Oxygen Is Not a Luxury: Why portable oxygen is essential to health equity, independence, and human dignity
For many people, oxygen is invisible. It is simply there — drawn into the lungs without thought, carried through the body, and converted into the energy required to walk, work, speak, laugh, travel, and live. But for someone living with interstitial lung disease, oxygen can become something far more conscious. It can shape how we plan a day, whether we leave home, how far we walk, and whether an ordinary activity feels possible or uncertain.
That is why supplemental oxygen must never be treated as a luxury, an accessory, or a sign of weakness. When medically prescribed, it is an essential therapy. Portable oxygen can mean mobility, independence, dignity, and the confidence to participate in everyday life. On World Oxygen Day, I want to speak not only about oxygen as a medical need, but also about oxygen access as a question of fairness and human dignity.
Living with an illness others may not see
Interstitial lung disease is not always visible to the people around us. A person may look well while living with breathlessness, fatigue, reduced exercise tolerance, or anxiety about oxygen levels. This gap between appearance and experience can lead to misunderstanding. People may assume that if someone can sit comfortably, speak normally, or smile for a photograph, the illness cannot be serious. Yet many respiratory limitations become apparent only during exertion — while walking, climbing stairs, carrying a bag, moving through an airport, or managing a demanding day.
This invisibility creates a second burden. Alongside the physical effort of breathing, people may feel pressure to explain, justify, or minimize their needs. Some hesitate to use oxygen in public because they fear being stared at, pitied, or judged. Others may restrict their movement because the equipment is heavy, difficult to refill, expensive, or unavailable where they need it. In such circumstances, the problem is not only the disease. It is also the environment that fails to accommodate the person living with it. The value of portable oxygen cannot be measured only in liters per minute or hours of battery life. Its true value is found in the life it makes possible. It may allow a parent to attend a child’s school event, a teacher to return to the classroom, an employee to travel to work, or an older adult to visit family. It may make it possible to walk through a market, attend a medical appointment without fear, join a social gathering, or take a short journey. These activities may appear ordinary, but illness can reveal how precious ordinary life truly is.
These activities may appear ordinary, but illness can reveal how precious ordinary life truly is.
Portable oxygen also offers psychological reassurance. Breathlessness can create fear, and fear can progressively narrow a person’s world. When patients have the therapy and equipment appropriate to their clinical needs, they may feel more confident about leaving home and participating in daily life. Oxygen does not define a person’s identity; it can help protect the freedom to express that identity beyond the confines of illness.
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Public understanding of supplemental oxygen is often shaped by dramatic images of intensive care. As a result, oxygen may be associated only with medical emergencies or the final stages of illness. This image is incomplete. Oxygen can also be part of planned long-term care, pulmonary rehabilitation, exertional support, or daily disease management, depending on an individual’s assessment and prescription. Another misconception is that using oxygen will make the lungs lazy or create dependence in the way an addictive substance does. Oxygen therapy should, of course, be used only on medical advice and at the prescribed flow and duration. But when a person meets the clinical criteria, the purpose is to correct or prevent inadequate oxygenation — not to surrender to illness. We also need to stop equating medical equipment with incapacity. Glasses assist vision, hearing aids assist hearing, and walking devices support mobility. Oxygen equipment supports a physiological need. None of these devices makes a person less capable, less intelligent, or less worthy of participating in society. The stigma attached to visible oxygen equipment says more about our limited understanding than it does about the person using it.
A prescription alone does not guarantee meaningful access. A person needs a reliable supply, suitable equipment, professional guidance, maintenance support, and a realistic way to pay. If only large or stationary systems are available, treatment can unintentionally confine someone to the home. If portable systems are unaffordable, mobility becomes linked to income. If cylinders cannot be refilled easily, travel becomes risky. If batteries, servicing, or backup arrangements are inadequate, the user is left with uncertainty rather than independence. Access also varies across geography. People living far from specialist hospitals or dependable suppliers may face additional logistical burdens. The cost is not merely financial: families may lose work time, travel long distances, or reorganize their lives around refilling and maintaining equipment. These hidden costs need to be recognized when health systems evaluate whether oxygen is truly accessible. In this sense, oxygen access is a health-equity issue. Two patients with similar clinical needs should not experience radically different freedom simply because one can afford a lightweight portable system and the other cannot. Essential respiratory support must not become a privilege available only to those with the right location, income, insurance, or social connections.
Healthcare rightly focuses on survival, disease control, and measurable clinical outcomes. But patients also care about autonomy, identity, relationships, and participation. We want to contribute, teach, work, travel when possible, spend time with family, and remain present in the social world. A therapy should therefore be judged partly by whether it helps people live, not merely remain alive. Dignity includes being able to make choices, move through public spaces, and take part in family and community life without unnecessary barriers. Portable oxygen may be the bridge between treatment and participation. When that bridge is absent or unaffordable, exclusion can become an avoidable consequence of illness.
What can policymakers and healthcare systems do?
The first step is to recognize oxygen as an essential part of the care continuum—from diagnosis and hospital treatment to home-based and ambulatory support. Planning must go beyond emergency oxygen supply and include the long-term realities of people living with chronic respiratory and cardiopulmonary conditions. Governments, insurers, hospitals, and suppliers should work toward affordable rental and reimbursement models for prescribed home and portable oxygen. Clinical pathways should assess not only oxygen need at rest but, where appropriate, oxygenation during activity and the patient’s functional needs. Patients and caregivers need clear training on safe use, equipment care, travel planning, and when to seek medical help. Standards for equipment quality, servicing, refill reliability, and backup provision are equally important. Portability must be considered in practice, not merely in product labels: weight, battery duration, noise, manoeuvrability, availability of consumables, and ease of maintenance all affect whether a system genuinely supports daily life. Public institutions can also remove practical barriers. Transport operators, workplaces, educational institutions, and public venues need clear, humane policies for medically prescribed oxygen. No one should face unnecessary embarrassment or exclusion simply because staff members do not understand the equipment or the person’s rights and needs.
Policy discussions often rely on budgets, procurement figures, bed capacity, and clinical indicators. These are important, but they do not fully capture what happens when a person declines an invitation because the oxygen system is too cumbersome, misses an appointment because a refill is unavailable, or worries about whether a battery will last through a journey. Lived experience gives these decisions a human scale. When patients and caregivers share their stories, they reveal the difference between nominal access and usable access. They show that a device can be technically available yet practically inaccessible, or clinically suitable yet financially out of reach. Speaking openly also reduces stigma. Every honest account helps others understand that using oxygen is not a personal failure. It is a responsible response to a medical condition. Patient voices should therefore be included in the design of respiratory services, procurement decisions, discharge planning, insurance policies, and accessibility standards.
Advocacy does not always begin with a large campaign. It can begin with a conversation. We can correct a misconception when we hear one. We can ask whether a hospital has explained portable options. We can encourage workplaces and public institutions to develop oxygen-friendly policies. We can support patient groups that document access gaps and amplify the experiences of people whose voices are often missing from formal decision-making. Healthcare professionals can ask patients what they need to do in their everyday lives, not only how they feel in the consultation room. Researchers can study affordability, mobility, quality of life, and regional disparities alongside clinical outcomes. Journalists and communicators can portray oxygen users as whole people — not as symbols of tragedy. Policymakers can involve patients early, before systems and contracts are designed. Those of us who live with lung disease can contribute by sharing what we are comfortable sharing. We do not owe anyone our private medical story, but when we choose to speak, our experience can challenge assumptions and help shape better care.
A call for oxygen justice
World Oxygen Day should remind us that oxygen is both universal and unequally accessible. The molecule is everywhere, yet the medical systems required to deliver it safely and effectively are not. That contradiction demands attention. I hope for a future in which no patient has to choose between mobility and affordability; no family has to struggle alone with unreliable supply; no person feels ashamed to use prescribed oxygen in public; and no healthcare system considers treatment complete while the patient remains effectively confined at home. For someone living with interstitial lung disease, portable oxygen can represent far more than a piece of equipment. It can mean the freedom to step outside, the confidence to participate, and the dignity of continuing to live as fully as possible. Oxygen access is not a luxury. It is healthcare. It is equity. It is human dignity.
Saswat Barpanda is a Associate Professor in Goa Institute of Management, India. He teaches organizational Behavior, Human Resource Management to Healthcare Management cohort.
