A woman whose leg got stuck between a Boston train and the platform screamed for passers-by not to call an ambulance.
"Do you know how much an ambulance costs?" the 45-year-old said, through the pain, reports the Boston Globe.
The ordeal began when her foot slipped into the 13cm gap between the train and the platform at Mass Ave Station. It took 10 people to push the train off her leg, which was cut down to the bone.
"It was twisted and bloody. Skin came off," Maria Cramer, a reporter for the Globe, wrote on Twitter.
"Just as upsetting she begged no one call an ambulance. 'It's $3000,' she wailed. 'I can't afford that.'"
Emergency staff were on the scene within minutes regardless. They told the paper an ambulance trip would cost US$1900 at most.
In New Zealand, the trip would have been free, covered by ACC. For a non-accident callout, St John charges $98 for people who aren't part of its Supporter Scheme.
In an editorial, the New York Times said the woman's predicament was "one you might expect to see in an impoverished country".
"In the face of a grave injury, a series of calculations follow: The clear and urgent need for medical attention is weighed against the uncertain and potentially monumental expense of even basic services, like a bandage or a ride to the hospital, and that cost, in turn, weighed against all the known expenses of living that run through any given head on any given day.
"This discord, between agony and arithmetic, has become America's story."
The US spends far more of its GDP on healthcare than most other Western countries. New Zealand spends about 10 percent.