Boston subway rider victimized by aged train and the high cost of medical services

During last Friday’s afternoon rush hour, a passenger stepping off an MBTA subway train at the Mass. Ave. station on the Orange Line was seriously injured when her leg got stuck between the train and the platform. The MBTA said afterward that the gap she fell into was 5 inches wide. She was rescued after at least 10 passengers pushed on the train and moved it enough to free her. Nonetheless, her leg was cut to the bone.

Equally disturbing is the fact that she begged her rescuers not to call an ambulance because she was afraid she wouldn’t be able to afford the cost. According to the Boston Globe, the cost of an ambulance ride in the city including emergency care is at least $1,200.

Boston is renowned for having some of the world’s best hospitals, including Massachusetts General Hospital, Brigham and Women’s, and the Boston Children’s Hospital. Boston Medical Center, which was formed through a merger of Boston City Hospital and Boston University Medical Center in 1996, is just blocks from where the accident took place.

No information has been released about the victim. However, in the South End neighborhood surrounding the station, the percentage of people living under the federal poverty line was at least 14 percent in 2010, according to the Ungentry web site, and in some areas approached 50 percent. While a Brookings Institution report at the beginning of the year found that Boston’s income inequality had decreased slightly—in 2014 the city had the highest income inequality of any major American city—Boston is still a place where multimillion-dollar condos tower over the homes of people making less than $20,000 per year.

The Brookings Institution found that in 2016 the income ratio between those in the 95th percentile and those at the 20th percentile was nearly 15. The income of those in the 20th percentile was only $17,734 per year.

While Massachusetts state law still has provisions for a Health Safety Net Trust Fund, into which hospitals are required to pay so that treatment can be provided to the uninsured, the use of this fund was deliberately made more difficult in 2006 by a law that presaged the federal Affordable Care Act. The 2006 law instituted an individual mandate with tax penalties for people who did not purchase health insurance deemed acceptable to the state.

Many of the plans sold through the Massachusetts Health Connector now have annual deductibles of $2,500 or more. Under such a plan, a commuter injured while stepping off the subway would have good reason to fear having to pay out of pocket.

The Massachusetts law was nicknamed Romneycare because Republican Mitt Romney was governor at the time. However, both of the legislative bodies that passed it were controlled by the Democrats. Liberal advocacy groups such as Health Care for All also championed the legislation.

There has been no indication, either in the news or the video released by the MBTA, that the subway car malfunctioned, but all 120 cars on the Orange Line are nearly 40 years old. A factory has been established in Massachusetts to build a new fleet, but the deployment will not be complete until at least 2021. Decades of inadequate funding and deferred maintenance have made the system dangerous for riders and MBTA workers. In February, for example, a Red Line train derailed on a routine trip through a tunnel.

The video of last Friday’s accident went viral in part because of the heroic efforts of the passengers who moved the train. The MBTA, despite the millions of riders who take it every day, has no emergency medical staff. Instead of funding this vital social need, the government instead funds a Transit Police force with more than 250 staff. In 2017, five of the sergeants and two lieutenants each made more than $200,000.

Clearly worried about the effect of such incidents on the growth of popular anger, the New York Times editorialized on Monday about the latest MBTA accident, calling it something “you might expect to see in an impoverished country.”

After wringing its hands about the increasing cost of health care in the US, the Times concluded disingenuously that “health care is a complicated problem, one exacerbated by the gridlock in Washington.” Its solution to the problem, for the hundredth time, is to accelerate the campaign to channel social discontent into votes for the Democrats in the November elections.