Watson Wire

Trauma and Training

Monday, August 31, 2009 |

As longtime Watson Wire readers may recall, I occasionally get it in my head that I should be running half-marathons.

Never mind that every part of my body – at least, every one capable of transmitting pain – tells me that’s a bad idea. 

Never mind that nothing about the way I'm built or look remotely suggests that running over 13 miles is a natural act.

And never mind that people who run marathons – people who may be built for it – have told me that, in my case, it’s not a great idea.

Never mind all of that.  I’ve done it multiple times now.  And even though I swear each time that it’s the last time (usually around mile 11), I’ve recently started training for another one.

I suppose I have my reasons for doing this.  None of them sound that good when I articulate them.

As a kid, when I did something my father just didn't understand, he'd often say, "Son, you have lots of book sense, but sometimes I question your common sense."  So one of the reasons may be that I'm not as bright as I hold myself out to be.  Another reason may be that I'm fighting back against those friends and loved ones making fun of my obviously legitimate status as one of the 10 Fittest Austinites.

But the real reason is it’s worth it whenever I cross the finish line.  You work that hard for something – particularly something that’s so good for you – and you can’t help but feel like you’ve accomplished something.

A Level 1 accomplishment

Two of our region’s most important hospitals crossed that kind of finish line last week.  On Thursday, University Medical Center Brackenridge and Dell Children’s Medical Center were both recognized as Level 1 trauma centers.  You can read about it here.

Now, I realize that Level 1 trauma sounds boring on its best day and kind of, well, traumatic the rest of the time.

But for hospitals, it’s an important designation.  As the Statesman noted, it certifies that a hospital can provide the most complex medical services and do more medical research.

For years, Austin has been the biggest city in the country without such a facility, and a lot of good people have done a lot of good work to end that distinction.  So last week’s announcement is a tribute to how far we’ve come and how much we’ve accomplished.

Less money, more problems

I made an important point at the press conference announcing this news.

The state has a designated fund to expand and improve hospital services – and, by extension, help Texas hospitals achieve these important milestones.  And there are hundreds of millions of dollars – money that’s mostly collected through fines on driving offenses – sitting in that fund and waiting to be given to hospitals that need it.

Unfortunately, budget writers have this habit of . . .

. . . wait for it . . .

. . . diverting that money to balance the state budget.

Ahh, yes.  The diversion of dedicated funds – money raised for one specific, inevitably popular purpose that instead is hoarded and diverted so the state can spend more money on other things.  Perhaps you've read about this before.

I’m glad to report that I passed an amendment during the last legislative session which, at a minimum, will make the budget more transparent and let Texans know how these dedicated funds are really being used.

I’m hopeful that a little bit of sunlight will at least start to put the brakes on these budget diversions.  Because the problem itself has only gotten worse.

In 2007, the state’s budget writers used a bit more than $3 billion from dedicated funds to balance the budget.  This year, they hoarded more than $3.6 billion to justify higher state spending.

Trauma to the trauma fund

The trauma fund has been among the more prominent victims of this bad habit.  As of right now, there’s about $238 million sitting in the fund unspent.  According to current projections, that total’s going to balloon to more than $331 million – a 39 percent increase – by 2011.

In addition, over the next two years, the state will divert:

• $670 million meant for low-income electricity ratepayers
• $515 million for clean air
• $186 million for petroleum storage tank remediation
• $157 million for fugitive apprehension (fugitive apprehension!)
• and another $1.8 billion for things like state parks, 911 service, and volunteer fire department assistance.

The new two-year budget goes into effect tomorrow.  We’ve got 16 months before the legislature reconvenes to start working on the next one.  I’m going to spend a good chunk of that time working on ways to end these diversions.

It’s not going to be easy, particularly in a tough budget cycle.  But getting this issue fixed is a marathon, not a sprint.