Health Care Costs for Boston Marathon Amputees Add Up Over Time

PHOTO: Medical responders run an injured man past the finish line the 2013 Boston Marathon following an explosion in Boston, April 15, 2013.
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The price of a new prosthetic leg can cost anywhere from $5,000 to $50,000. But even the most expensive prosthetic limbs are built to withstand only three to five years of wear and tear, meaning they will need to be replaced over the course of a lifetime, and they're not a one-time cost.

Ten days after the Boston Marathon bombing, the most gravely injured among the victims have begun the daunting road to recovery. At least 14 of those injured in the blasts had to have limbs amputated, and at least two people had multiple amputations.

Each prosthetic limb must be custom fit to every patient, and costs can add up. Once they're fitted with the prosthesis, patients also need to attend physical therapy for weeks or months.

"Depending on what components you get on it, [the cost] can vary greatly," said Glenn Garrison, director of prosthetics and orthotics at the Hospital for Special Surgery in New York. "They're probably in line with a cost of a car. It can be a pricey thing to work with."

With physical therapy, Garrison said amputees could start walking on their own within two to four weeks after receiving a prosthesis. According to Garrison, most patients will have one prosthesis for the first year, but will likely need a second one to accommodate their changing physique.

After that, a prosthesis usually wears out every three to five years, although Garrison said there were exceptions.

"I've seen people drive 20-year-old cars, and I've seen people walk on 20-year-old legs," said Garrison.

But the cost for prostheses are just one component of medical costs that can easily go from the tens to hundreds of thousands of dollars after a severe injury. A 2011 survey by the by the International Federation of Health Plans found the average cost of a single day in a hospital was approximately $3,949.

At that cost a patient being treated in the hospital for 10 days, the length of time for 34 patients still hospitalized after the bombing, this could mean at least $39,490 in medical bills.

The fact that the bombing took place in Massachusetts meant that many if not all victims had health insurance because of the state law that requires most residents to have some kind of health insurance.

There is no public information on how many bombing victims had health insurance, but only 2 to 3 percent of Massachusetts residents go uninsured.

Jon Kolstad, an assistant professor specializing in health care economics at the Wharton School of Economics at the University of Pennsylvania, said that while health insurance might not completely cover all expenses, it could keep patients and their families from financial ruin.

"If you had to buy that prosthetic without insurance that would be financial catastrophe on top of a medical catastrophe," said Kolstad.

Matt Albuquerque, president of Next Step Orthotics and Prosthetics in Manchester, N.H., is working with doctors at Massachusetts General Hospital to help patients who will need prosthetic devices. Albuquerque said even with insurance, some patients may still need financial help in the coming weeks and months.

"Most private insurance plans cover prosthetics at 80 percent level," said Albuquerque. "That challenge is going to be the 20 percent co-payments. ... That is going to be the areas that will need [help]."

Multiple funds were established in the days after the bombing, including the One Fund Boston, set up by Massachusetts Gov. Deval Patrick and Boston Mayor Tom Menino. The fund has already received $20 million.

Kenneth R. Feinberg, who is in charge of administering the One Fund Boston, said the money would be dispersed to victims and their families by the end of June. According to Feinberg, the tentative plan is to disburse the money to victims on a sliding scale according to the length of time they spent in the hospital. Feinberg, who also administered the 9/11 Victim Compensation Fund and victim funds created after the shootings in Aurora, Colo., and at Virginia Tech, said whether a victim had medical insurance would not be considered in the disbursement.

"Hospitalization is a pretty good surrogate for seriousness of injury," said Feinberg. "We would probably look at how long a physically injured victim remained in the hospital and come up with a formula tied to that hospitalization."

The families of the victims who died will also be given a certain amount of the funds.

In addition to the One Fund Boston donations, online fundraisers for victims of the Boston Marathon Bombing and their families have raised more than $2 million so far.

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