By Tiffany J. Gunter
It’s Monday morning, and thousands are gearing up to start their week by boarding their local bus — not only to get to work and school, but to get life-saving medical care. Dialysis at 6 a.m. Three-times-a week cancer treatments. Appointments that catch health problems before they become an emergency.
For these riders, public transit isn’t about mobility. It’s about survival.
I know this personally. My father suffered from kidney failure and needed dialysis three times a week. On good days, he drove himself. On bad days — when a snowstorm hit or when fatigue set in — he would skip treatments. There were services available to help, but he resisted them. He didn’t want to use public transit. He feared what it would look like. That stigma, that shame, cost him. He missed appointments. He died at 62.
I carry that truth with me every day. And I think of the thousands across our region who still face that same choice. The care exists. But access — safe, reliable, respectful access — does not always follow.
At SMART, we provide about 1,000 paratransit rides a day. Roughly half are for nonemergency medical needs like dialysis, therapy and specialist visits. Last year alone, we delivered more than 200,000 paratransit rides and 7 million fixed-route rides. And it’s not just patients. Many of our riders are nurses, aides, technicians or caregivers who keep our hospitals and clinics running. When a bus doesn’t show up, patients and professionals don’t either.
Without these rides, people miss treatments. Hospitals see more no-shows and health care costs rise. Missed dialysis turns into a 911 call. Missed preventative care turns into a hospital admission. This isn’t just about transit. It’s about public health.
For people who can’t drive, can’t afford a car or need extra support — whether because of age, ability, or income — public transit is a lifeline. It gives people independence and it gives communities a fighting chance at staying healthy and connected.
But today, Michigan is moving in the wrong direction. State funding for transit is falling behind, just as demand for reliable transportation is growing. If proposed cuts are implemented, routes will shrink. Our neighbors and our loved ones will fall through the cracks. Some already are.
It doesn’t have to be this way.
With the right investment, we can strengthen our system. We can provide safer shelters, more frequent routes, better technology and expanded door-to-door options. We can deliver service with the quality our riders deserve.
And when transit is delivered with quality, it is seen as quality. That shift in public perception matters because there is dignity in riding transit, and people should feel pride, not stigma, when they step onto a bus.
You may never have to take a bus to the doctor. But chances are, the person who greets you at the hospital, fills your prescription or hands you your smoothie on the way home may have. The ability to show up depends on transit.
Transit is health care infrastructure. And treating it as anything less puts lives at risk. Michigan cannot afford to cut that lifeline. State leaders must increase transit funding, not reduce it, to protect the health of our communities.
Let’s choose a future that respects people’s needs. Let’s fund transit like it matters. Because it does.
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Tiffany J. Gunter is the general manager and CEO of the Suburban Mobility Authority for Regional Transportation (SMART), Southeast Michigan’s regional bus system, helping people connect to work, school, medical appointments, shopping centers, entertainment and cultural events.
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