As a fiscal conservative, I dislike taxes and debt; I abhor wasteful spending. In the voting booth, I generally vote against raising taxes and adding fees. As a rule I don't trust the legislature to spend our money wisely.

On Nov. 2, an amendment is on the ballot asking Georgians to approve a $10 fee be added to each annual car registration fee for the purpose of funding trauma care in our state. I can understand the skepticism that I am hearing voiced about this amendment and the inclination you may have to vote against it.

However, this week I drove to Augusta. Interstate 20 is a lonely stretch of highway; towns are not nearby. Every time I get on this road, I pray for extra protection.

As a trauma surgeon, I know that accidents can happen in the blink of an eye. It doesn't matter if I am a safe driver if the person speeding by me is not or is intoxicated.

I also know that with major injuries, immediate care is critical, and on I-20 there is no major trauma center between Atlanta and Augusta. Getting to one is going to take more than an hour.

Trauma is the No. 1 killer of Americans under the age of 45, and the third most common cause of death in all age groups. We are all at risk, and not just from car accidents.

A child may fall from a high-flying swing or out of a tree; a hunter may drop his gun in the woods and shoot himself; a lawn mower may tip over on a hill and crush its rider; a parent may not see her child behind the car and run over him; a water skier may fall and be injured by the boat's propellers. All of these examples belong to "trauma;" they are unexpected and sudden and can result in serious injury.

Trauma research has established that there is a "golden hour." Persons with life-threatening injuries need to receive specialized care within a 60-minute window to maximize their chances of survival. For children, who have a much smaller blood volume, that window is 30 minutes. This means the trauma centers able to provide that specialized care need to be distributed across the state to give each of us access.

Georgia, with its size and population, should have 25 to 30 designated trauma centers. It only has 16, and eight of those are in the greater Atlanta area. The rest are widely separated; south of Augusta there are only four, (that's right, only four), such hospitals. Think about that next time you drive to Destin or Disney!

Television may depict emergency rooms as able to handle anything that comes through their doors; the reality is much different. Hospitals need to have the right equipment and medical personnel trained in trauma care. Many do not.

In 2007, the Georgia legislature created the Georgia Trauma Care Network Commission to study the situation, recommend improvements and then to implement the measures necessary to establish a statewide trauma system in Georgia.

In 2008, a one-time $59 million appropriation was approved that was distributed to providers of hospital care, but no long-term plan has made it through the legislature.

There needs to be an ongoing source of revenue to pay for all that is needed to bring Georgia's trauma care up to an adequate standard. This is what the proposed car tag, which would raise $80 million a year, is for.

This money will go directly to upgrading more emergency rooms and hospitals to become trauma centers. It will provide counties with adequate ambulances and emergency medical personnel. It will equip existing and new trauma centers with the best equipment and technology to help them save lives.

It will provide training for physicians and nurses, EMTs and 911 operators in the most up-to-date management and treatment of traumatically injured patients. It will assist smaller hospitals stabilize patients before transfer to trauma centers.

It will pay for development of a statewide trauma program with an integrated referral program and consistent care protocols. It will help fund trauma care for uninsured or underinsured patients. Trauma care is expensive and hospitals cannot continue to provide it without being reimbursed.

Georgia has a significantly higher death rate from trauma than the national average. We need a better trauma system. If we improve only to average, 700 lives a year will be saved. Is that worth $10 to you?

This car tag fee is coming to us as a constitutional amendment because if we, the people of Georgia, designate it for trauma care, the legislature cannot reallocate it for any other purpose. This is something we need, and this amendment should be an easy one to support.

Priscilla R. Strom is a surgeon with the Department of Surgery at The Longstreet Clinic, P.C. She also serves as trauma medical director at Northeast Georgia Medical Center in Gainesville.