The Cost Of Disability: Or, Why We Can’t Have Nice Things

Being disabled is expensive. Slap a label like “adaptive” or “assistive” on a product and the price skyrockets, just like that. It seems odd, doesn’t it? Exploitative? Yet, that’s what happens.

The free market was supposed to help us all. The invisible hand of competition was supposed to keep prices reasonable. We were supposed to have choice. Unfortunately, capitalism can’t accommodate markets that are too small to inspire competition, nor can it liberate us from monopolies that keep prices extortionately high. I don’t begrudge these companies the right to value the bottom line. People need to eat, after all. There’s such a thing as going too far, though. With basic Braille technology costing several thousands and wheelchairs so expensive you’d need a full-scale fundraiser to afford them, the landscape for low-income disabled people is grim unless they have access to substantial funding.
Considering that we have to use screen readers, wheelchairs and other assistive devices every day, it’s not practical to expect us to simply go without. We’re not a manipulative community whining about handouts. We really do need these products, especially in professional and educational contexts.

Living as a disabled person can incur significant costs when adaptable housing is needed. Installing adjustable beds and stair lifts can become staggeringly expensive, and for those living in low-income housing, proper accessibility is by no means guaranteed. It’s bad enough to be chronically unemployed and live in low-income housing; but living in a place where you lose much of your independence adds considerable insult to injury. Don’t even get me started on the markups on prescription drugs. Even life-saving drugs routinely sell at a 400% markup (100% is generally what is considered reasonable). It no longer surprises me when I see the lengths to which companies will go to monopolize a market and shamelessly exploit people who are already disadvantaged. We’re not asking for a pity party, to be sure, but a little reason would not go amiss.

We’re not the only ones affected, either. There are numerous grants available from governments and charities, which are intended to ease our financial burden. For example, the Government of Alberta provides $8000 a year which is spent on assistive technology and disability-related costs while I’m at university. You would think that’s overgenerous—I certainly did—but even during years when I did not buy any assistive technology at all, the entire grant was put towards paying for the editing of inaccessible textbooks. What is more, the grant did not even meet the full cost; my university covered the rest. It makes my head spin a bit, it really does. Governments are well and truly stuck, because manufacturers of accessible products have few incentives to lower their prices. Why mess with a business model that is working so well? There is more competition than there used to be, it is true, but for the most part, prices remain astronomical.

Worse still, these companies have managed to convince charities and governments that their most expensive products are the best, in any situation. Even though there are other viable options out there, many school divisions and universities insist that JAWS, one of the priciest screen readers, is the only wise choice. Encouraging this view is advantageous, so companies are happy to charge what they do, knowing that someone will gather the necessary funding.

The little things bother me, too. Take watches, for example: very few stylish accessible watches exist. Most are either obnoxious talking watches that draw a lot of unwanted attention (and make startling bonging sounds when you’re not expecting it), or braille watches (which aren’t braille at all, but tactile). These watches are generally affordable enough, but they are seldom fashionable. This may seem like a frivolous gripe, given the more serious struggles we face, but why can’t we have nice things? Why do we have to wear tacky accessories just because we’re disabled? I’m not a huge fan of braille accessories, but a lot of blind people are. Why can’t they have more legitimate selection? I mean, have a look at these charming braille hoodies: they say things like “peace”, “joy”, “Jesus”, and my personal favourite, “Can you read this?” The site boasts that you can “spark conversations with total strangers!” Uh, no thanks. If I really want to spark conversations with strangers, I’ll get a dog.

Simply having a disability is financially and socially punitive, and there are many who are happy to capitalize on the issue for personal gain. Certainly, this willingness to exploit customers is not unique to assistive technology companies. However, the problem is compounded when we’re forced to purchase necessary products, much as we wish we could do without them. It’s encouraging to see how many grassroots attempts to provide affordable adaptive products and services are emerging now. I am immensely proud of open-source screen readers and inexpensive mobile apps. We’ve come a long way. Nevertheless, I don’t think it’s wise to ignore the nasty elephant in the room: being disabled is prohibitively expensive, and few people know it.


15 thoughts on “The Cost Of Disability: Or, Why We Can’t Have Nice Things

  1. I couldn’t agree more with this post Meaghan! I know exactly that a lot of things that I need as far as blindness accessible equipment and software goes is prohibitively expensive because a lot of the disability items are for a small market. when I say a small market I mean just those people who have a disability it’s even worse when somebody was once healthy or able bodied and they end up with a disability later in life some wheelchairs can cost up to $15000 or more I could go on about benefits here too but that’s probably another topic for another time but we only ever think of accessible technology for necessity however. a computer or a phone we can think of as a want and a need. people often buy phones and computers because they want them but some people will often buy these things if they ever need them but if a newer model comes out I shouldn’t just necessarily just go out and buy it, I’d only ever go out and buy something if I really needed it and updating any firmware wasn’t viable due to the fact it may slow down the unit and it would lag like crazy. here’s an example of this. I once went to download an app onto my IPhone 4s and my phone said that the current operating system wouldn’t support said app and I would have to update to IOS8. I was told that if I did that with my old phone it would lag so it was decided I should look at a new phone just to combat that issue which I have done. and recently I had to replace my computer because a thunder storm killed my old one and I was without a computer for a fortnight but I did have a backup machine in the cupboard which I set up as a fill in. unfortunately I had to download NVDA which although I don’t really like to use it it’s what I had access to at the time and the machine I’m sorry to say had windows vista on it so navigating vista was a nightmare so sometimes it’s better to make do than to make a fuss.

  2. Thank you for giving the Canadian perspective. As an American, we typically have looked at your healthcare system as something to aim for (free for all sounds SO amazing!). But here is the other side of it. I’ve heard here in the states on Medicaid (which I used to be on) they will give you only one prosthetic brace to walk with even if you need two. You qualify for the second one a few months later. Ridiculous!

  3. So true! And those are just the big things. There are also a slew of little things like color identifiers, currency identifiers, and so on, which may not cost much individually but add up.

    Another big one for me is transportation. If I didn’t live with family, I’d have to pay for transit service (arrange 24 hours in advance, only available certain hours) or taxis (frightfully expensive). Asking for rides has its expenses, too, on others’ time and resources.

  4. I’ve used a power wheelchair since I was six years old and those cost as much as a car. The one I have currently was $26,000Cdn when I got it in 2010. Thankfully, it was paid for in full through my employer’s medical benefits, but it is exceedingly frustrating to have to pick where I’m going to work based on what sort of medical benefits that company has. I tried to work as a freelancer for about a year–better opportunities to further my career, better hours to accommodate my health needs–but I had to return to working 9-to-5 for a company because I couldn’t cover the cost of repairs to my wheelchair.

  5. Pingback: The Cost Of Disability: Or, Why We Can’t Have Nice Things | blindwriterblog

  6. Pingback: When WE are the Problem | Life Unscripted

  7. I could not agree more. This might sound bitter, But it is almost as if keeping the price up is their way of hoping we will just disappear. After all it’s all about survival of the fittest. It’s also a tease, we have the products for you, too bad you can’t afford them.

  8. I’m not a screen reader user so can’t evaluate it first hand, but both NVDA – or, if you feel like switching to Linux, Orca are free as in price and free as in freedom.

  9. I think your estimates of costs are excessively low. For example, with wheelchairs, your costing is for the most basic units. There are expensive wheelchairs that could provide way more independance that have been on the market for years (e.g. the wheelchair that the segway technology was based on, which could climb stairs), people will never see these in use because they are so prohibitively expensive. Even though they can easily be mass produced, as was shown when the company took it’s technology and produced segways en mass. The same goes for the braille display and note taker side of the house. The 24 and 40 character braille display is the norm; even though it only allows for 40 characters on the screen at once. 80 character displays are better suited for many tasks such as math, science and programming because you can get the whole equation or whole line of code on the screen at once. However; people never consider them because they aren’t just a little more expensive but rather are twice the cost of a smaller unit. There are more powerful note takers and braille displays than are currently common; such as the ATC displays that would make it easier to learn braille and work with a sighted braille instructor; however, kids will never see these devices because they are way more expensive than they should be.

    • Hi there. Thanks very much for reading and commenting. I’ve removed the price list from the blog entirely as this is not the first time I’ve had to edit them after receiving reader feedback. I’ll let people do the research in future, since I don’t have broad knowledge of all disabilities and associated equipment.
      As for your comment about NVDA…I would not call it overly limited, at least not anymore. I use it exclusively, both at work and at home, and it does everything I need it to do. Now, I don’t do any coding or other really complex work. I’m a Communications Specialist and editor, so I mostly work with MS Office, WordPress, and the major social networks. It’s been good to me in that context.

  10. This is interesting to read. I am an aspiring biomedical engineer and assistive tech (AT) enthusiast. Developing these kinds of devices is what I want to do, and I bet it is frustrating to see the insane prices on these products (why do adaptive switches cost $60 upwards???). To strengthen or complement your point, according to WHO, only 10% in the world with disabilities have access to their needed assistive technology. What do you think would lower the insane costs? Is it producing durable AT with low cost materials? Is it outsourcing? How do we get governments and the private sector to fund AT vendors? Finally, how do we make the general public more interested in assistive tech? Should we design AT with multiple functions or, one simple function, so that it reaches a wider customer base including various disabilities or the non-disabled (temporarily-abled)? Just wondering what your perspective is on this, and you probably know more about blind products in relation to this… Btw, I think your writing is very clever just like your blog name.

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