The call was for a seventeen year old pregnant girl with trouble moving. We were greeted at the door by the seventeen year old girls two year old son. Another teen girl led us upstairs into a bedroom where our victim rested. She said her neck was stiff and she couldn’t walk. I had her move her head from side to side, then up and down. She did it but said it hurt when she moved and had to go to the hospital for some muscle relaxers. I have given up arguing with people. “Where are your shoes,” I asked. She reluctantly walked down the stairs of her rent subsidised apartment. During the two block ride to Rhode Island hospital I copied her information from the State medical card she gave me. I noticed on the lower left edge of the card her co-pay arrangement. Emergency room co-pay, $0. Prescription co-pay, $0. Office visit copay, $0. Taxi ride to the emergency room by an advanced life support rescue, dispatch of Engine 13 with four firefighters to assist with a potentially serious problem, $0. I asked her why she didn’t have friends of family take her to her doctor’s office. She stared at me with a blank expression and ignored me. The states RITECARE program provides full healthcare for children and their caregivers until the child turns eighteen.

Later that night we were sent to Route 95 North at the Thurbers Avenue Curve for a vehicle into the jersey barrier. A car has lost control on the wet, slippery highway while navigating the tough curve in the road. The car was totaled, both air bags had deployed. Standing in front of the wreck was a twenty year old girl, covered in glass and holding the back of her head. We got her into the rescue. I automatically assumed we would take her to the Emergency Room, she adamantly refused. “Why?” I asked. “You might have a concussion.” “I don’t have health insurance,” she said. Rachel was driving home from work, travelling from New Haven to New Bedford after her shift. She was tired from working twelve hours and commuting two. Her employer didn’t offer health care. She was out of school, living in an apartment with her friend and barely making ends meet. The car was her roomates. She should have been seen that night at the emergency room but knew the bill collectors would be relentless in their pursuit of payment. I had her sign a form stating she refused transport against medical advice, then led her to a State Police car. They got her off the highway to a safe place where she waited for a ride home.