This is Part 2 of the post on the motorcycle helmet law.

Click Here to read Part 1

So, if there is overwhelming evidence that helmets do save lives, why is there so much controversy about it? Why do only a handful of states have mandatory helmet laws?

Obviously, the law would not have been repealed without strong support from the anti-helmet advocacy groups. There are several arguments that have been presented as a reason for why not to wear a helmet.

Helmets can decrease peripheral vision and hearing. Helmets can exacerbate cervical injuries due to the added weight of the helmet. And the most important one – helmet laws violate individual rights and infringe on personal freedom.

Several studies have shown that helmets do, indeed, decrease peripheral vision by approximately 20%. This reduction, however, is small and was shown to have no impact on motorcycle safety or collision rates.

In terms of the increased rate of cervical spine injury the evidence is somewhat contradictory. Some studies found no increased rate of spine injury. Other studies have shown an increased rate of cervical spine injury, yet there was no difference of the spinal cord injury. As far as I am concerned, cervical spine injury is a fixable problem as long as the brain and the spinal cord are intact.

So, if there are proven benefits of wearing a helmet and no real reasons to not to, why there is still so much disagreement about it? At the end of the day it all comes down to individual rights and personal freedom. If somebody prefers to live on the edge and take the chance of a severe head injury in a motorcycle wreck – why not let them?

And that is where the quandary begins. It is an individual right to not wear a helmet that becomes a burden to society of caring for this individual after the accident. A study conducted by the American College of Surgeons showed that more unhelmeted trauma patients have no medical insurance than trauma patients wearing a helmet (29% vs. 21%).

The same study showed a significantly higher resource utilization use with the unhelmeted trauma patients. And this is just the tip of the iceberg. Most healthcare expenses for the head injured patients occur later during the rehabilitation and placement phases of their recovery. Many patients remain permanently disabled and never return to gainful employment.

If the patient has no insurance, it becomes the taxpayer’s responsibility to provide funding for the long term medical care. Even for insured patients, the tremendous cost of caring for the chronically disabled head injured patient reflects in higher insurance premiums and overall healthcare costs. The individual choice of ignoring personal safety becomes a burden for society.

There is a flip side of this issue, though. If I was a lobbyist for the helmet-free group, I would focus not on the technical reasons for not wearing a helmet but on the social ones. The healthcare expenses for providing care for the head injured patients after motorcycle accidents is a drop in a bucket when compared to more common “lifestyle related” conditions.

You can easily enforce the helmet law, yet you cannot write a ticket for smoking, fast food binging, not exercising or not taking your medications.

Conditions like COPD (chronic obstructive pulmonary disease), congestive heart failure, and heart diseases are the big ticket items on the healthcare spending menu. Those are the things that could bankrupt Medicare. If smoking and abusing one’s body is considered a personal freedom, not wearing a helmet might not be much different…