Boston, Massachusetts, USA: Although a 45-year-old Massachusetts woman had a cut on her leg that went down to the bone she refused an ambulance at first because of the costs. She was doing what thousands of Bostonians do every day. She was stepping off of the train, when somehow her leg got caught in the gap between an Orange Line train and the platform on Friday.
Beyond her pain, she had another fear. Shaking and crying, she begged people not to call an ambulance. “Do you know how much an ambulance costs?” she wept.
Her fellow passengers rushed to her aid. One man stood behind her so she could lean on him. Another passenger placed a cold bottle of water to her leg. And at least 10 people pushed on the car together, moving it just enough for the woman to pull free, according to a video of the accident the Massachusetts Bay Transportation Authority Police (MBTA) Police Department released on Monday.
Marleny Polanco said she was at Mass. Ave. Station at the peak of rush hour when she heard the woman scream. Immediately, a group of men were there to help push the train away from the platform, Polanco said. “It all just happened so fast,” Polanco said. “I think within a minute or so, she was able to pull her leg out.”
A few people helped wrap her leg in a compress, Polanco said. Despite her injuries, the woman did not want anyone to call an ambulance, saying it would cost her thousands of dollars.
Polanco, who lives in Lawrence, said she didn’t think the accident was the woman’s fault, saying the gap between the platform and the train cart was too wide.
The gap was 5 inches, MBTA officials said.
The woman’s painful calculation that she could not afford an ambulance has drawn wide attention after a Globe reporter who witnessed the aftermath of the platform accident posted about it on Twitter.
“Awful scene on the orange line. A woman’s leg got stuck in the gap between the train and the platform. It was twisted and bloody. Skin came off. She’s in agony and weeping. Just as upsetting she begged no one call an ambulance. “It’s $3000,” she wailed. “I can’t afford that.”— Maria Cramer wrote.
“Luckily, she apparently suffered no broken bones but the EMTs who responded said she would need surgery. When I saw her sitting on the platform, she was shaking, crying, in terrible pain and very scared about what this injury would do to her financially.
The video shows at least ten passengers pushing on the car to get her out. To see so many people rush to help a person they didn’t know was incredibly moving. Afterwards, one woman who helped the injured woman wiped her hands with a napkin. She had woman’s blood on her.” — Maria Cramer added.
On Twitter, people registered their outrage that the cost of medical treatment could prevent someone from seeking urgent care.
According to a police report, the woman suffered no broken bones but her left thigh suffered a “serious laceration, exposing the bone” and would need surgery. She was taken to Boston Medical Center.
The accident happened at 5:30 p.m. Emergency medical officials arrived within minutes, according to the police report.
Jim Hooley, chief of Boston EMS, said an ambulance transporting people within the city would cost between $1,200 to $1,900 at most for patients with the most pressing needs, like resuscitation.
“We just worry about taking care of people,” Hooley said. “We don’t want to cause them more stress. We just want to reassure them that nothing bad is going to happen to them because of their inability to pay.”
In the face of a grave injury, a series of calculations follow: The clear and urgent need for medical attention is weighed against the uncertain and potentially monumental expense of even basic services, like a bandage or a ride to the hospital, and that cost, in turn, weighed against all the known expenses of living that run through any given head on any given day.
This discord, between agony and arithmetic, has become America’s story, too.
The United States spends vastly more on health care than other industrialized countries, nearly 17 percent of the nation’s gross domestic product in 2014, according to a report by the Commonwealth Fund, compared with just 10 percent of G.D.P. in Canada and Britain. But that disparity is not because Americans use more medical services — it’s because health care is far more expensive here than in other countries. One 2010 study by the Organization for Economic Cooperation and Development found that hospital costs were 60 percent higher in the United States than in 12 other nations.
And that cost is often passed on to patients, either in the form of deductibles and other out-of-pocket expenses or through ever-soaring insurance premiums.
Health care is a complicated problem in U.S.A., one exacerbated by the gridlock in Washington. But the trade-offs that everyday people are being asked to make, the calculations they are being forced to undertake in the scariest of situations, suggest that far too many of America’s politicians have placed too little value on the well-being of its citizens.