Every year, 3.6 million Americans miss medical appointments due to transportation challenges. Ride-sharing companies have pounced on this reality by partnering with health insurers, hospital systems, and other stakeholders to get patients to and from the doctor’s office. But according to a study conducted earlier this year, many patients are not taking advantage of these services.
In the March 2018 issue of JAMA Internal Medicine, three researchers reported that the missed appointment rate in a Philadelphia-based study was not significantly different between patients who were offered rideshare transportation services (scheduled by staff) and those in the control group. This finding led one of the lead authors to comment, “Transportation is often a barrier to care for many patients, but solutions that don’t address other barriers may not be enough to help patients get to doctor appointments.”
As a disabled woman who regularly relies upon Lyft to get to medical appointments, I have an idea what one of the potential “other barriers” might be: drivers’ degrading treatment of patrons with disabilities and government-issued insurance.
I live with fibromyalgia as well as mental disabilities, and I am on California’s Inland Empire Health Plan (IEHP) program. Through this program, I qualify for free Lyft rides to and from routine doctor visits. Nearly all of my rides begin with drivers letting me know they know I am an IEHP patient. They do this is the same breath that they confirm my identity: “You’re Alexis, and you have IEHP.” The first time this happened, I was as shocked as I was uncomfortable. Does it really matter who’s paying for the ride? I thought. You’re going to get paid.
Apparently, it does matter. When drivers know that the state is paying for my ride, they take liberties that they wouldn’t dream of taking with other passengers, such as my non-disabled twin sister who takes Lyfts from my complex without an ounce of trouble. Whereas her drivers are polite, on time, and willing to come into my apartment complex, mine are confrontational and refuse to enter the complex despite the fact that I am visibly in pain and reliant on a device. After limping to their car around the block, they claim not to know my address, even though I can see it on Google Maps on their phone. Or, they stay on their phone texting for another five minutes, as if I have nowhere important to go. Never mind what happens if I miss the appointment.
Once, a driver used his phone to get concert tickets while driving. He finally looked up to ask if I knew where I was going. Perhaps he thought that, since I wasn’t personally paying for the ride, I did not deserve the full service that other passengers take for granted. Also, whereas my sister is often asked if she is comfortable or if she would like the temperature adjusted, my drivers blast music and air conditioning, both of which impact my conditions.
“Some people in my situation have told me that they have trouble securing rides—until they remove insurance information.”
Perhaps I am expected to feel grateful that drivers come at all. After all, many persons with disabilities have reported that Uber and Lyft cars cruise right by after seeing their service dog, wheelchair, or other mobility device. This practice is so common that Uber responded by pledging to remove drivers for knowingly denying service to riders with disabilities. Lyft implemented its own rules shortly thereafter, but the discrimination reports against drivers continue to increase, according to the non-profit Disability Rights Advocates.
Some people in my situation have told me that they have trouble securing rides—until they remove insurance information. Once this information is no longer visible, they have several drivers nearby and available to pick them up.
It is shameful that having government-issued insurance means being treated as a second-class citizen who is not deserving of courtesy and respect. I live in pain every day and badly need to go to my doctors’ appointments. I dread calling for a ride because I am the person known as “IEHP.” But like many others, I will do so because I have no other choice.