Gunshot wounds drive up government health care costs

• Medicaid and Medicare end up paying %241.4 billion a year for gunshot wounds
• Higher costs stem from lost taxes caused by lost time at work
• Gunshot wounds also drive up insurance premiums

WASHINGTON — Gunshot wounds and deaths cost Americans at least $12 billion a year in court proceedings, insurance costs and hospitalizations paid for by government health programs, according to a recent study.

"I think people probably don't understand that as well as they ought to," said Ted Miller, author of a study that found that gunfire deaths and injuries incur a direct societal cost of $32 per gun.

About 20 years ago, Miller calculated the costs to society of shooting injuries and deaths with funding from the National Institute of Justice. He decided to run the numbers again this year after the shooting at an elementary school in Newtown, Conn.

"I was surprised," Miller said. "Back in 1994, the costs of drunk driving were substantially higher, but it has reversed."

Miller found that total costs per injury had at least doubled or come close for medical care, psychiatric care, court cases, insurance and emergency transport. For example, in 1992, medical care for a fatal shooting averaged $14,500. In 2010, that number reached $28,700.

He found that medical care in 2010 cost $3.2 billion for 105,177 deaths and injuries. In 1992, medical care cost $3 billion for 171,800 deaths and injuries, including 31,674 BB gun shootings, which were not included in the 2010 numbers.

According to government statistics analyzed by Miller for the Pacific Institute for Research and Evaluation, costs to the government in 2010 broke down this way:

• $5.4 billion in tax revenue lost because of lost work
• $4.7 billion in court costs
• $1.4 billion in Medicare and Medicaid costs for firearm injuries and deaths
• $180 million in mental health care costs for gunshot victims
• $224 million in insurance claims processing
• $133 million for responding to shooting injuries

Miller also found that Medicaid covers 28% of hospital admissions for firearm injuries, 37% of hospital days and 42% of medical costs. But in another study, he found that even if people weren't on Medicaid when they were injured, about 8% ultimately enroll in Medicaid after their injuries. "So about half of the medical costs borne by Medicaid may be the best estimate," he said.

A 2012 study by the Vanderbilt Medical Center in Nashville found that 79% of gunshot victims in greater Nashville were enrolled in Medicaid. That compared with 45% of Medicaid enrollment for all other emergency room patients. African-American patients were three times more likely to be gunshot victims than were white patients, the study showed.

Manish Sethi, a trauma surgeon at Vanderbilt University and a researcher for the study, said his team decided to look at the numbers after seeing "a bunch of African-American kids with gunshot wounds" coming through the emergency room. "We have to do something."