Letter To Michigan Representatives

This letter was sent to members of the State House of Representatives, from Karla Klas, BSN, RN, CCRP –  Injury Prevention Education Specialist University of Michigan, Trauma Burn Center.

September 5, 2011

Dear Representative,

As a safety and traumatic injury expert at the University of Michigan Trauma Burn Center, I respectfully submit the following research data to assist you in making an accurate, informed decision regarding Senate Bill 291. This bill proposes to modify Michigan’s 42-year-old mandatory universal (i.e. all-rider) motorcycle helmet law.

In this era of health care crisis and reform, laws that save health care dollars and resources are crucial. Weakening the current helmet law would directly conflict with our state’s declared priorities of economic stabilization and the health and well-being of Michigan citizens.

§ Extensive rigorous scientific research has been done worldwide that very clearly and repeatedly demonstrates both the protective safety and economic benefits of motorcycle helmets. These facts are proven by over 150 independent and expert-critiqued research studies.1-11

Data are so overwhelmingly conclusive, that we have an ethical obligation to protect and ensure the safety of our citizens by keeping the current universal helmet law in place.

Michigan citizens want a universal helmet law. Independent surveys by Marketing Research Group and AAA Michigan reveal that an overwhelming 81 – 90% majority of Michigan residents support maintaining the current helmet law.12

Helmets are effective! Recent robust statistical analyses confirm the findings of multiple high-quality studies showing motorcycle helmets reduce head injuries by 69% and deaths by 42%.1-7

Partial helmet laws are not enforceable. When universal laws are modified, helmet use drops dramatically to < 50% among all riders regardless of restrictions included in the law on age, safety training, or insurance coverage due to the inability to monitor compliance by sight.6,7,10,13

Unhelmeted riders are 3 – 4 times more likely to suffer traumatic brain injury (TBI) in a crash.5,7,10 TBI requires extensive, expensive medical treatment and often results in lifelong disability.3,5,6,9,11,13

Brain injuries are expensive! When universal helmet laws were repealed in other states, hospital admissions for TBI rose by 42 – 80% and acute treatment costs more than doubled due to increased injury severity.6,7,10 Senate Bill 291’s proposed $100,000 medical insurance coverage will not sufficiently cover the total initial and long-term costs associated with a serious TBI.

What is the cost of “personal freedom”? Numerous studies demonstrate nearly 50% of injured, unhelmeted motorcyclists either have governmentally funded medical coverage or do not carry insurance despite mandatory insurance provisions in the law.1,3,9 Medical costs should concern policymakers because the price for personal freedom is not isolated to the individual motorcyclist, but is borne by the entire community.8,9 How can Michigan’s budget and its citizens absorb the huge financial burden of healthcare for unhelmeted riders, including visiting out-of-state riders?

“The single most effective way for states to save lives and save money is a universal helmet law.”14 Data regarding helmet benefits are so indisputable, that numerous premier organizations echo this statement: World Health Organization, Centers for Disease Control and Prevention (CDC), American College of Surgeons, Insurance Institute for Highway Safety, Michigan

Department of Community Health, Eastern Association for the Surgery of Trauma, National Highway Traffic Safety Administration (NHTSA), American College of Emergency Physicians, etc.

Unhelmeted motorcyclists are proven to increase financial burden specifically in Michigan. A University of Michigan study revealed unhelmeted riders had 20% higher initial hospitalization costs and nearly 2x initial rehabilitation costs compared to helmeted riders.8 As alarming as these figures are, they do not include other intrinsic state economic drains that a TBI patient requires: emergency services, long-term rehabilitation and/or nursing home care, assistive medical equipment, long-term disability, reduced productivity, caregiver assistance, lost work, etc.

The CDC estimates that the state of Michigan has saved $43 million per 100,000 registered motorcyclists by maintaining a universal all-rider helmet law.14

Michigan’s universal helmet law is a priority economic and public health issue that must be independently considered. Burying revisions under the umbrella of a broader auto insurance reform plan is a disservice. It sacrifices public safety and places undue financial burden on citizens.

Senate Bill 291 will not protect young riders. Partial helmet laws enacted to “protect” young riders are proven disastrous: despite presence of mandatory helmet laws only 40 – 50% of minors were wearing helmets at the time of injury, TBI severity increased, and death rates tripled.5,7,10,11,13 In Florida, enactment of a partial law caused deaths of “protected” riders <21 years old to increase by 188%.7,10 A universal helmet law is the only effective method shown to protect young riders.

Helmet laws weakened in other states caused dramatic rises in death. Motorcyclist fatalities following repeals of helmet laws increased by: 100% in Louisiana, 81% in Florida, 52% in Texas, and 50% in Kentucky. The increases exceeded the number of new motorcycles registered.7,10,13

Why would Michigan eliminate a proven fundamental safety device? We do not question the necessity of other laws mandating basic safety equipment, such as air bags, child safety/booster seats, seatbelts, or life preservers on personal watercrafts. Helmets are a motorcyclist’s equivalent.

Commonly stated anti-helmet myth debunked: Scientific studies of the largest national trauma database prove that motorcycle helmets reduce the risk of cervical spine/neck injuries by 22%.1,2,13

As an avid motorcyclist I personally understand the viewpoints of the small, but very verbose, group of anti-helmet constituents in your jurisdiction. However, my professional expertise recognizes those desires for “freedom” place an enormous financial and emotional strain on others that cannot be justified. Legislators should not be influenced to overlook incontestable scientific evidence regarding maintaining Michigan’s universal helmet law.

Helmets are indisputably proven to save costs and lives, as well as reduce resource utilization and injuries. The proposed Senate Bill 291 is not based on scientific evidence. There currently are no methodologically sound research data to refute the findings highlighted above. Please do not hesitate to contact me if you have questions, or need assistance in obtaining referenced publications.


Karla S. Klas, BSN, RN, CCRP Injury Prevention Education Specialist University of Michigan, Trauma Burn Center


According to the U.S. Supreme Court ruling on Simon v. Governor of the Commonwealth of Massachusetts: “From the moment of the injury, society picks the person [motorcyclist] up off the highway; delivers him to a municipal hospital and municipal doctors; provides him with unemployment compensation if, after recovery, he cannot replace his lost job, and, if the injury causes permanent disability, may assume the responsibility for his and his family’s continued subsistence. We do not understand a state of mind that permits plaintiff to think that only he himself is concerned.”

An abbreviated research study reference list follows (a complete list is available upon request):

1. Croce MA, Zarzaur BL, Magnotti LJ, Fabian TC. Impact of motorcycle helmets and state laws on society’s burden: a national study. Ann Surg 2009;250(3):390-4.

2. Crompton JG, Bone C, Oyetunji T, Pollack KM, Bolorunduro O, Villegas C, Stevens K, Cornwell EE 3rd, Efron DT, Haut ER, Haider AH. Motorcycle helmets associated with lower risk of cervical spine injury: debunking the myth. J Am Coll Surg 2011;212(3):295-300.

3. Hundley JC, Kilgo PD, Miller PR, Chang MC, Hensberry RA, Meredith JW, Hoth JJ. Non-helmeted motorcyclists: a burden to society? A study using the National Trauma Data Bank. J Trauma 2004;57(5):944-9.

4. Liu BC, Ivers R, Norton R, Boufous S, Blows S, Lo SK. Helmets for preventing injury in motorcycle riders. Cochrane Database Syst Rev 2008;(1):CD004333.

5. MacLeod JB, Digiacomo JC, Tinkoff G. An evidence-based review helmet efficacy to reduce head injury and mortality in motorcycle crashes: EAST practice management guidelines. J Trauma 2010;69(5):1101-11.

6. Mertz KJ, Weiss HB. Changes in motorcycle-related head injury deaths, hospitalizations, and hospital charges following repeal of Pennsylvania’s mandatory motorcycle helmet law. Am J Public Health 2008;98(8):1464-7.

7. National Highway Traffic Safety Administration. Motorcycle helmet use laws, DOT HS-810-887W. Washington, D.C.: U.S. Department of Transportation, 2008.

8. Brandt MM, Ahrns KS, Corpron CA, Franklin GA, Wahl WL. Hospital cost is reduced by motorcycle helmet use. J Trauma 2002;53:469-71.

9. Lawrence BA, Max W, Miller TR. Costs of injuries resulting from motorcycle crashes: a literature review, DOT HS 809 242. Washington, D.C.: National Highway Traffic Safety Administration, 2002.

10. Ulmer RG, Shabanova Northrup V. Evaluation of the repeal of the all-rider motorcycle helmet law in Florida, DOT HS-809-849. Washington, D.C.: U.S. Department of Transportation, 2005.

11. Weiss H, Agimi Y, Steiner C. Youth motorcycle-related brain injury by state helmet law type: United States, 2005-2007. Pediatrics 2010;26(6):1149-55.

12. American Automotive Association (AAA) of Michigan.

13. Insurance Institute for Highway Safety. Motorcycle helmet use laws, 2011.

14. Centers for Disease Control and Prevention. http://www.cdc.gov/Motorvehiclesafety/pdf/mc_state/michigan-a.pdf

Our SMARTER partners

The following is posted to the website of the Skilled Motorcyclist Association–Responsible, Trained and Educated Riders, Inc. We have reproduced it verbatim here. The seven key messages below are excellent talking points.

Act Now to Help Save Michigan’s Helmet Law

The Brain Injury Association of Michigan (BIAMI) recently issued an “ePolicy Update” regarding the pending bills HB 4008, SB 291, and most recently HB 4608 that if passed would repeal Michigan’s mandatory all-rider helmet law. In order to combat what BIAMI described as “the consistent efforts of the small, yet boisterous group of motorcycle riders known as ABATE,” who assert that “their freedom to die with the wind in their hair is more important than your wishes, your pocketbook or your vote,” we support and applaud BIAMI’s spearheading a social-media campaign to confront this issue “head-on” and encourage active participation so that the contrary voice of responsible motorcyclists will be heard. Starting today and continuing for the next two weeks or for so long as the bills remain pending, log onto the following blog posts and facebook links to voice your collective opinions; engage in respectful dialogue; and share your personal views and experiences regarding the physical, emotional, and financial hardships that can affect persons with brain injuries and their families…experiences that will be shared by more Michigan citizens as a direct result of the increased injuries and fatalities that will surely arise as a result of the selfish choice of some motorcycle riders to ride without a helmet:

Michigan GOP
Michigan Capitol Confidential
Michigan Senate Democrats
Michigan House Democrats
Michigan House Republicans
Michigan Senate Republicans

Here are seven key messages and statistics BIAMI has identified that you can reference to help substantiate your position with FACTS not FEELINGS:

  • Michigan Medicaid is already paying nearly $20 million annually (NOT including auto crashes or the more than half of all Medicaid recipients who are in managed care plans) for the care of survivors of a brain injury.
  • Amidst soaring gas and food prices and an unstable state economy, Michigan taxpayers cannot absorb the increased public cost of care that will result from the repeal of the Motorcycle Helmet Law. Two University of Michigan studies (Trends in Motorcycle Crashes in Michigan: 1997–2002 and 2002–2005, University of Michigan, Transportation Research Institute) confirm that wearing a helmet saves lives and prevents devastating and debilitating head injuries.
  • Michael L. Prince, Director of the Michigan Office of Highway Safety Planning, stated in a June 2008 press release that “Based on analysis conducted by our office, if Michigan’s mandatory motorcycle helmet law was to be repealed, the state should expect to see an annual increase of at least 30 fatalities, 127 incapacitating injuries and $129 million in economic costs.”
  •  A study by the National Highway Transportation Safety Administration (NHTSA) found that within 30 months of Florida’s 2000 Helmet Law repeal, head-injury hospitalizations skyrocketed 80 percent and total cost for acute care of head injuries doubled to $44 million, not including the cost of long-term rehabilitation or the economic impact of lost wages for survivors of a serious head injury and their families.
  • ABATE of Michigan, the organization that actively lobbies to repeal or weaken Michigan’s universal helmet law, claims to represent all Michigan motorcyclists, when in fact they are a minority biker group of approximately 4,000 members. According to the Michigan Department of State, as of February 1, 2009, there were 533,005 motorcycle-license-endorsed Michigan residents. As of November 8, 2008, Michigan had 257,269 registered motorcycles; therefore, ABATE represents significantly less than 1 percent of Michigan’s license-endorsed motorcyclists. It is likely that anti-helmet advocates in every state represent a very small percent of the licensed riders in that state.
  • ABATE seems to consider the use of helmets by motorcyclists as a freedom-of-choice issue based on the American ideals of Truth and Liberty. The Constitution and the first ten amendments do not give individuals the “right to do as they please” to the detriment of other citizens. The state has a positive role in ensuring that all citizens have equal protection and justice under the law and equal opportunities to exercise the privileges of citizenship. Just as the rights of citizenship are balanced by responsibilities, such as voting and paying taxes, so too are its privileges. To enjoy the privilege of driving a car or riding a motorcycle, one must comply with certain requirements, among them being the nonintrusive requisite to buckle up or wear a helmet.
  • The “freedom” to ride with the wind in your hair isn’t free when Michigan’s taxpayers are expected to pay for the selfish choice of motorcyclists who simply do not want to wear a helmet.

For even more detailed research findings and concurring opinions that support the wisdom of wearing a helmet when riding a motorcycle, go to the Resources & Links and the News & Legislation pages of this Web site or access these BIAMI links: Motorcycle Helmet Repeal Brief, CDC Fact Sheet – Motorcycle Safety for Michigan, and/or NHTSA Traffic Safety Facts – 2009.

The Michigan Legislature, within two short weeks, is expected to repeal Michigan’s mandatory helmet law, and it is also expected that Governor Snyder will sign a repeal bill into law—this, despite numerous polling over the past five years, and as recent as March 2011, showing that over 80% of Michigan’s residents do not want Michigan’s current helmet law repealed; despite statistics from Florida, Texas, Louisiana, Pennsylvania, and other states that reveal the disastrous and deadly results of their so-called successful motorcycle helmet law repeal efforts; and despite the added financial burden to be placed on the already overburdened shoulders of the Michigan Medicaid system and Michigan taxpayers. 

Your opinion matters! Log on now. Collectively, we can make a difference. We MUST make a difference, or Michigan will follow the same tragic path as Florida, Texas, Louisiana, and Pennsylvania. And that’s something we cannot afford to do … literally.

General Session – September 20! The Impact on Healthcare of the Aging Population.

This is a reminder that our next General Session is scheduled for Tuesday, September 20, 2011.  The program is being held at the Ann Arbor City Club, 1830 Washtenaw Avenue, Ann Arbor.  The Social hour will begin at 6:00 p.m., Dinner at 6:45 p.m., and the program at 7:30 p.m.

The evening’s program is the “The Impact on Healthcare of the Aging Population.” Alan N. Dengiz, MD, Medical Director of Geriatric Medicine, Saint Joseph Mercy Health System and Gary J. Petroni, Director of Center for Population Health/Southeast Michigan Health Association, are the featured speakers.

The Michigan State Medical Society (MSMS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.  The MSMS designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)™.  Physicians should only claim credit commensurate with the extent of their participation in the activity.

Nurses: The ACCME is approved by the Board of Nursing as an acceptable provider of continuing education for license renewal or relicensure.

The following are the educational objectives of the program:

  • Physicians will be able to describe the changing local and regional population demographics as it pertains to healthcare.
  • Physicians will be able to outline the common multiple interacting medical conditions, psychosocial problems, and functional impairments of the aging population.
  • Physicians will be able to identify the needs and impacts on their practice and the healthcare system as a whole due to the growing aging population.

The general session is supported by the Washtenaw County Medical Society and the MSMS Physicians Insurance Agency.

Please make your reservations with the Society Office at (734)668-6241 or email your response to wcms@msms.org.


Posted in Events, Upcoming. Tags: , , , , , , , . Comments Off on General Session – September 20! The Impact on Healthcare of the Aging Population.

Follow up letter to Governor Snyder – We can’t afford helmet law repeal!

Dear Governor Snyder:

If a proposed bill to radically weaken Michigan’s universal motorcycle helmet law reaches your desk, a Coalition of County Medical Societies led by the Washtenaw County Medical Society, with the support of hospitals, physicians, and medical groups from across Michigan, urge you to veto it.

The proposed changes to Michigan’s 42-year-old law fly in the face of medical research showing helmets save lives and prevent serious injuries; it would result in higher financial burdens on taxpayers and motorists; and can’t be effectively enforced.

The federal Centers for Disease Control and Prevention, the nation’s preeminent medical authority, has concluded, “The single most effective way for states to save lives and save money is a universal helmet law.”

Helmet use reduces the risk of death by 37 percent and the risk of head injury by 69 percent, according to the CDC.

Other states that have eliminated mandatory helmet laws have seen a sharp decline in use. When Florida repealed its law in 2000, use fell from 99 percent to 53 percent, the CDC notes.

You have previously said that you would support changes to Michigan’s mandatory helmet law “only if other motorists don’t pay more as a result.” But research indicates taxpayers and motorists would pay more.

The National Highway Traffic Safety Administration (NHTSA) cites research that found only slightly more than half of motorcycle crash victims have private insurance. For patients without private insurance, medical costs are borne by the government, and thus ultimately by the taxpayers.

Moreover, helmet laws have been shown to save money. After California’s universal helmet law went into effect in 1992, hospital costs for motorcycle-related head injuries fell by more than half, from $36.6 million the previous year to $15.9 million, according to the NHTSA.

In Michigan, about 50 lives are saved each year, along with $86 million, under our current helmet law, according to the CDC. This makes Michigan a leader among neighboring states with partial or no helmet laws. Why would we want to take a step backwards?

Based on conversations with members of the insurance industry, we are also concerned that changes to the law would drive up insurance costs for all motorists. How can you guarantee that rates will not rise to cover increased injury payouts?

Lastly, the proposed law would be completely unenforceable.

Right now, it’s easy for a police officer to tell if someone is in violation, either they’re wearing a helmet or they’re not.

But the proposed law would exempt motorcyclists who are over 21 and who carry additional insurance. This would make it impossible for police to determine whether a rider was in violation without conducting a traffic stop. With roughly 200,000 registered motorcycles in the state, do we really want to allocate limited law enforcement resources to double checking riders’ ages and whether they are carrying the appropriate additional coverage? How would we enforce the coverage requirements on out-of-state motorcyclists?

Again, we urge you to stand up for Michigan taxpayers and motorists and for smart public health policy by keeping Michigan’s mandatory helmet law intact.


Cynthia H. Krueger, MD, Washtenaw County Medical Society (WCMS) President
William J. Meurer, MD, MS, Chair, WCMS Task Force on Helmet Law Legislation

Co-signed by:
Calhoun County Medical Society
Genesee County Medical Society
Ingham County Medical Society
Jackson County Medical Society
Kalamazoo Academy of Medicine
Kent County Medical Society
Macomb County Medical Society
Marquette/Alger County Medical Society
Michigan College of Emergency Medical Physicians
Michigan Health & Hospital Association
Michigan State Medical Society
Muskegon County Medical Society
Oakland County Medical Society
Saginaw County Medical Society
Saint Joseph Mercy Health System
University of Michigan Health System
Wayne County Medical Society of Southeast Michigan

Related articles