The hidden costs of disability

Picture of severely damaged carHow much does a disability cost you? Let’s take the example that (slightly too easily) comes to mind for most people: a disability that means you need a wheelchair to get around – how much of a dent in your wallet is this, compared to an identical life without any mobility limitations? There’s the obvious costs, like the wheelchair. There’s the less obvious costs, like the fact that public transport is often an utter nightmare (the tube in London is spectacularly inaccessible), and so you need to pay for a car/taxi.

And then there’s costs that probably never occur to you – but which were cleverly revealed in a paper that came out earlier this year.

Getting fleeced: A field experiment

The paper is by Uri Gneezy (lovely name) and colleagues earlier this year (£), and looks at a series of different aspects of discrimination in the US – finding, for example, that young black men are less likely to be helped by strangers. But that’s not what concerns us here.

The experiment that shows these hidden costs of disability is refreshingly simple. Take 12 middle-aged men in Chicago, and get them to approach a set of 36 garages (i.e. car repair shops, for US readers lost in translation) using  the same set of slightly battered cars. Half of the customers are in wheelchairs, and half aren’t – each pair of people approach a randomly selected garage with the identical car, and ask for an identical quote.

So what happens?  The people who weren’t using wheelchairs were quoted $1212 – but the people in wheelchairs were quoted $1425!  When they take account of some quirks of the design, they estimate that wheelchair users are charged 30% more than non-users to fix an identical car.

What’s happening here?

This was a bit puzzling to me – these were all wheelchair-accessible garages, after all. But Gneezy et al had a hunch, and then showed that their hunch was right. (Academic papers are designed to tell stories like this – people don’t usually tell you of the blind alleys they went down…).

Their hunch was that wheelchair users don’t shop around as much as non-users – so that when it comes to bartering prices, wheelchair users have a weaker hand. To check this, Gneezy et al first did a survey of customers and of mechanics. Their story here checked out: on averaged disabled customers visit half as many garages than non-disabled people when they’re getting their car fixed, and what’s more, mechanics knew this.

But still – how do we know this is the reason that wheelchair users were getting charged so much more? To really hammer the point home, Gneezy et al sent their volunteers out to 24 Chicago garages again. Everything was pretty much the same as before, except that the wheelchair users made a point of saying, “I’m getting a few price quotes”.

Bingo. In this case, there was absolutely no difference in the prices quoted to the wheelchair users and non-users (in fact, non-wheelchair-users had slightly higher quotes, but this wasn’t statistically significant). In other words, the reason that wheelchair users were getting charged more was ENTIRELY because they weren’t able to shop around as much.

The moral of the story

There’s several things I take out of this. Firstly, it shows to me (yet again) the power of social experiments – this really is much more convincing than the endless, increasingly complex analyses of people’s responses to questionnaires without any manipulation. I hold a guilty hand up here for past and future sins.

Secondly, and more importantly, it shows the continuing, hidden nature of disability discrimination. The US – like the UK – has anti-discrimination laws, and sometimes non-disabled people seem to suggest this has levelled the playing field. But the sheer spectrum and range of disadvantages goes beyond the situations that the law can deal with – not just in this particular case, but also in many others which I’ll come back to on the blog.

Third, it highlights the logic of having benefits to pay for the extra costs of disabilities, separate to benefits that are paid to people who are not working due to their disability. There’s a vast literature looking much more broadly at the extra costs of disability (I won’t review this all here, but see my comment below the post). But aside from affirming the importance of this benefit, there’s a couple of things to note:

  • The numbers claiming this extra cost benefit in the UK is being cut by 20%, as it moves from being called ‘Disability Living Allowance’ (DLA) to ‘Personal Independence Payment’ (PIP) – two genuinely bad names, and a change that will be devastating for those affected.
  • And amazingly, while we have this benefit to cover extra costs, it’s treated as ‘income’ in our official poverty measures, rather than as meeting extra needs. So the real levels of poverty in disabled people are much higher (for example, see Chanfreau & Burchardt 2008, p9).

And as a last word – if you use a wheelchair and have a car, then let us know if this tactic works with garages near you!

[As a general disclaimer: I’ve used the term ‘disability’ very loosely here, because this is a blog post, and repeatedly talking about ‘people with impairments’ has a tendency to put off some readers. But the social model of disability is underlying this, and hopefully readers familiar with these debates can pick this up. Apologies if not, and I promise to use terms more carefully in academic papers!]

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About Ben Baumberg

I am currently a Lecturer in Sociology and Social Policy at the School of Social Policy, Sociology and Social Research (SSPSSR) at the University of Kent. I also helped set up the collaborative research blog Inequalities, where I regularly write articles and short blog posts. I have a wide range of (too many...) research interests, at the moment focusing on disability, the workplace, inequality, deservingness and the future of the benefits system, and the relationship between evidence and policy. You can find out more about me at http://www.benbaumberg.com
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14 Responses to The hidden costs of disability

  1. Ben Baumberg says:

    For anyone interested in how big the extra costs of disability are overall, good places to start are UK government reviews in 2005 (domestic) and 2008 (international), and my former-colleagues at LSE’s nice paper from back in 2003.

    [I also saw a very clear book from 1991 with interesting chapters by Berthoud and Large, and a 2004 report by the UK Joseph Rowntree Foundation].

  2. Ben Baumberg says:

    You might also be interested in a piece that shows price comparison websites don’t serve disabled people well (from Apr 2012)

  3. Ben Baumberg says:

    Sorry, bad etiquette to keep commenting on my own post, but just so that I don’t miss this in future – a related paper here on the extra costs of disability in China.

  4. Pingback: Health Promotion Headlines from Robyn & Penny 2012/05/01 | Health Promotion Today / Promotion de la santé aujourd'hui

  5. Jane says:

    This is a shocking and stark example demonstrating that there are extra costs of disability arising from naked discrimination, which come on top of the extra costs arising from the impairment itself. In other words, even excluding the ‘real’ extra costs, such as adaptive equipment costing more than standard equipment, there are still extra costs arising from attitude alone, which anti-discrimination legislation, at least in the UK, is powerless to stop, partly because of the necessity for disabled people to take legal action after the fact, which most cannot due to the cost and hassle of going to court – never mind the knowledge required to do so.

    For some realistic examples of ‘real’ extra costs of disability, see the Wearespartacus response to the recent PIP consultation, at Wearespartacus.org.uk. The appendices to that document give examples of the extent of these costs, for which the current draft PIP criteria completely fail to provide proxies.

    Our response also makes the point that the Disability Discrimination Act, now superseded by the Equality Act, do not make nearly as much difference to the inequality faced by disabled people as the Government appears to claim in justification of the abolition of DLA and introduction of PIP. If the above US research represents the reality in the UK, which is highly likely, then this is further, clear demonstration of this crucial point.

  6. Carla says:

    A friend of mine having never experienced disability issues such as financing appliances came with me to the annual road show at NEC Birmingham. They were deeply upset to see the disgusting charges that were being made for appliances especially wheelchairs. I informed my friend that the current battery I have attached to the wheelchair I was in, cost £542 and it is not a big battery by any means. The words that came out of their mouth was “It sure is expensive being disabled”. Yes it is and when the government do allocate funding via benefits, these expenses are never ever taken into consideration. A pair of tyres for the wheelchair cost £25 each! That I believe is over and above what it would cost for bicycle tyres. I seriously feel that the government should look at the businesses who provide appliances to see if they are excessively over charging their customers because they now that their customers are more than likely not able to obtain these appliances anywhere else.

    I am aware that many appliances for the disabled have to be custom made for the customer and many probably have a nil VAT charge but such things as batteries, sticks, walking frames, shower chairs etc are universal, yet the price of them are astronomical. I would like to see the prices of appliances for the disabled investigated, as I am sure many disabled people are being financially ripped off when they are the last person that can pay such exuberant prices for appliances.

  7. Pingback: The hidden costs of disability | Jane Young

  8. Charissa says:

    Hi Jane, hope you are well. Sorry I have not been around lately, my health has deteriorated and I am unable to leave my bed at all. I have had the nurse out and have reassessments with doctor, OT and nurse this week coming. I am beyond exhausted after just eating or every little thing I sleep for hours!
    Anyway, I wanted to sat a HUGE thank you to you and and the rest of the team for the fantastic work you did on the PIP consultation I had a quick look through and I must say its pretty impressive and I hope for all our sakes they take you ideas on board.
    You mentioned in your blog about PIP being counted as taxable income whereas DLA was not. Does this mean that many will lose their ESA etc? Eg. At present I receive ESA support and DLA higher rate mobility and care if this is the case I would no longer be entitled to ESA. Have the rates been announced yet for PIP?
    With regards to costs, I have had to buy an electrical bed; convert a bathroom to wetroom, a dyson hot and cold fan because I cannot control my body temperature, special cups/flasks for me to use, bedding, washable incontinence pads, disposable pads, sangenic bin, body pillows, memory foam pillows, v pillows, containers to keep huge amount medication, storage box for items to be kept beside my bed; coffee pod machine and small fridge beside my bed. Lots of extra nightclothes and underwear bought; increased washing costs, cleaner one day a week to just do downstairs (all I can afford and she is ridiculously cheap!). When I was able to go out on a rare occasion I always need someone with me as I cannot propel my wheelchair due to weakness/pain/fatigue. There are very few buses that are able to carry wheelchairs and they are always full of buggys so it has to be a lift or taxi to wherever I am going. I cannot do anything without assistance and if the government get away with what they are trying to do my family would lose everything
    X
    Charissa Malcolm

  9. Jane says:

    Charissa – I’ve emailed you but just wanted to say, PIP isn’t proposed to be taxable – if you can tell me where you’ve read that on my blog, I’ll correct it straightaway!

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