The Hospital Wheelchair is the Ultimate Example of the Process of “Cheap-olution” - Erik Kondo

Cheap-olution is the process of evolving a product through years of successive designs (evolution) to enable the manufacturing of the product at the absolute lowest price possible (cheap) while still maintaining the bare minimum of functionality.

IMO, the institutional hospital wheelchair is the pinnacle example of cheap-olution. The most widely selling hospital wheelchairs have been designed in such a manner they can’t be mass produced any cheaper and still be (barely) functional (in limited environments).

I have been contacted by a number of people who want to improve the functionality of their hospital wheelchair. What I have to explain to them is that it is impossible to make their wheelchair perform better without spending money. The reason a hospital wheelchair performs so poorly is because every aspect of it represents the lowest possible cost. Therefore, any change will require purchasing more expensive parts or changing the geometry to a more expensive configuration.

A hospital wheelchair uses the cheapest materials possible. The design of a hospital wheelchair enables the cheapest manufacturing processes. Once the endstage of cheap-olution has been reached, you have to spend money to return it to something that performs better.

For example, a bolt is less expensive than a quick release axle. A plastic wheel with plastic tread is cheaper than a metal wheel with spokes and tires. Steel is cheaper than aluminum. A hole in the frame is cheaper than a mounting bracket. Screws are cheaper than nuts and bolts. A fixed axle position is cheaper than an adjustable axle position. One-size-fits-all is cheaper than customization. The list goes on.

Hospital wheelchairs from years past were made with higher quality materials and design features until they started the process of cheap-olution. This is a unique situation where both the manufacturing cost and functionality have decreased overtime. Contrast this situation to popular consumer products that have become less expensive over time, but their functionality has increased, such as personal computers. A mobile phone may have become more expensive in price overtime (the iPhone), but it is leaps and bounds ahead in terms of what it can do with each new version.

If you are using a hospital wheelchair, it is important to realize that its baseline of functionality is very low. However it is functioning for you, there is an existing model of wheelchair that would work better for you. The difference is that it will cost more. Generally speaking, your wheelchair mobility output is highly dependent on economic considerations.

An able-bodied person is highly debilitated by using a hospital wheelchair too. Not just because they are using a wheelchair, but because they are using a hospital wheelchair. This is an important distinction.

Society has determined that the value of wheelchair mobility is very low. Therefore, it accepts the poor mobility output created by hospital wheelchairs. You get what you pay for. Society is unwilling to spend more than the absolute bare minimum on hospital wheelchairs. Hence, the cheap-olution process.

People who walk don’t buy flip flops and think they are an acceptable form of all-around footwear. They understand the importance proper footwear makes for their mobility. Why would a wheelchair be any different?

On a final note, there are many people whose personal financial situation forces them to use a cheap hospital wheelchair. In this case, the fact that the wheelchair is so inexpensive allows them to afford it.

The problem is not the availability of very cheap wheelchairs for those who cannot afford to pay more. The problem is the widespread societal acceptance that the poor functionality of this type of wheelchair is an acceptable choice for people, institutions, and insurance companies like Medicare that are able to pay more but choose not to because they don’t realize (or care) that it matters.