Boston Marathon attack creates massive health costs

As scores of people injured in the Boston Marathon bombing remain in hospital, efforts are underway to help them cover the cost of medical bills that will likely cost millions of dollars.

U.S. health economics expert says total could easily top $9M

As the makeshift shrines for victims of the Boston Marathon bombing swell on Boylston Street, many are wondering how the injured fans and runners will foot their medical bills. (John Rieti/CBC)

As scores of people injured in the Boston Marathon bombing remain in hospital, efforts are underway to help them cover the cost of medical bills that will likely cost millions of dollars.

The police said Friday night that they had captured Dzhokhar Tsarnaev after a lengthy search in a Boston suburb. He was found in a boat parked on a trailer in a backyard in Watertown, Mass., a suburb of Boston. His brother, who was also a suspect in Monday's bombings, had already been killed in a gunbattle with police.

Since the explosion Monday afternoon, teams of doctors and medical staff have treated more than 170 victims – many of whom were brought to hospital in critical condition – for a horrendous list of wounds, including some that required amputations.

Major surgeries, hospital care and rehabilitation are expensive everywhere. But in the U.S., there’s a heavy burden on the victims to pay.

An ambulance streaks down a Boston Street on Thursday. It's unclear how much paramedics spent during the massive effort of treating bombing victims and racing them to hospital. (John Rieti/CBC)

How much money was spent treating bombing patients?

"One reported suggested a number like $9 million … I think that’s reasonable," Dr. Ted Miller, a senior research scientist at the Pacific Institute for Research and Evaluation, told CBC News. "There will be other costs because that doesn’t include any of the mental health care."

Miller has become well-known in the U.S. media after he used a complex system to harmonize large national datasets of health-care costs to determine the true cost of expensive gun crimes, such as the Arizona shooting of former U.S. congresswoman Gabrielle Giffords.

Because the injuries suffered in Boston are so varied and the patients’ information is mostly unknown, Miller said he couldn't come up with an exact figure. And while he’s not worried about the initial cost of treating the patients, he said it will be an expensive proposition down the road.

"In some other mass disasters, people have stepped up when it was terrorism. Employers will step up and say, ‘We’ve got you.’ Hospitals will say, ‘We’ve got you,’" said Miller.

"The question is what happens in two years. What happens in four years. What happens in 25 years later when my prosthetic needs to be replaced?"

Good news and bad news

While the Boston Marathon is an international event, it’s likely many of the victims come from Massachusetts, where a bill signed into law by former governor Mitt Romney requires citizens to puchase health insurance. This means it’s highly unlikely a Massachusetts resident would end up paying the full price of their treatment.

The Boston Bruins advertised for the One Boston Fund on their boards Wednesday night and collected money from fans on the mezzanine. (John Rieti/CBC)

The state’s funds will be bolstered by charity. Boston Mayor Thomas Menino established the One Boston Fund hours after the bombing, and raised more than $7 million in 24 hours.

Kenneth Feinberg, the Boston-area born lawyer who oversaw the September 11th Victim Compensation Fund, will administer the One Boston Fund, a large chunk of which is expected to help with hospital bills. Families of the three people killed in the bombing will also likely receive compensation.

There’s also the possibility that hospitals will absorb some of the medical costs, Miller said.

However, the bad news is that people disabled by the twin blasts may face short-term financial pain, especially if they lose their job. In the U.S., it takes two years to apply and be granted disability assistance, Miller said.

And, it would take far more than $9 million to make up for the quality of life lost when those bombs went off.

Mental health a key concern

Boston Public Health set up a series of counselling stations in the immediate aftermath of the bombings. On Friday, the main station has moved to a smaller community centre on Columbus Avenue.

Rev. Angelo Pappas, a counsellor with the International Orthodox Christian Charities, said he’s deeply worried about lingering effects the bombings will have on people’s mental health.

Rev. Angelo Pappas helped with Boston's counseling effort on Thursday. He says the city need to keep funding mental health assistance. (John Rieti/CBC)

"The speech was good," he said, referring to U.S. President Barack Obama’s remarks Thursday at an interfaith church ceremony. "It brought closure to some, but it could have been false closure."

Pappas, who has also worked as a Myrtle Beach fire hall chaplain, said there’s also an atmosphere of machismo in Boston — the "we have to be strong or the terrorists win" thing — that’s not healthy in the long term.

Pappas said he’s "no fan of socialized medicine," but he thinks the city should continue paying for mental health services such as counselling. A Boston Public Health official said it’s difficult to tell how much the city has spent on counselling at this time.

"I think [counselling] should be free," Pappas said. "These people were in a public area when this took place … you want government to help you at times like this."

Runners and Bostonians seek help

Inside the centre, a young woman in running gear slipped through the clinic’s glass doors. City worker Meagan Seamen ordered journalists out of the room and started the woman’s paperwork.

On the other side of the glass another city employee, Sandy Holden, did a quick count. The woman is the seventh person of the day.

"Something has to continue with the counselling," Holden said.

Runners, fans, first responders and regular Bostonians have all visited the counselling centre in the days since the bombing. Holden said she's happy to see the numbers going down, but she’ll be happy to keep it open for as long as people need someone to talk to about the tragedy.