Rethinking access: the Internet, people with disabilities, and good planning

Access. Although the word has a very broad definition, that definition has come to mean something very specific in the era of the Affordable Care Act: health insurance. But access is much bigger than that.

A number of cases regarding the accessibility of Internet sites have recently hit the courts. The idea being advanced by the people bringing these cases is that if the Internet is a public space, then Title III of the Americans with Disabilities Act (ADA) should apply. That law requires equal access to public accommodations and commercial facilities for people with disabilities.

The results of these cases so far have varied. The federal Ninth Circuit Court of Appeals recently ruled in two cases, one brought against eBay and one against Netflix, that Title III requires a connection to an "actual, physical place." Since websites do not meet that requirement, the ADA does not apply.

The U.S. District Court for the District of Vermont came to a different conclusion. In a case against Scribd, a subscription service that provides access to digital documents such as ebooks and comic books, the court decided that the company's website does qualify as a place of public accommodation under the ADA. The case focused on the website's lack of an interface that would allow users who are blind or have other visual impairments to shop. Some people have reacted with concern to this ruling, since compliance could be costly for other companies that operate websites.

Then there's another approach. It may just be good business to provide content to users who need help accessing it. Recently, in response to users advocating for improved accessibility for people who are blind and people with visual impairments, Netflix began to provide content with audio descriptions.

According to Netflix's blog post announcing the change, an audio description "is a narration track that describes what is happening on-screen, including physical actions, facial expressions, costumes, settings and scene changes." (Click here for an example of a movie trailer with an audio description.)

Whether designing health care systems or providing entertainment content, we should try to plan for every user and consider the range of individual access needs, whether it be for audio descriptions, subtitles, or content in different languages. And it's important to remember that accessibility isn't a problem limited to people who are visually impaired or hearing impaired. Many people need subtitles to decipher the dialogue in The Wire.

Most of us will need help accessing systems in one way or another at some point in our lives. We may get that help through the law, through responsive business strategy, or through good planning. Let's encourage the last one and build systems that work for everyone.

___________

Marcelo H. Fernandez-Viña is a third-year student concentrating in health law at Drexel's Kline School of Law.

-----

Have a health care question or frustration? Share your story »