he needs to get an xray pronto

Oh hell.

Yikes. He really does need to get to hospital. I hope his mum makes him go.

I've never had to call and hope I never have to.

Well, the guy refused treatment. You can't *make* an adult go to the hospital. The riders that stayed behind didn't make too big of an issue about it, since his mom is a nurse. She will know what care he needs.

I have no doubt that part of the issue is that the guy probably doesn't have health insurance. If we had universal care this wouldn't be an issue. :/

Hope he's OK.

I've had to call 911 many times over the years but I guess that's life in the big city on something.

Yeah, no helmet either.

That blew my mind. On a pub crawl ride? Is this any kind of organized group running the ride? I don't know if you're in charge, but just a thought, if I were the organizer I would refuse to bring anyone along who wasn't wearing a helmet - just a ride rule. I've been on other group rides that are 'helmet required' and you'd think especially a pub ride would require it too.

I get that it might not have prevented a collarbone break but that fall could have gone down any number of ways, including banged-up noggin.

Un-fun, Doohickie. Yes, 911 is nothing short of miraculous - I had to call on St. Patrick's Day for a street injury incident (to a stranger) and the combined professionalism of the medics and kindness of the passersby gave me hope for the country. People still do some things right.

I think you are right about the health insurance. I can't imagine us Canadians not going to the hospital in that situation. It wouldn't even be a question.

Did someone have to pay for 911 to show up? (I had elective surgery to remove an ovarian cyst last Friday and didn't pay for anything other than painkillers to take home, so am really unclear on when Americans have to start paying.)

You'd have to start paying the minute you get into an ambulance or, if you get yourself into an emergency room, the minute you start to receive medical care.

I took a spill on the sidewalk at the beginning of summer, fell and hit my head pretty hard. I called for my boyfriend who called for an ambulance to take me to the ER. Later, we were billed almost immediately by the FDNY, and it took months for them to factor in my health insurance deduction.

Doohickie, that sucks, I'm sorry you got involved in that.

just to pile on with my own scenario- At a time when I was marginally underemployed as a temp (at a major military defense contractor, OH the irony) I have personally refused transport and medical services after breaking a CB at a bike race. Crazy, right?

Well, it depends. Due to the many complications related to obtaining health insurance in the USA, I had no primary coverage at the time, and trying to get hospitals to take secondary (the race association's half-assed liability coverage) insurance is like trying to use the pot of gold at the end of the rainbow.

Here is my scenario. I have been involved in many crashes in my race career, and know my body pretty well. I was basically unharmed beyond some contusions and the aforementioned broken collarbone. As in, no concussion, no further trauma. Yes I was wearing a helmet (them's the rules). And broken collarbones, while painful, are probably the least serious fracture one can have. They suck but unless they're really badly displaced or breaking the skin, there's really not that much you can do about them, beyond time and some swearing.

For those of you outside the US, understand that medical practices do vary between nations. In the US, the MO for the majority of orthos on relatively straightforward, clean clavicle fractures is to do nothing beyond xraying it, saying "yep, it's broken", sticking you in a figure 8 sling, and sending you home with some prescription opiates (which I have serious adverse reactions to anyway), and billing you a sum total of at least a couple grand for the visit, the labs, the meds, the sling, and the xray, in separate unreferenced bills that come trickling in over the next few months.

If you're even luckier and someone insists on putting you on an ambulance, you can tack on at least another $3K to those bills, depending on the ambulance provider in question (in CO they are private for-profit contractors), their relationship to (whatever) local or regional hospital, and how far out in BFE the wreck happens.

So yea. Faced with all that, I said "nope", argued vigorously about it with the EMTs onsite, explained my situation, got lectured at length for racing bikes with no primary coverage (ARGH...) then had my SO drive me to urgent care, where at a cost of a few hundred bucks payable on a no-interest payment plan, I got a professional opinion; which amounted to the doctor looking at it, saying "yep, it's broken, here's a figure 8 sling and let's clean that road rash out properly - do you want to bother with an xray or a referral to a specialist?" Me: "nope, can't afford that but thanks for checking!"). And then I took shitloads of ibuprofen, swore a bit, used the figure 8 for a couple weeks, and went back to life as normal shortly thereafter. IIRC I did another race about four weeks after the break with no harm done. There's a knot on it from the healing process, but that's typical.

Now if dude has a major concussion all bets are off, but really if he's un / marginally / underemployed with no primary coverage, then I really cannot fault him for refusing treatment. There but for the grace of god go I.

A follow-up: One of the regulars knows the guy who fell as a regular at the first stop, and is a drunk. He is also notoriously bad about getting drunk and falling/getting hit by cars. He simply joined the ride at the first stop. In three years, this is the first serious injury we've had, and it was an interloper that slipped into the group.

As for the helmet issue: I do help out on the rides somewhat, but the founders of the group set the rules, and not all of them are helmet wearers. My personal position on the helmet thing is that while I encourage anyone and everyone to wear a helmet, I respect that it's a choice an adult can make for themselves. The group itself is no more than a group on Facebook.

Even so, if I owned that Facebook page I would be somewhat worried about my personal liability for someone's injury on the ride. Ah well, I guess you can only protect yourself against that kind of thing so much.

It kind of evolved.

It started out three years ago with a small number of friends, maybe 4 or 6, that wanted to ride together at night. They started the Facebook page, and some friends joined, and then it spread. I started riding with them two years ago, when it was usually one to two dozen riders.

Then earlier this year, the group was written up in the local major daily paper, and has been written up several times in the alternative and online press. The FB page now has over 1300 likes, and a typical Sunday night crowd is now 60-70, and maybe about 40-50 on Wednesdays.

I was invited into the planning committee (a private FB group) this summer. We've thought about the liability thing, and have an upcoming planners' meeting to discuss what we can do to make things safer and more orderly. We want to keep it as open and informal as possible, but with a group that big there are challenges.

Totally. That's something that's definitely grown far beyond the grassroots. Time to think about that stuff.

Living somewhere where helmets on cycles are mandatory and riders are regularly ticketed if they are caught, the idea of someone riding at those speeds without one is a bit hard to fathom. Except that I guess where the community doesn't bear the cost of someone needing medical care as a result of their own carelessness, it balances out somewhat.

Can it seriously cost $3k just for an ambulance? That's insane. Perhaps I shouldn't mention that, where I live, ambulance services are absolutely free at the point of service, because there is a levy of a couple of dollars on every electricity bill we pay to fund the (state-run) service.