Why is AT so expensive?
Supply and demand
The more specialized a technology’s function, the fewer people’s problems it solves, even if those problems are profoundly important. The fewer people’s problems solved, the smaller that technology’s market. The AT market is smaller than that of non-AT because the pool of people who have a need for (and would therefore purchase) audio description services is simply smaller than the pool of people who would purchase a television. Basic economics tells us that when the demand is low, the price is high. Just nineteen percent of the US population lives with a disability of some kind, with that percentage breaking down further as you split out different AT needs (2012 US Census Bureau). Since this is just a portion of the general US population, the AT market is a much smaller technology pond, hence causing a higher price for AT devices.
Spreading out the cost
Relatedly, when the overhead cost of research, manufacturing, marketing, and supply chain can be spread over a large customer base and pool of manufactured products, the overall cost per product decreases. Since AT companies have a smaller denominator of customers and products to spread their overhead costs over, the price per unit naturally increases. Building polished technologies and experiences is no easy feat, and it certainly does not come cheap. AT is no different. While Apple has the luxury of spreading out its research, design, and development costs of a new iPad over its millions of devices, HIMS can likely only do it over the thousands of braille displays it manufactures and sells.
Why is it important to have affordable AT?
AT Ownership
Many users of AT will inherit their devices from vocational rehabilitation or educational programs. But if their AT device one day breaks or gets stolen, these users might not have the means to replace it, and most insurance companies do not cover AT as “medical necessities” in their plans. In this situation, users are often stuck paying out of pocket (if they can), using a device on loan, or having to live their lives without the AT that they really need, simply because they cannot afford it.
Median household income and employment rate
According to Cornell University’s Disability Statistics, the median annual household income in the US in 2017 that included any working age (21–64) people with a disability was $45,500. For households without a person with a disability, that number was $71,000. A 156% difference.
Additionally, people with disabilities have a lower rate of employment. The US Bureau of Labor Statistics reports that in 2018, the employment-population ratio of persons with a disability was 19.1%, while the employment-population ratio for those without a disability was 65.9%. That means that in 2018 if you did not have a disability, you were approximately 3.5x more likely to be employed than if you did. Given that hiring discrimination is still very much a barrier for people with disabilities despite the Americans with Disabilities Act of 1990, those with disabilities face significant challenges in obtaining and retaining well-paying jobs that would help fund their AT needs.
How might we make AT affordable?
As technology advances and the AT market expands with the growing elderly population, the cost of AT will eventually go down. But in the meantime, what can we do?
Design/Product Thinking + Maker Movement
Design thinking is an iterative approach to problem solving that “relies on the human ability to be intuitive, to recognize patterns, and to construct ideas that are emotionally meaningful as well as functional.” Product thinking is a philosophy and practice of building products that identifies the core user problem, delivers the most value with the least effort, time, and cost, tests assumptions, measures progress, and iterates based on learnings. The Maker Movement is a shift from traditional, waterfall manufacturing processes to rapid, cheap, and DIY tinkering, prototyping, and hacking.
How it works:
- Ask — What’s the problem we’re actually trying to solve? Through research and talking with the end user, “uncover the job the [AT device] is hired for,” and solve for that. Then, what is the minimum technology we need to build in order to solve this problem?
- Prototype — Use whatever tools available (3D printer, laser cutter, tape, re-used cardboard, chopsticks, etc) to prototype something quickly. Make the idea real.
- Test — Put it in front of a real user to gather feedback. Does this solve their problem? Why? Why not? Which of our assumptions proved to be untrue? Why?
- Iterate — Incorporate the feedback and learnings into the next iteration, and rinse and repeat!
Many ATs today are expensive because of their really refined and finessed UX. But what’s the point of a sexy UX if no one can afford the device? AT builders who focus on solving the core problem, prototyping rapidly, and continually testing their assumptions against user feedback have the best chance at delivering the most value to their users. And by doing so quickly without a steep cost, these makers make accessibility accessible.
AT Makers
AT Makers is an awesome organization that sets a prime example of this. AT Makers partners with local high school robotics teams to build quick, cheap, and usable AT. Since these teams are scrappy in their rapid prototyping, they’re able to come up with technology solutions in a fraction of the time and at a fraction of the cost. For many accessibility challenges, perhaps a perfectly buttoned-up device isn’t what’s really needed, but rather a usable technology that really fits the user’s needs and solves their real problems, quickly. Like the 3D printed switch below that cost $2.40 to print and less than an hour to assemble.
Conclusion
AT is expensive, and for many people with disabilities, not being able to afford AT is yet another barrier to equal access. If we start solving real AT users’ needs through design thinking, product thinking, and making, we can deliver real value to users faster and cheaper than traditional models of building technology. All it takes is an inquisitive mind, an empathetic heart, and a tenacious spirit!
