Health insurance: Helmets save lives, medical costs

Rita Colorito

While parents have been teaching their kids to wear helmets while riding bicycles, the adults haven’t necessarily been practicing what they preach. The latest figures from the Insurance Institute for Highway Safety show that only one in 10 fatally injured bicyclists were wearing helmets. The average age of bicyclists injured on American roads is 31.

“Adults were smart enough to give bicycle helmets to their kids, but don’t seem to be cognizant that they should be doing the same thing,” says Bill Windsor, associate vice president of consumer safety for Nationwide Insurance.

That could be a tragic and costly oversight. Sports and recreational activities lead to more than 447,000 emergency room visits each year related to traumatic brain injury, according to the American Association of Neurological Surgeons. An estimated 1.7 million Americans sustain a traumatic brain injury each year, according to the federal Centers for Disease Control and Prevention. Of those people, 52,000 die and 275,000 are hospitalized.

Avid cyclist Rik Lantz says a helmet saved his life in a bike accident that happened in 2000.

BrainandSpinalCord.org pegs the medical costs of a mild head injury at $85,000, a moderate head injury at $941,000 and a severe head injury at $3 million. Brain injuries can take months or years to heal. More than 3.1 million American children and adults are living with lifelong disabilities caused by traumatic brain injury.

Helmet use drastically reduces injuries

Experts say wearing a helmet while bicycling — or engaging in other activities, such as snowboarding and skateboarding — can prevent head injuries and prevent health insurance headaches.

Helmet use is estimated to reduce the risk of head injury among bicyclists by 85 percent, according to a study published in 1989 by the New England Journal of Medicine. When the study was published, children suffered the majority of serious injuries from bike accidents.

“Years ago, a lot of the fatalities were with young bicyclists, but parents got really good about them wearing helmets,” Windsor says.

Health insurance may fall short

Most health insurance covers acute medical care resulting from a brain injury, such as going to a trauma center. But oftentimes coverage dwindles when traditional medical treatment ends and rehabilitation begins.

With health insurers, “the most common issue is either a cap on the cost, so they will only spend X number of dollars or will put a cap on the number of days. You may only get 30 days of rehabilitation, which may not be sufficient,” says Greg Ayotte, director of consumer services for the Brain Injury Association of America.

Ayotte adds: “Insurance companies look at it from a medically stability standpoint. They may say you are medically able to go home, but you would clearly need more therapies to return to work or school or everyday activities. That may not be something that insurance would cover. You may have medical stability, but not a functional ability to return to the level of functioning pre-injury. And that kind of recovery could vary considerably.”

Painful memories

Fortunately, Rik Lantz was able to recover from a head injury he suffered while riding a bike in July 2000. An emergency room doctor told Lantz’s wife that if her husband hadn’t been wearing a helmet that day, he would have died.

Lantz wound up in a hospital emergency room after getting into an accident while pedaling along a lakefront path in Chicago, heading home from work. Lantz — whose bicycle helmet cracked in half and was smashed on one side — suffered a severe concussion, bruising of the brain and memory loss.

“For a month afterward, I was repeating myself, not recognizing people and stuff like that,” says Lantz, who’s an environmental scientist.

Lantz’s three fractured vertebrae healed more quickly than his brain injury. Lantz says he now feels like he’s back to normal, although he still experiences some memory loss.

A double standard

Lantz, a self-professed helmet evangelist since his bike accident, finds it frustrating when Mom and Dad require their kids to wear helmets during outdoor activities like cycling, but the parents themselves don’t use them.

“That sends the worse kind of message possible. It’s like you don’t have to wear a helmet if you know what you’re doing. No! I know what I’m doing, and I had a very serious accident,” says Lantz, who requires his son to wear a bicycle helmet.

Lantz didn’t always think that way.

“When I first started riding, I thought helmets were for wimps, and my wife convinced me to wear a helmet,” he says. “I look back on that as a very good decision.”