Road traffic accident victims: Who should bear the initial cost of treatment?

With reference to an article published by Lawrence Markwei on ‘accident victims cry for help, scrap third party insurance’ published in the Ghanaian Times of Wednesday, January 27, 2010, what have we as a country done about the fate of road traffic accident victims?

Insurance companies will pay claims of valid insured cars after the patient has been treated at a health facility. Who pays the initial cost of treatment? The victims and their relatives, of course. If you are fortunate, the car owner might help. 

If your fracture can be managed in a cast, thank your God, but if you will need surgical intervention, you need to pay upfront for the implant, be it an external fixator for open fractures or implants for closed fractures. 

The bill can be huge, especially if it has to do with multiple-injured trauma victims. It  runs into several thousands of Ghana cedis. If you are unfortunate that you have to pay the bills upfront, you are denied definitive treatment.

Many victims have fallen victim to such treatments and some have lost their lives or have had to stay in hospital for months until funds became available to have their surgeries, bearing in mind that fractures do not wait, some will heal anyway in abnormal or normal positions and others will not. 

Some victims will get away with complications but most will not, leading to further complications such as nonunion, malunion or the shortening of the affected limb. 

Hardly do you visit our accident centres without seeing  patients lying on stretchers of ambulances until beds become available, with some falling off such mid-shift beds.

With the increasing rate of road traffic accidents and its associated  morbidity, mortality and high cost of treatment which is beyond the average Ghanaian’s pocket, something  needs to be done as early as possible to relieve victims who not only have to suffer the tragedy of  the accident but also the initial financial implications.

I am advocating the establishment of a trauma fund for such victims. The money for the fund should be from a 

1. Percentage of duties on cars and spare parts paid at our ports and entry boarders

2 Percentage of road worthy renewals

3. Percentage of insurance renewals

4. Percentage of tollbooth fees

5. From benevolent organisations and individuals 

The benefits of such a fund are enormous; just to mention a few,

1. Road traffic accident victims will not have to pay for the initial cost of treatment, and if they have to pay at all, it will not be that much

2. Some of such monies can be used to equip our hospitals with modern equipments such as digital X-rays, image intensifiers, ventilators, monitors, implants, power drills and instruments.  

3. Emergency investigations such as computer tomography for head-victim patients.

4. It will reduce the duration of hospital stay which will in turn reduce the workload, decongest the wards and reduce the amount of monies the NHIS pays as claims to health facilities and boost morale among health workers, patients and their relatives.

5. Procurement of ambulances and training of health personnel to provide first aid to accident victims

6.To augment the budget of the road safety commission.   The insurance companies can later pick up the claims from victims and reimburse the trauma fund. When seed money is realised, the deduction from the above could be stopped and a revolving fund set up.  

Trauma may happen to anybody, since we and our loved ones are road users at one time or another but we should not be traumatised further by the financial implications. Somebody has to foot the initial bills and a firm decision has to be taken by those who care.

The writer is with the Trauma and Orthopedic Dept, Korle Bu Teaching Hospital .