St. Peter's Times
November 7, 2005
Some Need More Air To Take Flight
Those who use medical oxygen may win easier access from airlines, which often shut them out.
By Steve Huettel

Hilde Hanson was delighted to find a $430 airfare to Germany to visit her 92-year-old mother for Christmas last year.

But the great deal quickly turned pricey. Delta Air Lines told Hanson, who suffers from emphysema, that federal regulations didn't allow use of her portable oxygen machine on board. Delta provided oxygen for the trip, for an additional $400.

"The rate was not so cut-rate any more," says Hanson, 65, a retired real estate agent living in Lakeland.

As many as 1-million Americans that require medical oxygen and aren't homebound face numerous obstacles flying commercial airlines, if they can fly at all.

Discount carriers such as Southwest Airlines and JetBlue Airways won't sell them a ticket. The same goes for regional airlines that often make the only flights into small cities. Some airlines like Delta offer oxygen, but charge from $75 to $150 for each leg of a trip.

Now there's encouraging news for travelers who require oxygen. In a move that alarmed airlines, the Department of Transportation has proposed requiring that airlines provide free oxygen for such passengers or let them use oxygen-generating devices deemed safe by the Federal Aviation Administration.

"Passengers who use oxygen deserve the same access to our air transportation system as do travelers with other disabilities or medical conditions," said Transportation Secretary Norman Mineta when the draft rule was released Sept. 7.

Airlines already mired in a four-year financial slump say they could be burdened with new costs beyond simply giving away oxygen.

Discount carriers and regional airlines that aren't certified to handle hazardous materials such as compressed gasses would need extensive training for workers. Dispensing oxygen would gum up procedures to quickly load and unload planes so they can fly more hours each day, said a Southwest spokeswoman.

Trade groups for large and small airlines wrote the Transportation Department that the proposal raises "enormous technical, operational and cost issues." The agency extended the deadline for filing comments from today to Jan.30.

Meanwhile, two airlines recently began allowing passengers to use a personal oxygen device, called a portable oxygen concentrator, on their flights.

Concentrators filter nitrogen out of the air, providing a concentrated dose of oxygen. The FAA determined that two models were safe on aircraft and gave airlines permission to allow them on flights.

In the last two weeks, Northwest Airlines and US Airways began letting passengers use concentrators. Other airlines, including American Airlines and Southwest are testing the devices and hope to allow them soon.

But advocates for the disabled say the FAA rules don't go far enough. Airlines can choose not to let passengers bring their own oxygen concentrators. And the devices aren't cheap. One of the approved models, the Inogen One, carries a retail list price of $5,495.

The American Lung Association says only the Transportation Department proposal would give people on oxygen, mostly sufferers of emphysema and chronic bronchitis, the same opportunities to fly as everyone else.

"There are literally hundreds of thousands of people for whom air travel is prohibitively expensive, unavailable or inconvenient because of the current rules in place," said Paul Billings, the group's vice president of national policy and advocacy.

"We hear all the time from people who can't go see grandchildren, can't attend a graduation or the funeral of a loved one. You can see why a lot of these people just give up on the airlines."

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The FAA prohibits passengers from bringing their own oxygen tanks on commercial aircraft for obvious safety reasons.

Oxygen spewing from a malfunctioning tank could ignite and cause a disastrous fire. The danger was underscored by crash of ValuJet Flight 592 in the Florida Everglades in 1996, which killed all 110 people on board.

That fire was sparked not by tanks but oxygen generators, devices that create tremendous heat as they produce oxygen for passengers to breathe in emergencies. The generators were wrongfully being transported in the plane's cargo hold.

The crash set back a growing campaign to make it easier for people requiring oxygen to fly on commercial airlines, Billings said.

A breakthrough came as technology improved so manufacturers could make portable oxygen concentrators, which don't produce enough oxygen to sustain a fire, small enough for air travel.

That put more pressure on the Transportation Department to address complaints from travelers that airline policies made flying too difficult and expensive. The agency is responsible for making sure airlines don't discriminate against people with disabilities.

"We view it as one of the biggest areas of disabled travel concerns with air transportation," said Sam Podberesky, an assistant general counsel with the Transportation Department.

A consultant's study for the agency estimated that between 750,000 and 800,000 Americans require medical oxygen and are healthy enough to fly.

The number is closer to 1-million because the report counted only Medicare patients, not people younger than 65 or in the Veterans Affairs Department health system, according to Phil Porte, executive director of the National Home Oxygen Patient's Association.

* * *

Either way, only about 67,000 medical oxygen patients per year go through the expense and hassle to fly commercial airlines, according to the consulting firm.

Consumers report it's getting worse as financial conditions at traditional airlines deteriorate and they cut flights, Podberesky said. That leaves more flying to discounters and regional airlines that don't provide oxygen.

"In many markets, people cannot find the air transportation they need or avail themselves of low-cost carrier service," Podberesky said.

Snowbird John Beddall of West Chester, Pa., bought first-class tickets last summer to Fort Myers on US Airways for the annual migration he and his wife make each winter to Florida. A sufferer of chronic obstructive pulmonary disease, he also ordered oxygen.

His travel agent called in August with strange news: The airline had stopped flying passengers needing medical oxygen and would refund his two $1,016 tickets. US Airways had merged with discounter America West and adopted its partner's no-fly policy for oxygen patients.

"I think that's ridiculous," said Beddall, who will take Amtrak's Auto Train to Sanford this week, then drive to Naples.

Airlines are deferring to their industry trade groups to make an official response to the Transportation Department. But they're not happy about the proposal.

American Airlines tries to break even charging passengers $100 per flight for oxygen and would absorb "a significant cost" giving it away, said spokesman Tim Smith.

Like other low-cost airlines, Southwest relies on running lean and keeping things simple, spokeswoman Whitney Eichinger said.

The cost of employee training for handling hazardous material like compressed gases "long ago led us to the conclusion that the nature of our operation would not permit us to furnish oxygen," she said.

The proposal stuck a raw nerve with Robb Boscardin, an airline employee from Scottsdale, Ariz., who took issue with people upset over the price of oxygen.

"If you cannot afford a service - and that's what this is - then you simply go without," he wrote in a comment posted on a Transportation Department Web site. "If that means you travel by bus, or - gasp! - don't travel at all, then so be it."

--Steve Huettel can be reached at or 813 226-3384.