Thursday, June 9, 2011

Let’s fix the hole in the windshield (Natalie’s Bill)

Guest article by Greg Parkinson, M.D., Chairman
Committee on Injury, Violence and Poison Prevention
Massachusetts Chapter of American Academy of Pediatrics

Health care cost containment is the buzz phrase of 2011 on Beacon Hill. You can hear it from Gov. Patrick and both chambers of the Legislature. While heated debates over solutions have ensued, most legislators are ignoring one easy component: the seat belt. When unbelted people crash through a windshield, they create a hole through which lives and money are being needlessly thrown.

As a pediatrician, I see this issue as one of saving lives. Too many dreams have been cut short and too many families have been devastated. However, not everyone is moved by personal tragedies. Perhaps now, at last, as we struggle financially, others can see that it is time to pass a better seat belt law. Primary seat belt enforcement can save more lives than I can hope to save in an entire career — and it also makes financial sense.

Health care is expensive, but an ounce of prevention is still worth a pound of cure. Furthermore, an ounce of prevention saves money. That is, injury prevention equals cost containment. Since car crashes represent the No. 1 cause of death under age 45, the seat belt emerges as a tool for saving money. This can be an “aha” moment.

Car crashes cost Massachusetts more than $6 billion annually. One major reason is our abysmal seat belt use rate of 74 percent; we rank 48th in the nation. This results largely from a failure to embrace primary seat belt enforcement. The 30 states where police can stop a driver solely for a belt violation have belt use rates 12 points higher than those, like Massachusetts, that require another reason to stop drivers.

Changing to primary enforcement would prevent more than 650 serious injuries and save 18 lives and more than 70 million health care dollars (private insurance, Medicare, Medicaid and self-pay) every year. That’s $70 million for one small change, and it actually improves health care. Not only that, but if the law is signed by June 30, the federal government will add $13.6 million in grants.

State Speaker Pro Tem Patricia Haddad and state Sen. Patricia Jehlen have proposed “An Act Establishing a Primary Seat Belt Law” (HB 2401/SB 1211). This bill, which does not affect insurance premiums, awaits a hearing in the Joint Committee on Public Safety and Homeland Security, which includes Cape Reps. Cleon Turner and David Vieira. It is referred to as Natalie’s Bill, after 21 year-old Natalie DeLeon of Springfield, who died in an unbelted crash in 2006, and is supported by a coalition of more than 40 organizations.

So what’s the holdup? Some say seat belts are a personal choice; however, almost three-quarters of crash costs are paid by those not involved in the crash. This makes it everyone’s business. Oliver Wendell Holmes said, “The right to swing my fist ends where the other man’s nose begins.”

And while racial discrimination has understandably raised fears in the minority community, research shows that primary enforcement does not increase racial profiling, but does reduce racial disparities in seat belt use. The wrong of racial profiling will not be righted by the wrong of people being thrown through their windshields. And the car traveling at 60 mph doesn’t care about race, socioeconomic status or religious beliefs. The crashing car treats us all equally.

We need to admit that education and secondary enforcement have given us a seat belt use rate that is almost the worst in the nation. We must care about the victims — not just the occupants, but the workers, the caregivers and the loved ones. We must recognize that we can save $70 million in health costs, millions more in related costs, and receive $13.6 million in federal money, at a time of drastic cutbacks.

This is low-hanging fruit for the Legislature. It is time to fix the hole in the windshield, to pass Natalie’s Bill and adopt a new, effective and cost-saving strategy for the commonwealth.

Dr. Greg Parkinson, a Falmouth pediatrician, is chairman of the Committee on Injury, Violence and Poison Prevention for the Massachusetts Chapter of American Academy of Pediatrics and co-chairman of the Belts Ensure a Safer Tomorrow Coalition.

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