Costs and Funding

A severe head injury averages lifetime costs of over $3 million and for a moderate head injury over $1 million. For the population as a whole, it has been estimated that the costs for care of people with a new TBI is $6.5 billion per year and ongoing care for people with existing head injuries is $13.5 billion. Indirect annual costs have been calculated at over $33 billion. This totals over $50 billion in annuals costs for TBI related injuries in the US.

The costs of health care in the United States have increased markedly in the past 30 years. While the costs of care are going up, current trends in medical insurance systems such as health maintenance organizations (HMO's) are reducing the amount of benefits that will be paid. This is producing a crisis in the payment for long-term, catastrophic injuries like TBI.

In the United States, 35 million individuals are without any health care coverage. Only 39 percent of small businesses offer health benefits to workers. In the elderly, Medicare and Medicaid cannot pay for comprehensive rehabilitation services after a severe TBI. The large number of individuals now in HMO's or managed care organizations (MCO's) usually do not have coverage for brain injury rehabilitation. Even those with health insurance often decide not to pay for the catastrophic coverage that would pay for brain injury rehabilitation, even if it is offered. Individuals needing an ideal 80 weeks of acute and postacute rehabilitation may get only two weeks paid for. In fact, only 1 in 20 individuals who suffer a severe TBI have adequate insurance funding to guarantee that comprehensive rehabilitation services will be provided to produce a maximum overall recovery from such a severe injury. Most will receive only acute hospital care and possibly a short rehabilitation stay before being discharged home or to a nursing home, far too early, with far too little rehabilitation, and far short of the recovery in functioning that could have been achieved.

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