What gun violence costs US healthcare: $1B in initial ER costs, hefty medical bills for patients

It is no news to anyone that the U.S. is number one among high-income countries for firearm deaths. Some are still coming to terms with the fact that firearms are the leading cause of death for U.S. children.

But even if informed Americans know that 17 mass killings have occurred so far this year, they might not know the health costs of gun violence.  

A new study from the Commonwealth Fund compares the U.S. to 13 other high-income countries to reveal that not only does the country have the highest overall rate of firearm deaths, but that rate is also nearly five times higher than the nation with the second-highest rate: France.

“Each year in the U.S., firearm-related injuries lead to roughly 30,000 inpatient hospital stays and 50,000 emergency room visits, generating more than $1 billion in initial medical costs,” the Commonwealth report authors wrote. “In 2020 alone, deaths from these injuries cost $290 million, an average of $6,400 per patient. Medicaid and other public insurance programs absorbed most of these costs.”

The analysis showed that Medicaid pays most of the cost associated with hospital care for firearm injuries. Hospitals in the American South had the largest share of inpatient hospital stays and overall hospital costs for firearm injuries. Black Americans are most likely to be admitted for firearm injuries and incur the most cost related to firearm injuries.

Women were found to be significantly more likely to be killed by firearms in the U.S. than in the other countries analyzed, and the U.S. is the only high-income country where the number of civilian-owned guns exceeds the total number of people, according to the analysis.

In 2019, eight times more Americans died from violence by firearm as compared to the second-highest country in the category, Canada.

Firearm injuries also left victims with substantial medical bills. In the year following a firearm injury, medical spending increases on average $2,495 per person per month. Survivors are more likely to experience mental health conditions and substance use disorders.

The Commonwealth study analyzed data from the Institute for Health Metrics and Evaluation’s Global Burden of Disease database, the Small Arms Survey’s Global Firearms Holdings database and the U.S. Government Accountability Office’s (GOA) Firearm Injuries: Health Care Service Needs and Costs report.

“Survivors often face barriers to receiving needed care, such as being denied care when it is not covered by their insurance,” the GOA report said. “While not receiving needed services may minimize costs initially, the consequences of unmet health needs for firearm injury survivors may ultimately result in greater costs.”

The GOA report was part of a concerted effort by 18 hospitals and health system executives which urged Congressional leaders to fund hospital-based gun violence intervention programs in July 2021. The group used the example of a Baltimore program that brought reinjury rates down as far as 5%.

This year the country is setting a record pace for mass gun violence deaths. As of April 21, 88 people have died in 17 mass shootings, categorized by involving four or more fatalities.

Guns surpassed car accidents as the leading cause of death for children in America in 2020. In 2021, firearms were the cause of 19% of childhood deaths. In that year alone 3,600 children died at the hands of guns, roughly five children killed for every 100,000.

“Nobody should be shocked,” Fred Guttenberg, whose 14-year-old daughter Jaime was one of 17 people killed at a Parkland, Florida high school in 2018, told PBS News Hour. “I visit my daughter in a cemetery. Outrage doesn’t begin to describe how I feel.”