Last week I had the wonderful opportunity to attend and present at the 34th Annual Fall Conference of the Brain Injury Association of Michigan (BIAMI). Attending brain injury events and gatherings is a regular part of the outreach efforts in working with our clients. The Michigan conference offered a chance to experience what it takes, from the state level, to create a well rounded continuum of care for persons surviving brain injury. It starts with a well organized, supported, and determined statewide brain injury association. It was an impressive conference with over 150 vendors and 1500 attendees. The Keynote address from Lee Woodruff about her family’s journey of recovery following her husband Bob’s roadside bombing in Iraq kicked off the opening day of the conference. Kevin Pearce inspired attendees on the second day, sharing his “Crash Reel” documentary and “Love Your Brain” social movement, both of which were motivated by his personal journey of living with brain injury after his 2009 snowboarding accident while competing for the Winter Olympics.
One of the more inspiring aspects of the conference for me occurred before the first keynote address. The pre-conference dinner included a healthy representation of state legislators. It was an environment in which attendees, made up of brain injury survivors, care providers, and family members, could engage state lawmakers on legislative concerns that were personal and important. A topic of frequent discussion throughout the conference centered on proposals to change Michigan’s “No Fault” automobile insurance laws.
As I listened to people articulate their points of view regarding this topic as it relates to brain injury, one troubling problem began to surface. The rising cost of insurance side of the debate was armed with statistical information as recent as six months old. Yet, the brain injury responses had to rely on the same old numerical responses that have been quoted in TBI circles for the past 4 to 8 years. Statistics such as “17 million people sustain a TBI annually”, “52,000 die”; “275,000 are hospitalized”; “1.3 million hospital visits”; and TBI is a contributing factor to 30.5% of all injury deaths”. If you research the origins of these numbers they are compilations of statistics compiled by the United States Centers for Disease Control (CDC) from 2002-2006. The total annual cost estimate of $60 billion has not seen a calculation adjustment since the year 2000.
On the surface, it appears that the root cause of our lack of information is tied to US Congress HR Bill 1098, better known as the Traumatic Brain Injury Reauthorization Act of 2014. This bill is currently awaiting consideration and review by the US Senate. Included in this legislation are appropriations for (brain) “injury surveillance” by the CDC through 2019. Appropriations for brain injury surveillance by the CDC through 2012 were defined in the 2000 and 2008 reauthorizations of the original TBI Act of 1996, yet the numbers have not been published for 4-8 years. How can a fair explanation of rising healthcare and insurance costs occur without an accurate representation of the facts? There have been some significant changes in TBI awareness in the past fourteen years thanks to our military veterans and the sacrifices made by former NFL players. The emergence of electronic medical record keeping in healthcare over the past decade should provide more accuracy in the number of brain injury patients seeking medical services, the types of services, as well as the level of care and duration. So the question is this: What is the current state of TBI in the United States, and based on what measures?