Mounting morbidity and mortality from trauma should be viewed as a societal problem. Preventable trauma deaths can be reduced to less than 10% with a regionalized trauma system. Trauma systems, however, incorporating categorization, regionalization, registry data, and prevention efforts, are difficult to design and maintain. As of 1988, only two states had full coverage of all components deemed essential to such a system. Burdens such as uncompensated care, increased malpractice liability, and the need for uniform standards must be overcome to insure survival of trauma systems.