The University of Texas Medical Branch in Galveston was not a profitable institution, even before it was destabilized by Hurricane Ike. The hospital consistently accrued $40 million in losses, mostly by accepting patients with inadequate insurance coverage. (Roughly sixty percent of UTMB’s patients are uninsured or on Medicaid, which pays for only a portion of the bill.) The daunting financial realities of UTMB have lead many to question whether or not the UTMB trauma center should be reopened at all.

In September of 2008, Hurricane Ike left Galveston’s communities in shambles. UTMB’s infrastructural foundation was also swept away. The first floor of the building was lost, including the blood bank, sterol supply, and in-patient pharmacy where they mixed chemotherapeutic and intravenous solutions. Accelerators used for cancer treatment were underwater, the food service had been swallowed, and the electrical operations for one hundred and sixty elevators were shot.

“With the infrastructure down, you can’t feed [our patients], can’t get blood or intravenous fluids to them, and admissions would say, you can’t even get a bill for them,” said Ben G. Raimer, Senior Vice President of Health Policy and Legislative Affairs, who sounded surprisingly optimistic. “We’re eating out of a tent on the top of a parking garage. Most hospitals can’t boast that. But we haven’t stopped, and won’t.”

The hospital currently houses an average of two hundred and thirty one patients, and since last September, they have delivered roughly two thousand six hundred babies, resumed solid organ transplants, and have reopened a limited intensive care unit.

Without the necessities once available in the trauma center, all critical patients have gone to hospitals in Houston, taking their financial burdens with them. Memorial Hermann and Ben Taub General Hospital have been swamped with patients, especially those who can’t pay for the care they need. This fact may put those hospitals on diversionary status, which impacts law enforcement and emergency services.

If UTMB’s trauma center really is slated to reopen, the hospital will have a few questions to answer. What funds will be used for the restoration, and how will the institution proceed with indigent care?

Raimer believes that the state will help UTMB offset the cost of uninsured patients rather than dispense with the hospital’s history of indigent care, but continuing that tradition will require some steep financial support. “Most hospitals have a pot of money…pouring them together,” he said. If the profits from insured patients is less than the amount owed by unsponsored patients, the hospital will continue to lose money “unless the legislature steps up to the plate and says, ‘We’ll cover [the loss].’ And for us, that’s close to $200 million a year. That’s a lot of money.”

After Ike, Galveston supports a population of 45,000, and upwards to 150,000 in the summer due to the second-home market. Texans come from all over the state to be seen at UTMB because they are known for their accepting services. The trauma center is also in a good position to tend to offshore emergencies from the oil platforms.