looked at that way, the $28.6 million "premium" seems reasonable, doesn't it?