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Tuesday, August 19, 2025

What a difference a continent (and government) makes

Carmen’s Broken Arm

By Richard Schweid

It happened less than a month after we arrived from home in Barcelona to our cottage in neighboring Green Hill in South Kingstown to begin our annual four-month summer stay, fugitives from the Mediterranean heat. Just before dawn, on her way to the bathroom, Carmen tripped and fell. She heard something crack and knew instantly that she had broken her right arm.

I threw a robe over her shoulders and we headed to the nearest emergency room. There, they took an x-ray, put her arm in a sling, gave her a prescription for Tramadol, and told us the humerus bone was broken, and she needed to see an orthopedist right away. The sling helped to hold the arm still, but if she moved it in the slightest, the pain was excruciating. The hospital receptionist declined to tell us how much we would be billed for the visit. It turned out to be $5,196.94.

I called the nearest orthopedist. His secretary said he did not normally accept visits from ”self-pay” patients who were without North American insurance plans. After consulting the doctor, she told me he would make an exception and allow one consultation, as long as we paid what seemed a reasonable $160 in advance.  She made us an appointment for two days in the future.

We showed up early after Carmen had spent two painful, sleepless nights, eager for relief. She winced every time she sat, stood, or moved her arm. In the doctor’s waiting room, I read the news on my phone.

At a París NATO meeting, Spain’s Socialist Party prime minister, Pedro Sánchez, was the only head-of-state who did not bow to Donald Trump’s demands that NATO members increase their defense spending to five percent of their nation’s gross domestic product. Sánchez said that he considered Spain’s defense spending of two percent as "sufficient, realistic, and compatible with the welfare state." An increase, he pointed out, would have to come from funds earmarked for Spain’s social programs, including its public health system, and this was unacceptable.

The Rhode Island orthopedist was good. Thorough and sympathetic, ready to operate in a few days, and confident that he could insert a spike that would join her broken humerus back together, and that her arm would heal completely. He said he would send us a more exact cost estimate later, but figured the 40-minute, in-house operation would run about $20,000, and Carmen would be sent home the same day.

The doctor belonged to an orthopedic group practice with a “surgery center” and fifteen offices across New England. His estimated bill included about $3,000 for his services, and $17,000 for “the facility.” This would not include physical therapy, or the costs of any complications that might arise during surgery requiring hospitalization, or further operations.

Four days later, Carmen was still in pain, and we were on a flight back to Barcelona. Twenty thousand dollars would have been a chunk of our savings, and there would have been no guarantee that we would not have to spend more. On arrival we went to the emergency room at the public hospital, where, after a three-hour wait, the Rhode Island orthopedist’s diagnosis was confirmed by x-ray and consultation with an orthopedic specialist. An operation was scheduled for the following week. It would be free, along with everything connected to it, including medication and physical therapy.

Carmen’s broken arm, in the context of Pedro Sánchez’s insistence on protecting the programs that make life easier for Spaniards, was a stark example of why NATO might have chosen to stand up to Trump’s bluster.

Instead, they chose to placate him, caving to his demands. As wars rage across the globe, do we really want to spend even more of our resources on the notion that they are inevitable, and we must prepare for them?

Or is providing everyone with the basics for maintaining a decent life a more effective way to keep the peace? Shelter, food,  health care, work, and a basic education? Are these things more potent than bombs for discouraging territorial or ideological aggression?

Once Carmen’s arm was set and healed, we would not have a substantial debt, a financial catastrophe looming over our lives should circumstances prevent us from paying it. The broken arm put an end to our summer plans, but there were no vulturous collection agencies waiting in the wings to swoop down if we were unable to pay for its repair.

Spain’s citizenry is by no means unanimously supportive of Pedro Sanchez’s decision to target spending on social programs rather than on weapons. The strident voice of a xenophobic, Trump-ish extreme right wing (the Vox Party), counseled by the likes of Steve Bannon, is frequently heard in opposition, and the traditional conservative party (the Popular Party) is constantly nipping at the heels of the Socialists.

In addition to the opposition voices from outside the Socialist party, former ministers of Pedro Sánchez’s own government are currently embroiled in various corruption investigations, which are providing the right-wing parties plenty of ammunition, and have the potential to force elections. Will Spain’s welfare state hold, or will it be swamped by the Trumpists loose in the world?

At the same time as Carmen came home from an overnight stay in the hospital following the surgery, the U. S. Congress finished putting its stamp of approval on a budget that will reduce or eliminate health care assistance for some seventeen million Americans. The money saved will be used to help offset tax cuts for the wealthiest citizens among us. They are people who will never have to decide whether to bring an ill child to a doctor and go deeper into debt, or skip the doctor’s visit. They will never have to think twice before seeking medical attention.

Meanwhile, Carmen’s humerus is healing.