FROM THE NEW YORK TIMES
For Wounded, Daunting Cost; for Aid Fund, Tough Decisions
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Victims of the Boston Marathon bombings waited to be treated on April 15 at Brigham and Women’s Hospital in Boston. More Photos »
By ABBY GOODNOUGH
Published: April 22, 2013
WASHINGTON — For victims of the Boston Marathon bombings, the terrible physical cost may come with a daunting financial cost as well.
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Many of the wounded could face staggering bills not just for the trauma care they received in the days after the bombings, but for prosthetic limbs, lengthy rehabilitation and the equipment they will need to negotiate daily life with crippling injuries. Even those with health insurance may find that their plan places limits on specific services, like physical therapy or psychological counseling.
Kenneth R. Feinberg, the lawyer who has overseen compensation funds for victims of the Sept. 11 terrorist attacks, the shootings at Virginia Tech and other disasters, arrived in Boston on Monday to start the difficult work of deciding who will be eligible for payouts from a new compensation fund and how much each person wounded in the bombings and family of the dead deserves.
The One Fund Boston, which Mayor Thomas M. Menino of Boston and Gov. Deval Patrick of Massachusetts created a day after the bombings, has already raised more than $10 million for victims and their families. At the same time, friends and relatives have set up dozens of smaller funds for individual victims.
For at least 13 victims who lost limbs, including William White of Bolton, Mass., expenses may also include renovations to their homes that make it easier for them to get around.
“What if his stairs are at the wrong incline, or he needs a ramp, or the cobblestones in his backyard are uneven?” said Benjamin Coutu, a friend of the White family who helped create a donation page on a fund-raising Web site for Mr. White and his wife and son, who were also wounded in the blasts. “People who are insured in these situations think, ‘Wow, I’m O.K., I’m covered.’ It’s not until a month or two later that they realize, ‘I’m covered for the bare bones.’ ”
The overall medical costs are difficult to estimate, especially since it is not yet clear how much rehabilitation or future surgery the victims with the worst injuries will need. But as a basis for comparison, medical costs for shooting victims average about $50,000, said Ted Miller, a senior research scientist at the Pacific Institute for Research and Evaluation who studies the costs of injuries.
For Mr. Feinberg, whom city and state officials asked to administer the One Fund Boston, the first task is to determine how much money is going to be available through it. Most donations typically arrive in the first month after a disaster, he said, adding that the fund-raising window should ideally be brief. “I’m a big believer, in most of these programs, that the fund should be a very small duration,” Mr. Feinberg said in a phone interview. “Because you’ve got to begin to get the money out the door to the people who really need it, and you’ve got to know how much you’re going to distribute.”
The thornier job, though, will be figuring out who qualifies for the funds and how much each victim who survived — as well as the families of the three who died — should receive. More than 170 people were wounded in the blasts, and more than 50 remain in the hospital.
Mr. Feinberg said that he would seek input from victims and their families before deciding on a formula. For victims of the Virginia Tech shooting, he said, compensation amounts were based on how long they were in the hospital. After the movie theater shooting in Aurora, Colo., victims who were paralyzed or suffered traumatic brain injuries received just as much as the families of those who died.
“You can’t pay everyone the same if someone has a broken ankle versus a brain injury,” he said. “There’s got to be some sliding scale.”
After the shootings in Aurora, some of the hospitals who treated victims agreed to limit what they charged and to waive charges entirely. Tim Gens, executive vice president of the Massachusetts Hospital Association, said that the hospitals treating the Boston victims had not yet discussed how to handle billing, but that it would be decided case by case.
For the uninsured, Mr. Gens said, Massachusetts has a charity care fund that covers all or part of their costs, depending on their income. Each hospital also has its own policies for waiving costs in certain situations, he said.
Meanwhile, Mr. Gens said, “For those who have insurance, there really shouldn’t be an issue.” Massachusetts requires most of its residents to have health insurance, although a small number refuse to comply or get waivers. It is not yet clear how many of the wounded were visiting from other states, or how many were uninsured.
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