The economic spectrum is very broad in the wheelchair-bound. Here, the wheelchair-bound refer to the long-term wheelchair-users, rather than those who are using the wheelchair for temporary purposes.
A sizeable chunk of this segment is heavily financially-dependant, and is in need of some welfare.
The high cost a wheelchair will be a big burden to the financially-dependent demographic, but there is little state welfare available to alleviate these costs. Of course it depends which country they reside in. Wheelchairs sold outside Europe and North America are relatively expensive, as they are imported from overseas. A very basic wheelchair from the local supermarket already costs US$43, and more expensive self-propelled wheelchairs can easily cost US$3000. This is especially unfavorable for low-income groups, who may already have problems making ends meet.
There are 2 reasons why wheelchairs cost a tad more expensive.
- Taxes
Singaporeans pay 7%, Australians pay 10% , Vietnamese pay X% and Americans pay on average 7.25% (http://www.vidaamericana.com/english/salestax.html) for Goods and Service Tax or in some countries known as Sales Tax. As a result, consumers pay up to a few hundred dollars more for their electric wheelchair or life support system, just for tax! (10% x 5000 = 500). From a patient’s point of view, that money could have been much better spent for his physiotherapy sessions or other needs than give to the government.
- Middle men
Just like computers, wheelchairs go through different hands before reaching the consumer. The direct implication of having middle men in this trade is the increase in price of the item. From the manufacturer, it is imported by the distributor in another country before being distributed to the smaller retailers. Each party needs to make a profit and the more the “hand-overs”, the higher the final price.
It is not only the cost of wheelchairs that impose a financial burden on the wheelchair bound. Here’s a list of what else do.
Vital equipment that is just too expensive
A power wheelchair that costs a few thousand dollars may not be very surprising to some people but what about special backrests that cost US$1500? Some patients with Muscular Dystrophy require special backrests that suit their posture so as to minimize further deterioration.
Some of the wheelchair bound requires special breathing equipment, which again costs a few thousand dollars to purchase and maintain.
The impact is the greatest for low income families who do not have many reserves in their accounts. The sudden need for such amounts of money will put them in financial strain and unease especially.
Hidden Burdens
A family may have a car, a maid or caregiver, and a decent house but what others do not see is the overall financial strain on the family. Many times, families like these have no choice but to own a car and hire a caregiver to take care of the wheelchair bound in their home. Cost of petrol is rising and in some countries like Singapore and Hong Kong, maid levies of US$50 to US$100 are imposed on employers. As such, even mid income families will find it hard to cope with the extra expenses.
In some countries, due to the lack of wheelchair-friendly transport systems, wheelchair uses have to spend extra money hiring special taxis that cost much more. In Singapore, a return trip on a maxi cab (that’s what they call it here) costs US$30. Unlike countries like London, where the service is offered at a very subsidized rate, customers here have to bear the full cost.
Policies and Welfare systems
Not every country has a well developed social safety net for the wheelchair bound. Needless to say, the lack of governmental help means that those in need have little relief from their burdens. Red tapes and inflexibility of policies sometimes deprive some of their deserved aid, many and it is usually because of some minor condition that they do not fulfill.
Case Study A
Before ComCare was launched in Singapore in 2007, households had to have a monthly income of less than S$1200 to be eligible for financial aid from the government in form of the items they need. This red tape had left many unable to receive aid from the government. For most, VWO’s were their best source of help, financially and emotionally. However, VWOs being small organizations with not much extra cash cannot fulfill every applicant’s request.
MDAS (Muscular Dystrophy Association of Singapore) managed to help 11 people in 2006 with machines purchases, averaging S$6000 per applicant. 11 people a year and S$66000 worth of aid, does that sound like a lot? VWOs are supported partially by the government and from private contributions.
Case Study B
Medisave, Medisheid and Medifund are the 3Ms in Singapore’s Public Health Service. Under medisave, individuals are required to put aside a fraction of their monthly income into their Medisave account. The money gains interest and individuals are allowed to use the reserves when paying for hospitalization, day surgery or on some outpatient expenses. Medishield is a low cost insurance scheme to help patients alleviate expenses on major operations or prolonged illnesses. Medifund is targeted at those who cannot pay for their bills even after subsidies from Medisave and Medishield. However, the problem pertaining to wheelchair users is that they cannot use any of these to purchase their wheelchair equipment. I.E Mr X needs a new wheelchair and does not have the enough money for it but is not allowed to use his medisave savings to fund his purchase.Of course there are also efforts carried out to aid the wheelchair users financially. Click here to take a look at current efforts.