Hundreds of motorcyclists are expected to rumble into Lansing on Wednesday to deliver a blunt message: Don't mess with Michigan's helmet law.
“Our perspective is that this is a freedom issue and an individual rights issue,” said Jim Rhoades of ABATE of Michigan, the nonprofit cycling rights group that pushed for the 2012 repeal of Michigan's law requiring motorcyclists to wear a helmet.
As for a return to that mandate, Rhoades said: “We would fight that tooth and nail. We want people to know we're not going anywhere.”
Message apparently heard. Legislators who backed the 2012 repeal are showing no inclination to revisit the issue, even as evidence continues to mount of the human and economic toll of unprotected heads colliding with pavement.
According to Michigan State Police data, 138 persons were killed in 2015 motorcycle crashes – higher than any year dating back to 1985. From 2000 to 2011, an average of just under 112 motorcyclists were killed a year. From 2012 – when the helmet repeal took effect - through 2015, that number averaged nearly 126 persons, a total of 56 additional deaths.
Over that same period, a 2016 hospital study found, of 345 motorcycle crash victims brought to Spectrum Health Butterworth Hospital in Grand Rapids, 10 percent of riders who were not wearing helmets died, compared with 3 percent of riders who wore helmets. Riders not wearing helmets also had more severe head injuries, spent more days in intensive care, and more time on a ventilator, the study found.
The average hospital cost for non-helmeted riders was $27,760 – 32 percent higher than for those wearing helmets.
View from the ER
Dr. Carlos Rodriguez, a trauma surgeon at the hospital and a co-author of the study, happened to be on trauma call the first few days after the helmet repeal took effect. What he witnessed prompted him to take a closer look at hospital and crash scene records for motorcycle accidents.
“We had three or four really bad motorcycle crashes and all of them had not been wearing helmets. It made an impression on me. I thought, 'Wow, this is more than we normally see.'”
“We are into evidence-based medicine,” he said. “That's why I started keeping track of it. Fortunately, as a Level 1 Trauma Center we have data collected for everything that comes in the door.”
Among motorcycle crash patients brought to the hospital, the proportion of riders who had not been wearing a helmet quadrupled, from 7 percent before the law change to 28 percent after.
Riders pronounced dead at the crash scene were also far more likely to have not worn a helmet since the repeal. Before 2012, 14 percent of those who died at the scene were not wearing helmets. After 2012, that number rose to 68 percent.
The study, which compared hospital and deadly crash records from 2011 with those from 2012-2014, also found higher alcohol use among non-helmeted riders.
Separate crash data from the Michigan State Police indicates that about 30 percent of crash victims were not wearing helmets in 2015. But riders without helmets accounted for about 43 percent of the 130 fatalities for which helmet use was determined.
Dr. Todd Vitaz, a Butterworth neurosurgeon, said he has seen the results of enough motorcycle crashes to convince him beyond doubt helmets work.
“I've seen instances where there are two people on a motorcycle and the one that has a helmet is scratched and bruised and the other has severe injuries or dies,” Vitaz said. “As a neurosurgeon, the people we see with head injuries in crashes, the majority of them are not helmeted.”
There is no guarantee of surviving a crash even with a helmet, of course. But Vitaz said a helmet can prevent or reduce potential brain damage by absorbing some of the force to a rider’s head at impact.
“The brain doesn't heal itself. You are born with a certain number of brain cells and you have those cells for the rest of your life.”
Lansing good with law
State Sen. Tom Casperson, R-Escanaba, chairman of the Transportation Committee and a proponent of the current helmet law, declined comment on the wisdom of the helmet repeal. So did fellow committee member, Sen. Ken Horn, R-Frankenmuth. The office of Sen. Phil Pavlov, R-St. Clair, sponsor of the 2012 repeal, did not return a call asking for comment.
In 2014, Casperson told Bridge that a bill introduced that year by state Sen. Rebekah Warren, D-Ann Arbor, to restore mandatory helmet use would not make it out of committee. It never came to a vote.
Warren introduced a similar measure in 2015 that has also gone nowhere.
“He (Casperson) has never really shown any interest in giving it time on his committee,” Warren said.
“It's very disappointing. This is really a public health issue. We are seeing a lot more injuries and deaths for people not wearing helmets.”
Warren said she is getting growing support for restoring the mandatory helmet law from medical groups, including the Michigan College of Emergency Room Physicians and the Washtenaw County Medical Society. But that means little if the bill never gets a public airing.
“I feel with an issue like this, if we could actually have a hearing on what this means in our emergency room, what this means to our loved ones and what it means to all of us as taxpayers, I think you would change some minds.
“But you have to convince the chair (Casperson) if you are going to have that hearing.”
Repeal also brought training
Under the 2012 law, riders 21 and older may ride without a helmet if they pass a safety course or have ridden at least two years. They are required to carry $20,000 in medical insurance. It repealed a helmet requirement in place since 1969.
Democratic Gov. Jennifer Granholm twice vetoed repeal of that law before GOP Gov. Rick Snyder signed it in April 2012, making Michigan the 31st state to let motorcyclists ride without helmets.
Snyder spokesperson Ari Adler said the governor is “always open to listening to ideas if people believe there is something that needs to be addressed. At this time, however, the governor does not have any initiative underway to revisit that law.”
In the meantime, Rhoades of ABATE said he remains unpersuaded the helmet law has made riding more dangerous. He attributed the 2015 death total to a good riding season that brought out more riders than usual.
“The primary thing you have to look at is the weather. If the weather is good over the weekend, more people will be riding. Last year was a great riding season,” he said.
The number of registered motorcycles in Michigan has indeed fluctuated wildly over the years, from just under 150,000 in 2003 to just over 250,000 in 2012. But even allowing for the increase, the 2015 death rate of 5.75 fatalities per 10,000 registered motorcycles was the highest since 2005.
As for the Butterworth Hospital study, Rhoades said he is skeptical.
“I think that's an isolated situation,” he said, adding his view that doctors as a group tend to be leery of motorcycles. “Any report you get from a hospital, those people already have a skewed perspective.”
Closing a loophole
Rhoades also pointed to evidence that unlicensed riders comprise a disproportionate share of riders who crash. It’s a disparity that ABATE said it has been working to combat, by advocating for rider skills training for all new riders.
A 2012 Mlive report found 52 percent of motorcyclists who crashed in the first six months after the helmet law was repealed were not fully licensed, many of whom were apparently exploiting a loophole that allowed motorcyclists to obtain a temporary permit each year without ever passing the skills test needed for endorsement.
That was was roughly consistent with state police data dating back to 2008 on more than 19,000 crashes that found only 54 percent of riders who crashed were endorsed to drive motorcycles.
In 2014, Snyder signed a measure aimed at closing that loophole. It limits riders to two temporary permits over the course of 10 years.
Beyond the Butterworth Hospital study, the Virginia-based Highway Loss Data Institute, an affiliate of the Insurance Institute for Highway Safety, compared medical data involving motorcycle crashes for the two years prior to Michigan’s repeal of the helmet law and the year it took effect. It found a 36 percent increase in the severity of injury claims after repeal and that overall medical payments were 50 percent higher than would have been expected under the mandatory helmet law. Higher medical costs are passed along through higher insurance premiums or hospital charges, which are paid by consumers or absorbed by federal programs like Medicaid.
That echoes national findings.
A 2006 West Virginia study that compared states with mandatory laws with those with little or no helmet regulation found notable differences in fatality and serious brain injury rates. According to the study, 16.5 percent of motorcycle crash victims in states without a universal helmet law had a primary diagnosis of brain injury compared with 11.5 percent in states with mandatory helmet laws. The in-hospital death rate in states with no mandatory helmet law was also higher – 11.3 percent versus 8.8 percent.
Not on Lansing’s agenda
Groups that fought repeal of the helmet law concede there is nothing on the political horizon that would reverse that decision.
“When you look at the politics of this right now, there are many other priorities that are taking the time of the state Legislature,” said Tom Constand of the Brain Injury Association of Michigan, a nonprofit that provides support for those with brain injuries and their families.
Constand said he is hardly surprised by the findings of the Butterworth Hospital study, noting that his group had predicted exactly that kind of result for non-helmeted riders.
In the meantime, Constand said, his group will push for better safety practices among both motorcyclists and automobile drivers as a means of reducing injuries and deaths.
“We have to come together on safety as a whole,” he said.
Heather Drake, manager of government relations for AAA Michigan, said AAA will continue to fight for restoration of the mandatory helmet law, just as it fought against repeal. But she speculated it could be years before it picks up enough support to gain serious consideration.
“I think the legislature is not interested in this right now. We recognize this is a reality,” Drake said.
Drake said AAA Michigan will continue to compile data to make its case – that riding without a helmet is more dangerous, leads to higher medical costs and ultimately costs the public with higher insurance premiums or taxes to support government insurance like Medicare or Medicaid.
“Somebody has to bear those costs,” Drake said. “At the end of the day somebody is picking up the cost. As our costs increase, that has to be reflected in the rates that we charge.”