Motor vehicle injuries are a major public health problem. They are a primary cause of: 1) death and injury in the United States; and 2) result in a substantial loss of productive life. These injuries and fatalities have serious social and economic consequences for the injured individual, their families, and society. This report focuses on the portion of health care expense borne by the public and the tax revenue implications of these injuries and fatalities.

The relationship between motor vehicle injuries and fatalities, health care costs, and income taxes was analyzed for four situations: 1) 1990 baseline; 2) achievement of modest goals for safety improvements; 3) population growth with constant injury and fatality rates; and 4) the effect of higher injury and fatality rates. Total health care costs, publicly funded health care costs, lost income tax revenue, and increased public assistance were estimated at the [U.S.] federal level, and at the state and local level.

Study of these relationships indicate that: 1) the lifetime economic cost of motor vehicle injuries, fatalities, and property damage that occurred in 1990 is $137.5 billion. American taxpayers will pay $11.4 billion of that total to cover publicly funded health care ($3.7 billion), reduced income tax revenue ($6.1 billion), and increased public assistance expenses ($1.6 billion); 2) the lifetime economic cost of alcohol-related, motor vehicle injuries, fatalities, and property damage that occurred in 1990 was $46.1 billion. Of this, the American taxpayer will pay $1.4 billion to cover publicly funded health care and $3.8 billion to cover reduced income tax revenue and increased public assistance; 3) reducing the percentage of the alcohol-related portion of these fatalities from 45% to 43% (1,200 lives saved), and alcohol-related injuries by a proportionate amount, would save American taxpayers $73 million in publicly funded health care and $208 million in income taxes and public assistance; 4) by increasing observed safety-belt usage in passenger cars from 62% to 75%, (1,700 lives saved plus a proportionate reduction in injuries), publicly funded health care costs would be reduced by $180 million, and $328 million would be saved in the combination of increased income tax revenues and reduced public assistance; 5) Further reductions in publicly funded health care, increases in income tax revenues, and reductions in public assistance are possible as a result of reasonable gains in other areas, such as increased safety-belt usage in light trucks, increased usage of motorcycle helmets, increased correct usage of child safety seats, and reducing the number of speeding drivers; 6) if injury and fatality rates remain at the 1992 level, population increases alone would result in 3,300 more fatalities in the year 2000. Economic costs from these fatalities and a proportionate increase in injuries would increase by an estimated $7.4 billion, including a $277 million increase in publicly funded health care costs, and $573 million in reduced income tax revenue and increased public assistance; and 7) if injury and fatality rates increase from the 1992 level, injuries, fatalities, and costs will increase. In one scenario, with 5,800 more fatalities than the population growth scenario, economic costs would increase by $13 billion, including a $350 million increase in publicly funded health care, and an additional $1 billion in taxes to cover lost income tax revenue and increased public assistance.

It is obvious that inaction is a costly alternative and that anticipated population gains will require further reductions in injury and fatality rates just to maintain current injury and fatality rates. Fortunately, countermeasures are to be available that can accomplish this. Lack of vigilance that would result in deterioration of safety levels would be even more costly.