HERE IS A QUICK FIX IDEA for the US healthcare system - GUARANTEED to reduce utilization of overburdened emergency and outpatient care, saving about $1.4 billion per year and preventing about 20,000 avoidable deaths per year. This idea is evidence-based and has been proven effective in many other countries. Claims in this article are based on a 2017 Johns Hopkins study that estimates the cost of emergency and outpatient care for this scourge at $2.8 billion annually, and results from Australia where harm has been reduced by 50%. Other sources estimate between 30-40,000 die each year in the US, and more than 70,000 are affected annually, but not killed.
What did they do in Australia?
In 1996, about 1 month after the Port Arthur Massacre, they passed tougher laws on firearms, reducing all firearm-related injuries by more than 50% over a period of 8 years. Interestingly, suicides and homicides by other means also dropped.
What did they do in Australia?
In 1996, about 1 month after the Port Arthur Massacre, they passed tougher laws on firearms, reducing all firearm-related injuries by more than 50% over a period of 8 years. Interestingly, suicides and homicides by other means also dropped.
New Zealand also took swift action recently. One week after the mosque shooting in Christchurch, New Zealand passed laws prohibiting ownership of semi-automatic weapons and self-loading ammunition cartridges and imposed stricter rules for acquiring firearms.
Deaths from firearms can be described in three categories:
- Suicide
- Homicide
- Accidental/Unknown
Universally, firearm deaths are most frequently associated with suicide:
Countries differ, however, in the number of firearm deaths and the number of guns per inhabitants.
Of course, correlation does not necessarily indicate causation. Having a firearm does not always result in harm. However, it is impossible to have a firearm death or injury without a firearm.
What does the harm from firearms cost?
Death is costly, but surviving with injuries may be costlier. Patients with a firearm injury in the Johns Hopkins study (2016-2017) incurred average costs of $5,254 and $95,887 for emergency and in-patient care, respectively. About half of those in the study who experienced firearm injuries had insurance and if their insurance policy covered this type of injury, they may have only paid out-of-pocket expenses of a few thousand dollars for their deductible portion, assuming they were considered "in-network" by the hospital or health provider where they were treated. The other half without insurance would have paid out-of-pocket the full or negotiated amount.
Costs from medical treatment are one part of the financial burden. Expenses of lost wages or cost of future health issues resulting from the injury would be in addition to the initial cost of care.
Imagine recovering from a firearm injury and having the additional stress of financial burden that resulted from that incident. That scenario differs from the experience of the Christchurch shooting victims, where all medical, funeral, and rehabilitation costs are covered by the New Zealand government's Accidental Compensation Corporation (ACC).
Unfortunately, the $1.4 billion in suggested savings will not raise a pencil as it represents less than 1 percent of the total $3.5 trillion dollars the US spends annually on healthcare. Neither will the 800 people killed each year accidentally nor that 126 of those accidents were children or adolescents. A study on Deaths of Adolescent and Children in the United States published in the New England Journal of Medicine (NEJM) in December 2018 concluded, "Solving this problem will require a shift in public perceptions so that injury deaths are not viewed as accidents, but as deaths that can be prevented by changes in public health approaches".
The NEJM study was published 6 months after the American Medical Association (AMA) urged for a ban on assault weapons in response to what it calls a public health crisis.
This is a crisis. And personal.
In the last six months, two of my family members have had their lives disrupted by active shooters, one in Florida and one in Colorado. Very personally, I feel this public health crisis in the US and I will be voting for change.
This article is not suggesting a ban on all firearms. They still have firearms and people with mental health problems in Australia, Canada, and elsewhere. However, these other countries have figured out how to reduce risks and harm and we should learn from them.
