Trauma Fees to Double at Palomar Hospital

Trying to recoup spiraling losses from its costly trauma care center, Palomar Hospital in Escondido, which runs the only trauma center in North County, plans to double its fees for treating trauma patients.

Without such an increase, hospital officials say, the trauma program will lose about $2.2 million this year. The trauma center lost $2.6 million last year, which was covered by revenue from other programs.

“Our intention at this point is to get the program to be self-sustaining,” Robert Edwards, president and chief executive officer of Palomar Pomerado Hospital District, said Tuesday.

Edwards has indicated that Palomar Hospital will consider pulling out of the trauma care network if it is unable to come close to breaking even on the program.

Care for Badly Injured

The six trauma centers in San Diego County, designated to provide emergency care for gravely injured patients, are extraordinarily well-staffed and well-equipped. Seriously injured patients are taken to trauma centers even if another hospital is closer, on the presumption that they will get better care at the trauma centers.

Edwards called the rate increase a “temporary, Band-Aid approach” to the chronic problem of uninsured trauma care patients. The rate increase will automatically expire next June unless renewed.

The increase will take effect as soon as the hospital figures out how much to raise the fees for each individual service the trauma center provides.

About one-third of the center’s patients cannot pay their bills, Edwards said. Last month, Palomar’s trauma center treated about 120 patients.

“The big problem is that we have so many illegal aliens and indigent patients that it’s a heavy burden,” said James H. Smith, the hospital district’s senior vice president for finance.

Both Edwards and Smith said they hope trauma centers will get a government subsidy, either from a special county tax or a statewide program.

‘Like Fire Protection’

“We feel it’s like fire protection. You wouldn’t want to pay firefighters $10,000 or $15,000 to come put out your fire,” Smith said. “Those who don’t use (the trauma centers) can just consider themselves lucky.”

Depending on length of stay and seriousness of injury, trauma center patients are billed anywhere from “a couple of thousand dollars to $30,000 if the patients stays in intensive care for two or three weeks, which often happens,” Smith said.

Edwards added, “We’re all potential victims of trauma, and for about $10 a head, we can finance the whole system in San Diego County. That’s relatively cheap.”

County supervisors are considering putting an initiative on the June ballot to levy a tax for the trauma care system.

At least two other area trauma centers--Scripps Memorial and Children’s hospitals--are losing a substantial amount of money and also are seeking government help.