They may well have had a poor bedside manner, and they may well have tried to pressure him into having a surgery they thought necessary, but doctors disagree with treatment methods all the time. That doesn't mean that they were necessarily evil in disagreeing with the doctor in Boston.
It's also fairly standard practice for insurance companies to decline to pay a patient's hospital bill if that patient signs out against medical advice. So, if they said that he would have to pay out of pocket, they may well have been telling the truth. If he was signing out against medical advice, he may well have been responsible for the entire transfer bill, which would likely have been in the tens of thousands of dollars.
Also, if the hospital was the closest qualified trauma center, and if it was deemed by the Attending Neurosurgeon that he have surgery soon or risk permanent paralysis, it's understandable that they would have been reluctant to transfer the patient. And, if he was refusing emergency back surgery and if he was demanding transfer, he may well have been risking permantent paralysis as well as being financially liable for the hospitalization.
The same thing happens in small town India as well where doctors are more interested in keeping you admitted above and beyond the needed duration and doctors in large cities are just better because they have a greater patient load to be well versed with complex surgeries if needed.
According to the Harvard neurosurgeon she made the less risky decision. Given the choice between believing a random poster to hacker news and someone with those qualifications, I'm going with the known expert every time. It is just icing on the cake that the expert's opinion fits with what I've been told about the risks of back surgery by multiple doctors, physical therapists, and even a panel appointed by the US government. (Admittedly the last is somewhat out of date.)
A rural surgeon is going to be professionally offended if their patient calls up an egghead at Harvard from their pre-op hospital bed and then tells him she doesn't trust his judgement and instead wants to be medivac airlifted back to Boston. It's like when you watch a detective show when the FBI takes over and the local cops are all bent out of shape. The hospital staff may have been thinking about health insurance and losing their accreditation but I doubt it was a sinister plot to meet their spinal surgery quotas. It was probably more along these lines: "a crazy lady from Boston just broke her back jumping off a bridge with some 13 year olds. Now she's telling us to schedule a chopper to Boston because she's Facebook buddies with some prick neurology prof at Harvard. Quick, give her some morphine and get her under the knife before her spinal column collapses and she's paralyzed and we get slapped with a half billion dollar malpractice suit... "
Note that I'm not defending that sort of attitude. That's just what I think they would be thinking, rather than some nefarious conspiracy to maximize insurance profits, which is what the article and most commenters on this post seem to be suggesting.
The other thing is that I don't think the doctors were necessarily wrong in their diagnosis. The higher you go up in the spine, there's a lot more danger of paralysis or other severe spinal cord problem. If you're over 30 and shatter your T12, there's a 50% chance you're going to end up with a serious neurological problem. The odds for recovery are far better the sooner you have surgery, if the surgery is necessary.
Timing of surgery is also an important issue in the treatment of thoracic spine fractures. ... Some studies suggest that patients with thoracic spine fractures treated within 72 hours, irrespective of concomitant injuries, do much better physiologically postoperatively than those in whom stabilization is delayed.
http://emedicine.medscape.com/article/1267029-treatment
Lastly, I don't think a patient requested 370 mile helicopter flight for a treatment which could be performed locally could possibly be covered under any insurance plan, no matter how good the coverage is.