Sunday, December 6, 2015

Gun Ebola

I said in my last blog post that there are two crisis resulting from the increasing problems surrounding gun violence - health and financial.  The costs to treat those who survive from gun assaults, be they self inflicted or by others is immense.  The average cost of treating gun wounds as of 2012 found this:

WASHINGTON — Gunshot wounds and deaths cost Americans at least $12 billion a year in court proceedings, insurance costs and hospitalizations paid for by government health programs, according to a recent study.

"I think people probably don't understand that as well as they ought to," said Ted Miller, author of a study that found that gunfire deaths and injuries incur a direct societal cost of $32 per gun.

MORE: Despite studies, researchers hold off on gun control

About 20 years ago, Miller calculated the costs to society of shooting injuries and deaths with funding from the National Institute of Justice. He decided to run the numbers again this year after the shooting at an elementary school in Newtown, Conn.

"I was surprised," Miller said. "Back in 1994, the costs of drunk driving were substantially higher, but it has reversed."

Miller found that total costs per injury had at least doubled or come close for medical care, psychiatric care, court cases, insurance and emergency transport. For example, in 1992, medical care for a fatal shooting averaged $14,500. In 2010, that number reached $28,700.

He found that medical care in 2010 cost $3.2 billion for 105,177 deaths and injuries. In 1992, medical care cost $3 billion for 171,800 deaths and injuries, including 31,674 BB gun shootings, which were not included in the 2010 numbers.

According to government statistics analyzed by Miller for the Pacific Institute for Research and Evaluation, costs to the government in 2010 broke down this way:

$5.4 billion in tax revenue lost because of lost work
$4.7 billion in court costs
$1.4 billion in Medicare and Medicaid costs for firearm injuries and deaths
$180 million in mental health care costs for gunshot victims
$224 million in insurance claims processing
$133 million for responding to shooting injuries

Miller also found that Medicaid covers 28% of hospital admissions for firearm injuries, 37% of hospital days and 42% of medical costs. But in another study, he found that even if people weren't on Medicaid when they were injured, about 8% ultimately enroll in Medicaid after their injuries. "So about half of the medical costs borne by Medicaid may be the best estimate," he said.

A 2012 study by the Vanderbilt Medical Center in Nashville found that 79% of gunshot victims in greater Nashville were enrolled in Medicaid. That compared with 45% of Medicaid enrollment for all other emergency room patients. African-American patients were three times more likely to be gunshot victims than were white patients, the study showed.

Manish Sethi, a trauma surgeon at Vanderbilt University and a researcher for the study, said his team decided to look at the numbers after seeing "a bunch of African-American kids with gunshot wounds" coming through the emergency room. "We have to do something."

We know that nearly 60% of bankruptcy's  are related to medical bills. What the means in the long run is that financial services raise interest rates, fees and costs to offset the losses of said filings.  So we pay that back in ways through rising costs of medical insurance, medical bills as well as taxes to pay for the Medicaid bills that largely cover the medical costs of many of the victims.

Then we have the costs associated with a loss of our personal freedom as monitoring calls, emails and other exchanges, such as where we travel and whom we associate are duly documented and noted and used for whatever reasons or purposes law enforcement elects to do so.

And all of this because we need people to own assault weaponry and a gun cache enough to wreak havoc on a Christmas party of municipal employees at the local disability service center.

Yes I see that having guns are more important than any rational reasonable argument that not having them or at least limiting them brings.

Gun violence is an epidemic. It is time for a public health response

Georges Benjamin

The epidemic of intentional gun violence can be reversed with a science-based approach. It worked with highway deaths and Ebola, why not guns?

The Guardian Uk
Friday 4 December 2015

To reverse the gun violence epidemic – and it’s important that we use the word “epidemic” – we need to do the same thing we’d do for any infectious disease outbreak. We should track it, find the root causes, use science to find research gaps, create policy solutions and use mass public education campaigns to eradicate the threat.

Each year we lose over 30,000 people from firearm-related violence. Wednesday’s mass shooting in San Bernardino, California, struck especially close to home with me and my colleagues at the American Public Health Association. The county’s health department had its holiday party interrupted by gunfire that killed at least 14 people, injured at least 21 more and emotionally harmed countless families in the community. Yet, this tragedy is not an outlier. So far this year, we have seen more than 350 mass shootings in the US and it happens almost every day.

But what’s even more heartbreaking is that gun violence is preventable.

When the Ebola virus reached the US last year, the public health community leapt into action to address it. We had an evidence base for the disease because we had studied it. Ebola was tracked, prevention measures put in place, gaps in knowledge were assessed and the White House appointed an “Ebola czar” to coordinate our national response. Every health department in the US was put on alert. This was for just a handful of cases.

I can only imagine how many lives would be saved if we treated gun violence the same way.

The way to do this would be to start with the things you know will work. Congress has the power to start making the numbers go down right now with some common-sense steps. It should establish universal background checks for all gun purchases, including at gun shows and on the internet, to ensure people who should not have access to firearms don’t, for example. Right now, the policies we have don’t stop bad-apple gun dealers from putting their weapons in the hands of people who are motivated to cause death and injury – often to themselves.

Congress should also allow federal funding for research and prevention strategies to close the gap in knowledge surrounding gun violence and ensure our national and local data systems are in place, adequately resourced and working to collect and analyze injury-related data from firearm related violence.

There has been an effective ban on federal funding related to gun violence prevention research since 1996, when Congress put language in its Appropriations Bill stipulating: “None of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.” This hamstrings our national health protectors, CDC and the National Institutes of Health, from getting the science necessary to make headway. We have seen members of Congress recently step up to try to lift the ban, but we’ve already lost 20 years of life-saving research.

We’re not debating the constitutionality of guns. What we want to do is work to make people safer with firearms, the firearms themselves safer and our society safer with firearms in the environment.
We should not rationalize the tragedy of San Bernardino but we will. Again

Look at what we’ve done to make auto crashes less deadly. In just a decade we cut US highway deaths by 25% – down to a historic low – not by blaming the victims, but by making people safer in their cars, the vehicles themselves safer and the roads and environment safer for cars and people to transit on them.

Time and again a public health approach to solving health threats is a proven, evidence-based approach to improving health and preventing injury. That approach looks upstream to prevent bad things from happening downstream, and then doing everything possible to prevent them.

Health epidemics don’t end unless we intervene taking the best science about what does and does not work and using it. The epidemic of intentional gun violence can be reversed with a science-based approach. It happened with Ebola, it worked for automobile crashes and it can absolutely reduce gun violence.

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