Wendy Max: Thank you very much for the opportunity to come testify today in opposition to AB-244. My name is Wendy Max. I'm a Professor of Medical Economics at the University of California San Francisco. My testimony today is based on our findings from an economic evaluation that we've conducted of the helmet law in California over the last four years.

Our findings have provided, I believe, compelling evidence of the overwhelming success of the helmet law in terms of dollars saved. This is the primary thing we were looking at, but also in terms of lives saved and injuries reduced and dollars saved to both the State of California as well as all other payers for health care of injured motorcyclists.

I want to make two key points in my testimony, the first being the economic success of the helmet law. The second being the relatively small proportion of costs that are accounted for by those under the age of twenty-one. Those to whom the law would apply if this bill were to pass.

Let me turn first to those who are hospitalized with motorcycle crash injuries. The number of motorcyclists hospitalized between 1991 and 1993. In other words we looked at one year before and two years after the helmet law went into effect. The number of hospitalized motorcyclists went down by 36%. During that same time period, the number of motorcyclists hospitalized for head injuries went down even more, by 51%. And again motorcyclists under the age of twenty-one represented only about a fifth of those injured, either head injured or looking at all types of injuries.

Head injuries are much more costly than other injuries. If you look just at the hospital bill, the average charges for a head injured patient are more than twice those for a motorcyclist injured with other types of injuries. The total hospital charges for those who are just head injured, and these are the people that we expect the helmet to have had some potential effect in, the charges associated these head injured motorcyclists fell by about $50 in each of the years that we looked at. And the data that we've looked at for the years after our study period seem to be showing the same trend in injuries.

And when you look at charges again you see that only about a fifth of those charges are associated with the younger under the age of twenty-one motorcyclists.

In terms of who pays for the care of injured motorcyclists, fewer than half of California's injured motorcyclists have private health insurance. And let me say in response to some comments earlier, whether or not the insurance profile of motorcyclists differs from those injured in all types of motor vehicle crashes or any type of hospital care, from my perspective doesn't matter that much. Because we have an intervention that we believe can reduce the cost here. From an economic perspective you want to look at the places where you can have an effect, and we do have such an intervention for motorcyclists.

We found that those who chose not to wear helmets, and this is primarily before the law went into effect since now there is little choice, those who chose not to wear helmets were more likely to be on Medical or more likely to rely on county indigent care services to pay for their care or more likely to be uninsured and less likely to have private insurance than those who chose to wear helmets.

When you look at the . . .

Senator Monteith: Excuse me, where is this information coming from?

Wendy Max: This is based on the hospital discharge data for the State of California that's compiled by Office of Statewide Health Planning and Development. So this is California hospital data that is provided to the public and reported nationally.

Senator Monteith: Do you have copies of that for us? . . . to substantiate this?

Wendy Max: Copies of the . . . ?

Senator Monteith: The information you're giving us. As the other party has substantiated their statements, do you have that? Do you have copies of information to substantiate your statements.

Wendy Max: This study has now been completed and the reason that . . .

Senator Monteith: No, that's the point. Do you have copies of it with you that we can see?

Wendy Max: I don't have them with me. The study is under scientific review as in the journal period process at this point.

Senator Monteith: Well I can appreciate your knowledge but we do need information that we can read to substantiate we've asked the other side to do.

Wendy Max: Yes, I can appreciate that too.

In terms of the hospital charges that are paid for with public dollars, and by public dollars I'm including Medical, the county indigent services, Medicare, some other Federal programs, you see that during the first two years that the law was in effect the public costs were reduced by $44 million. And again, this is just the first two years of the helmet law.

And let me add that hospital charges are not the whole picture. We have also looked at other types of care that injured motorcyclists may require such as emergency visits, long term care, attendant care and so forth. This would add easily another third to the costs when compared to just the hospital charges.

Let me just say in conclusion that I believe firmly that rewriting the law to apply only to those only under the age of twenty-one would result in coverage for only a small part of those who are injured now. It would only effect only a small proportion of the costs, and in fact it would make the law much more difficult to enforce due to the difficulty of identifying the age of a motorcyclist at sixty miles an hour.

I urge you to continue this highly successful law as we view it economic terms. Thank you.

Senator Kelley: Thank you very much. Let me remind the opponents that time is clicking on if you look at the clock up there. I admonish you to keep your statements brief as their is a long line of people that would like to come up and say a few words.

Senator Russell: Can I use my time to ask a question? Do you have any comments or information about the spinal injuries that was alleged to be a result of wearing helmets?

Wendy Max: I can't say what the cause of the injuries was. I'm an economist. But we did look at the charges associated with spinal injuries of those who were hospitalized and we found that the charges and the number of people injured fell by about a third from 1991 compared to the first two years of the law.

Senator Kelley: Thank you, next witness.

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