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September 18, 2014

Math

Yesterday, I had an ice cream in Halifax's Public Garden with my friend J.  He is in his final semester as an Undergraduate, then on to a Master's program and a PhD, before entering University teaching.

I would say that J.'s success is highly likely - he's smart, articulate, pleasant and confident.  I base that assessment on 25 years experience interviewing, representing and advising thousands of candidates for Harvard.

Last time I saw J. he had a rickety and ill-fitting old wheelchair.  This time, he had a spiffy new titanium one.  It fits better, his posture is better, his health is doubtless better.  Nice wheels!  He's a wheelchair rugby athlete, so he goes everywhere by pushing.  The Garden is almost exactly a mile uphill from his apartment.

My wheelchair is the same model, so out of curiosity asked J. what his cost.

$4600.00

Knowing his precarious student finances, (there are no family resources) I asked J. how he was able to afford it.  It's a long and discouraging answer.

"I applied to Easter Seals, but was rejected based on my income.  I work in the library, making student IDs for something slightly better than minimum wage, maximum 15 hours/week term time.   My student health insurance has a $300 limit on durable medical equipment.  In order to get help from the Department of Community Services, I'd need to be on public assistance.  If I was on public assistance, it would be tricky to attend university and my income would be limited to $300.  But I could get an allowance of $800 or so a month and a wheelchair.  So they would end up paying $9600/yr + $4600 or $14,200.  In any case, I'm unwilling to give up my education."

"In the end, two of my buddies starting crowdfunding for me and raised about half.  It turned out Easter Seals didn't spend their entire budget, so they came through with the other half."

Let me be clear on that.  Community Services will help J. get a wheelchair, but only if they also spend an additional $9600 for support.

If you use a wheelchair, you will understand how much it matters to have a comfortable, bespoke place to park your butt 16 hours a day.  It's like having only one suit - it better be Wool, not Wal-Mart. In pursuing any career, it's wise to look your best.  In order to look your best in a wheelchair, you can't be using a $299 model from Lawton's.


The simple act of getting around shouldn't require J. to surrender his ambition.

Here's an analogy:

One of the few drawbacks of single payer medicine is that there are no bills.  In the US, the bill for a new hip is typically about $30,000.  Probably a usable figure for us.  Say 6 of J.'s wheelchairs.

Is a hip the same as a wheelchair?
  • Wheelchairs are used by people for whom walking is difficult or impossible due to illness, injury, or disability.                                                                                             -Wikipedia
  • The goals of hip replacement surgery include increasing mobility, improving the function of the hip joint, and relieving pain.                                              -National Institutes of Health
It would require serious semantic acrobatics to concoct a difference.

So there we sat eating our ice cream, the hopeful young scholar and I.  While a dozen or so seniors, recovering from hip replacement surgery in the QEII were wheeled around the Garden by loving family members.  The expense of those hips represents 72 wheelchairs.

For aging Nova Scotians joint replacement is a ritual, an entitlement.  In my building, people are always showing off scars.  For an up and coming scholar, getting a decent wheelchair is just another in a long series of hurdles.  Hips vs. wheelchairs is an arbitrary and indefensible distinction, serving only to discriminate against largely disenfranchised Nova Scotians with disabilities.

Ray Ivany:  J. is the human capital you've told us to maximize.  Got any ideas?  I do.  
  • Send Community Services back to math class.
    • Reward work, don't punish it
    • Same for ambition
  • Make doctors explain why hips and wheelchairs are different
    • When they can't, devise a mobility program  that includes both
  • Make universities negotiate realistic health insurance for students
Gus Reed

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