When big-city local television news broadcasts overflow with gun death stories, it’s easy to overlook the 30,000 hospital stays and 50,000 emergency room visits annually caused by gunshot injuries. Furthermore, the recent Government Accountability Office report found that about 16 percent of firearm-injury survivors were readmitted to hospitals at least once, with costs averaging $8,000 to $11,000 per patient.
This is the real-world backdrop to the political turmoil surrounding David Chipman, Biden’s pick to lead ATF, the Bureau of Alcohol, Tobacco, Firearms and Explosives. His nomination “has languished in Senate confirmation purgatory,” as my colleagues on the Washington Post editorial page wrote, because of political opposition to Chipman, despite his 25 years of agency service.
That plague leaves many gunshot survivors, particularly Black people, without the care they need because of inadequate health insurance. “The consequences of unmet health needs for firearm injury survivors may ultimately result in greater costs,” GAO noted.
“Many firearm injury survivors are from communities of color and are low income,” the report added. “Because of this, they may be more likely than the general population to face access barriers due to systemic inequities that disproportionately affect those groups.”
One expert interviewed for the report told GAO “that at their hospital, surgeons cannot provide follow-up care for patients with certain types of insurance after discharge, and instead must transfer their care to the county facility,” which often has too many patients, no personal patient advocate and where they “may not receive the quality of care they need or have to wait longer for care.”
Rep. Carolyn B. Maloney (D-N.Y.), chairwoman of the House Oversight and Reform Committee, said the report “provides shocking new evidence of how gun violence strains our health care system and disproportionately harms historically marginalized communities in the United States.” The report was addressed to her, Sen. Elizabeth Warren (D-Mass.) and Rep. Robin L. Kelly (D-Ill.). “Congress must do whatever it takes — including abolishing the filibuster if necessary — to address this public health crisis,” Maloney added, “and keep our constituents safe from gun violence.”
Statistics show many Americans are not safe now.
“In 2019, close to 40,000 people died from a firearm injury in the U.S., and around twice that number sustained non-fatal injuries,” GAO, an independent, nonpartisan congressional watchdog agency, reported.
GAO considers its report groundbreaking because the agency is “not aware of any other federal estimates of the health care costs of firearm injuries,” said spokesman Charles Young.
Yet, as big as the $1 billion estimate is, it’s probably low because it doesn’t include physician services that could boost the estimate by 20 percent. Moreover, a 2017 study by Johns Hopkins University researchers placed the annual hospital cost of firearm-related injuries at $2.8 billion.
Hospital care is always costly, but per patient, firearm injuries “are relatively expensive to treat compared with other types of injuries or conditions,” GAO found. In 2016 and 2017, according to the report, the average cost of initial treatment for firearm injury patients, for emergency room services or inpatient care — was more than twice the cost of treating other patients.
Gunshot patients are almost 90 percent male, and more than half are young, between 15 and 29 years old. Over 50 percent of inpatients are African American and victims were “disproportionately concentrated in the South,” GAO added, with almost half concentrated in that region.
Amy Hunter, a National Rifle Association spokesperson, downplayed the study, saying it “ignores the lives that could have been saved and costs reduced had laws been enforced, violent criminals not furloughed, and law enforcement and prosecutors been given the resources and support to do their jobs.”
Firearm injuries and their aftereffects don’t heal quickly.
“Experts told us that firearm survivors with injuries resulting in permanent disability or serious medical complications are most likely to need significant post-discharge care, sometimes for the remainder of their lives,” the report said.
The delayed impact includes mental health issues. Victims can suffer from depression, post-traumatic stress disorder and other conditions. Victims, in this sense, include those who were not shot. “Survivors’ families and communities can have behavioral health care needs after a firearm injury,” according to GAO.
The GAO report “tells a narrative that we don't speak to often enough in this country, which is that the toll of gun violence in America is more than just the deaths that we see daily,” said Christian Heyne, the vice president for policy at the Brady Campaign to Prevent Gun Violence.
He should know. His parents were victims of gun violence in 2005 that wounded his father and killed his mother.