The demographic stays pretty constant—mostly young men, mostly poor, often people of color without any way to pay for lifesaving surgery. Of those 2,753 victims, 45% were uninsured, according to Jackson, which is a public, not-for-profit hospital. Many more were on Medicare or Medicaid. That means the hospital has to swallow the cost of many of the treatments.

Jackson officials declined to estimate how much the shootings cost the hospital every year, saying there are too many variables. In general, it is difficult to estimate the actual medical costs of a trauma visit for a gunshot wound. No national studies have been done.

Further complicating the scenario, Florida’s Republican governor, Rick Scott, and the state Legislature declined to expand Medicaid under the Affordable Care Act. That put Jackson Memorial in a bind, because federal “low-income pool” funding, which is used to defray the costs for treating the uninsured and underinsured, is being phased out precisely because the feds anticipated Medicaid coverage would be expanded. State legislators have cobbled together a solution, but Jackson meanwhile lost about $15 million in funding for treating the poor for fiscal 2016.

That’s a shame because Ryder, which is part of the public Jackson Health System, is the only Level 1 adult, pediatric and burn trauma center in Miami-Dade County. It has its own helipad, through which about 40% of its patients arrive. This is where virtually all of the county’s gunshot victims were brought until two other hospitals opened trauma units in the past three years. If you’ve been seriously injured in the Miami area then you want to go to Ryder, which is one of only nine Level 1 trauma centers among the state’s 31 trauma centers.

Modern Healthcare