Oct 10th, 2017, 05:56 PM

A Tale of Two Crutches

By Imani Barbarin
Underarm crutches. Image Credit: Shutterstock/Varandah
Comparing healthcare through the lens of mobility aids.

For patients with injuries and disabilities, the Tale of Two Crutches, whether to use forearm or underarm style mobility aids, is a competition to see how much pain one can withstand—or how much pain you can afford not to experience.

When I walk into a room, I count the people that look like me—those with mobility aids. Usually it helps me gauge just how accessible a venue is and how accommodating the function will try to be. When I notice someone using the same kind of crutches as me, forearm, this usually tells me that someone has a long-term disability as opposed to underarm crutches, which are most commonly used for temporary injuries in the U.S. Moving to Paris has thrown my time-honored system out of whack, and with the healthcare debate back home, I have realized that the way Americans treat injuries is based on a lie.

The general consensus around using forearm crutches in the U.S. healthcare system is that they’re designed for more permanent disabilities because they are more comfortable for long-term use. The system pays no mind to underarm crutch users who complain about underarm, shoulder and back pain. Yet in France, everyone uses forearm crutches regardless of their level of mobility or the severity of their injuries. The reason for this difference between France and the United States when it comes to mobility aids, hits at the core of the healthcare debate that plagues U.S. discourse: it is a little thing called money.

Image Credit: Shutterstock/Romaset

As innocuous as it sounds, each hospital in the United States uses what is called a, charge master to bill insurance companies for the cost of products and services. But often, the prices in these documents are greatly inflated so that the hospital can turn a profit after negotiations with said insurance companies. So, hospitals can charge hundreds of dollars for the same forearm crutches I use (which I bought on Amazon for $50 because the last nice pair I bought I broke while I was playing dodgeball) while, like the bell-bottom resurgence in the early 2000s, underarm crutches remain cheap because they’ve flooded the market. On the other hand, what we find with the socialized healthcare and social security system in France, there is less of a financial incentive to go cheap on crutches. French health authorities are more concerned with people healing properly, so that they return to the workforce and are less likely to need the social safety nets available to them in the future.

From a philosophical perspective, I believe that this difference in treatment goes deeper than crutches. France views healthcare as a right, where the U.S. sees it as a privilege—even when patients are able to pay for their insurance. In France, the health of the individual is of greater importance to the public as it lessens the public’s responsibility through social security programs. Therefore, the most economical choice is to invest in crutches that cause less pain, allowing patients to heal properly, so that they are less likely to need to use the system in the future.

Americans view healthcare as an expensive, and often exclusive, privilege. With recent Affordable Care Act repeal efforts by the GOP-led government, this view has led to massive protests by disabled advocates who are the least likely to be able to afford care should protections for pre-existing conditions be gutted. For those unable to afford it, and even those who can, healthcare is going to be as uncomfortable as possible, so insurance companies can have less to pay but hospitals can still accrue a profit.

#ADAPTandRESIST protest against the repeal and replace of the affordable care act. It was to demonstrate how much of a struggle or pain it is to acquire healthcare in the states. Image Credit: Twitter