Is Hospital Parking an Obstacle for Health Care? Part 1

This blog series will be analyzing the highly debated topic of hospitals charging for parking. Today we will be taking the stance against this charge and exploring the arguments backing up this stance. Becker’s Hospital Report tells us that “Parking fees are not universal across all U.S. hospitals, but where they do exist, patients have displayed increasing levels of dissatisfaction.” This dissatisfaction tends to stem from people feeling that these are hidden user fees that, ultimately, create an obstacle for people and stop them from getting the health care they need. Andre Picard, from the Globe and Mail, stated that these fees “are a burden for many patients and their families, especially if they spend a lot of time in the hospital because of a severe illness or injury.” There are many examples that demonstrate how quickly this minor burden can become unbearable. One patient at UNC Health Care in Chapel Hill, N.C. has been told that they will be an inpatient for two months, due to chemotherapy treatments. To visit him, according to a News & Observer report, his wife will have to pay “$8 per day, or $500 total during that time, to visit him.”

The claim that one’s significant other should be able to visit their loved one in a hospital is raised to another level with a different example of support, a parent supporting a sick child. Vanessa Milne, Andreas Laupacis and Mike Tierney from Healthy Debate published an article that depicted a Hospital for Sick Children where “visitors pay up to $20 a day and parents can buy monthly passes for $200, which adds up to $2,400 a year.” Susan Kuczynski, a parent liaison for Ontario Parents Advocating for Children with Cancer, captured this sentiment by stating “I understand the visitor having to pay the rate-that’s a choice. As a parent, you don’t have a choice.”

Dr. Rajendrea Kale states that this is not the only issue with such a fee, but that it also can interfere with doctors’ and nurses’ ability to carry out their job. “They can, and sometimes do, interfere with a clinical consultation, reducing the quality of the interaction and therefore of care."

The Healthy Debate article included a drastic example from Shalimar Novak, a woman who is pregnant and tired of paying for parking. “She and her husband have decided they’ll probably take a taxi to the hospital when she goes into labour, rather than dealing with the hassle and cost of days of parking.” While this dramatic and, albeit, comical proclamation may seem absurd, it is one that pro-hospital parking charges people have argued. A lot of economic theory surrounding parking states that people will rationally find another way to get where they need to go if cities and businesses stop giving spaces away for free. However, there is a distinct difference between finding parking while out to eat and going to a hospital. Picard captures this distinction well by stating, “The glib suggestion that patients take public transit is unrealistic. Most people are not treated conveniently in their neighborhood, and many travel long distances for care.” This claim is reinforced by Emily Badger, from CityLab, as she reminds us that “people don’t really have a choice about when to go there. And often, they don’t have a choice about how to get there either, as many hospitals are located beyond the reach of public transit.” Emily concludes that these fees are in fact a public health issue because “if patients can’t afford to pay to park at the doctor’s office” then they will be lacking the proper health care that they need.

Many pro-hospital parking charges argue that this cost is needed to fiscally maintain the hospitals, but Dr. Kale argues that this is a charge that most hospitals could do without. For example, in The Ottawa Hospital "for the fiscal year 2011/2012, the net parking revenue is projected at $10.8 million while the total revenue is about $1.16 billion, excluding revenue from parking. That is a small sum to pay to get rid of parking-centered health care." This issue has become substantial enough within Ontario that, recently, their government has promised to cap or cut this fee.

Dr. Kale maintains that, ideally, we could all follow the example of Scotland and Wales, where their National Health Service hospitals abolished parking fees in 2008. He goes even further to say that, even more ideally, all hospitals could have “have volunteer-run valet parking services for patients,” However, he acknowledges that this is far from being achieved in the near future and concludes by stating, "Let us start by validating our patients' parking."

Stay tuned for the second part of this blog series: Why hospitals need to charge for parking!

The Vark Team