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CDC study: Motorcycle helmet laws save billions in health care costs

Hopping on a motorcycle with a helmet saves lives and billions of dollars in costs related to brain injuries, according to a study by the federal Centers for Disease Control and Prevention (CDC).

The report points to the success of universal motorcycle helmet laws, noting that annual savings in states that require motorcyclists and passengers to wear helmets are about four times greater than states lacking comprehensive laws.

The CDC study, released in June 2012, found that universal helmet laws resulted in more than $3 billion in cost savings in 2010 by increasing helmet use, which decreases crash-related deaths and injuries. If all motorcyclists had worn helmets, another $1.4 billion could have been saved, says Dr. Thomas Frieden, director of the CDC.

But this most recent data – an analysis of fatal crash data from 2008 to 2010 –continues to generate strong opposition from motorcyclists. They contend that it's their right to decide to strap on a helmet and that the data from the National Highway Traffic Safety Administration (NHTSA) are skewed.

The CDC is trying to show an economic cost associated with helmet use and the lack of helmet use, says Pete terHorst, a spokesman for the Ohio-based American Motorcyclist Association. “That’s a very slippery slope, because the NHTSA is on record as supporting helmet laws. The (American Medical Association) is not against helmet use. The problem we have is with mandates,” he says.

Eighteen states and the District of Columbia have universal helmet laws, which require all riders and passengers to wear helmets. Four states (Illinois, Iowa, Michigan and New Hampshire) have no helmet law, and 28 states have partial laws that apply to certain riders, such as those under age 21.

The CDC study found that cost savings ranged from $2.6 million in New Mexico, which has a partial law, to a high of $394 million in California, which has a universal helmet law. Savings per registered motorcycle range from $48 in New Mexico to $1,627 in North Carolina, with a median of $286, the CDC found. The CDC analyzed medical costs, productivity losses at work and at home, legal expenses resulting from deaths and injuries, and insurance administrative costs (such as billing).

Savings in states with a universal helmet law were, on average, nearly four times greater per registered motorcycle than in states without such a law. Average savings per 100,000 registered motorcycles, according to the CDC, are:

• $73 million: States with a universal helmet law.

• $21 million: States with a partial helmet law.

• $9 million: States with no law.

Motorists who do not wear helmets are much more likely to require rehabilitation or need to recover in a long-term care center, says Dr. Oscar Guillamondegui, director of the Traumatic Brain Injury Clinic at Vanderbilt University Medical Center in Tennessee and associate professor of surgery at Vanderbilt. Long-term care costs an average of $2,500 a day.

Data for trauma centers in Tennessee show that helmets have reduced brain injuries by 67 percent. The percentage of motorcyclists without helmets who suffer a severe head injury is double the percentage of motorcyclists with helmets, Guillamondegui says.

Keeping motorcyclists safe

Federal data shows that motorcycle crash-related injuries and deaths totaled $12 billion in one year, in both medical care costs and productivity losses.

According to terHorst, the NHTSA’s approach for many years has been, “Put a helmet on everybody’s head and the problem will be solved.” That mentality addresses the aftermath of crashes, he says, but not the causes.

“When the federal government intervenes and tries to blackmail or coerce states to passing helmet mandates, invariably federal dollars get directed out of other programs that support motorcycle crash prevention programs. That’s a big problem,” he says. “You can’t just look at helmets as a silver bullet and severely reduce funding for these other (education) programs and expect to receive results.”

Jacqueline Gillan, president of Advocates for Highway and Auto Safety, whose members include insurers, says motorcycle education is not a substitute for mandated helmet use.

“Right now, if you take the money you’re spending on education and bought helmets for people, you would probably save more lives. You need both,” she says. “Certainly, you can promote education, but it’s not an either/or situation.”

She says helmet laws are proving to be successful, with the CDC study finding:

• Helmets prevent 37 percent of crash deaths among riders and 41 percent among passengers.

• Helmets prevent 13 percent of serious injuries and 8 percent of minor injuries to riders and passengers.

As a 19-year-old, Andrew McGuire climbed on the back of his friend’s new motorcycle without a helmet. Ten minutes later, they were hit by a driver who ran a stop sign. McGuire, now executive director of the Trauma Foundation at San Francisco General Hospital and a key supporter of California’s universal motorcycle helmet law passed in 1992, suffered a severe concussion and cuts in the 1965 crash.

“I ended up missing a semester of college with severe headaches,” he recalls. “There was about a three- to four-month period where I was pretty much incapacitated because of these severe headaches, which got less and less frequent.”

Traumatic brain injuries result in costs for permanent disability, long-term nursing care, rehabilitation and physical therapy, and costs to welfare and other social services. The cost to the public is high, as federal data show that almost half of motorcycle crash victims lack private health insurance.

Fighting over helmets

Data point to universal helmet laws as being the most effective strategy for increasing helmet use, according to the CDC. In states with universal helmet laws, the CDC found that 12 percent of motorcyclists weren't wearing helmets.In states with partial helmet laws, 64 percent of riders weren't wearing helmets. In states with no helmet laws, 79 percent of riders weren't wearing helmets.

The American Medical Association says the federal data fail to take into consideration factors such as seasonality when counting ridership (fewer riders are on the road during the winter, for example). The rate of motorcycle deaths overall is on the decline, which terHorst says is “ignored” by backers of helmet laws. The group expects research by Oklahoma State University researchers, set to be published in 2014, will shed new light on the issue.

In 1967,the federal government required states to enact helmet laws so they could qualify for highway construction funds and certain federal safety programs. States followed suit, but then efforts began to repeal laws. About a decade later,

Congress voted to keep the U.S. Department of Transportation from penalizing states that didn't have helmet laws.

Gillan says there are more efforts every year to repeal motorcycle helmet laws. Michigan in 2012 repealed its law, with new tie to insurance coverage. Motorcyclists 21 and over who want to ride helmet-free must carry at least $20,000 extra in medical insurance, which terHorst says is discriminatory.

“In return for their relaxing laws, they are increasing the requirement for insurance on motorcycles,” terHorst says.

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