When you rely on your powered wheelchair to get around, any delay in repair is not only a quality-of-life issue, but a matter of life and death. Yet a constrained market for wheelchair service and repair makes delays for repair of weeks or even months common.
This is Monopolies 101: when there is only one option for getting something done, quality and customer service go down while prices go up. One of the main goals of the Right to Repair campaign is to foster an open market for repair and service that offers real choice and price competition to consumers.
But today, a skewed market for wheelchair repairs often results in even simple, mechanical repairs taking weeks or months to complete. In this report, we’ll assess the reasons that repair choice is constrained and investigate policy options for state and federal leaders such as so-called “right to repair” laws that provide wheelchair owners with access to the information, software and parts to repair their own equipment. We’ll also review the results of a survey we conducted of 141 American wheelchair users that provides insights into the state of wheelchair repair, and whether wheelchair users believe that right to repair reforms would improve conditions.
Wheelchair Users: Suffering in Silence
National conversations about the need for a consumer right to repair in recent years have largely focused on anti-competitive restrictions on repair of agricultural equipment, automobiles and smartphones. However, we uncovered similar practices in the national market for wheelchair service and repair. There, Americans who rely on wheelchairs can be left stranded in a multi-billion-dollar market for Complex Rehabilitation Technology (CRT) like power wheelchairs—part of a $50 billion Durable Medical Equipment (DME) industry that is increasingly dominated by a handful of large, national suppliers.
For wheelchair users in the United States, the rules and the marketplace are stacked against them—and against repair. Requirements forced on wheelchair users by private and public insurers—including publicly funded Medicare and Medicaid programs—put responsibility for repair and service in the hands of authorized CRT suppliers that, together with wheelchair manufacturers, severely restrict access to replacement parts, administrative software and the information needed to repair manual and power wheelchairs and keep them working. Wheelchair users are further hemmed in by consolidation in the marketplace for CRT in the last decade. During this period a handful of large, national suppliers—many backed by private equity firms—have emerged and now dominate the CRT markets in many states, according to industry experts interviewed for this report.
With few choices of suppliers and no easy way to fix their chairs themselves, wheelchair users complain that they endure months-long waits for even simple repairs. Delays in repair and faulty service have also been linked to injuries, hospitalizations and even death, according to interviews and a review of court casesfiled against wheelchair manufacturers and suppliers.
Finally, with modern power wheelchairs increasingly run by sophisticated, Internet-connected software, wheelchair users find themselves in a similar position as agricultural equipment, smartphone and automobile owners: hemmed in by so-called “digital rights management” (DRM) features and software locks that block access to administrative features for wheelchair owners and independent repair shops. As in other sectors, DRM and software locks enable manufacturers to lock out owners and independent service technicians, creating de-facto monopolies for aftermarket service, parts and repair.
Wheelchair Service and Repair: A Broken System
Wheelchair users, advocates for the disabled and those representing CRT suppliers all agree on one thing: the market for wheelchair service and repair is deeply flawed and inefficient. That is, in part, a reflection of the U.S.’s complex and conflicted healthcare system.
Delays in service in repair have many causes. Suppliers point to cumbersome and bureaucratic procedures for obtaining approvals for repairs required by federal Medicare and state Medicaid programs, as well as low reimbursement rates from both private and public insurers that make service and repair a “loss leader” for CRT suppliers. Their customers and disabilities rights advocates often point to bottom line-focused business models at large providers that keep staffing for field service technicians and inventories for replacement parts low, exacerbating the delays created by the health care bureaucracy.
Wanted: A Right to Repair Wheelchairs
Whatever the causes, the dire situation has spawned calls for change and drawn wheelchair users to the front lines of a national fight for the right to repair. In Colorado, for example, House Bill 22-1031, filed by State Representative Brianna Titone, would provide wheelchair owners and independent repair shops with the parts, embedded software, firmware, tools, or documentation to allow them to conduct diagnostic, maintenance, or repair services on the powered wheelchair.
With access to functioning wheelchairs critical for disabled Americans’ livelihoods, their health and their quality of life, regulations like Rep. Titone’s are needed to clear the way for wheelchair users and independent repair providers to service and repair their chairs.
Survey Finds Long Waits for Repairs, Support for New Laws
Support for right to repair laws protecting wheelchair users was one of the clear takeaways from our survey of 141 manual and power wheelchair users. So too was evidence that long wait times of a month or more are the norm, and the biggest issue facing wheelchair users when it comes to service and repair.
For example, when we asked our survey respondents to estimate the average time it takes from initial request to completed repair, 62% of them (87 of 141) said the average repair took 4 or more weeks. And 40% of respondents (56 of 141) estimated it takes 7 or more weeks on average to get a repair completed.
And it’s not that repairs are uncommon occurrences for wheelchair users. Just the opposite. Ninety-three percent of respondents indicated that they have required service in the last year, with 68% indicating they needed two or more repairs in the last year. A month or more of wait time, multiplied by multiple repairs a year adds up to a lot of downtime for wheelchair users. It is not a surprise, then, that 77% of respondents reported that “long wait for service and parts” was among the biggest challenges they have encountered getting wheelchairs serviced and repaired.
Wheelchair users we surveyed overwhelmingly supported legislation to address repair restrictions. For example, when we asked survey takers to indicate how they feel about a new Colorado law, which requires manufacturers of powered wheelchairs to make parts, documentation and service tools available to wheelchair owners and independent 72repair technicians, 83% responded by saying that the new law would “make life better for wheelchair owners by making it easier to get wheelchairs serviced and repaired.” Just 4% indicated it would make life worse, and another 8% said it would have no impact.
Similarly, 69.5% said the “strongly agreed” with the statement “As a wheelchair user, I would benefit from more choices for having my wheelchair serviced and repaired, including the option to repair it myself.”
This report outlines why wheelchair owners, like farmers, hospitals and smartphone owners, would benefit from a legal right to repair their equipment. Absent these and other reforms, wheelchair users will continue to face long wait times for repair that adversely affect their mobility and, with that, their physical and financial well-being. Right to Repair legislation that encompasses complex rehabilitation technology (CRT) devices like power wheelchairs would improve the market for wheelchair repair that would help ensure that disabled Americans receive prompt, high-quality service at an affordable price.