Reuters

Not all parking fees are created equal, and some may amount to a hidden medical cost

Hospitals are, by definition, a distressing destination. There are the waiting rooms, the gowns, the needles and, for many patients – once they’ve gotten through all of that, and worse – the final indignity: the $5, $10, $15 bill to exit the parking lot.

Parking critics have made a strong case (including in Atlantic Cities) for charging people what society really pays to pave parking spots. But maybe the hospital is the exception. 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 (especially for patients who must travel great distances to get there).

Hospitals simply defy a lot of the economic theory around parking, which assumes that people will rationally find another way to get where they need to go if cities and businesses stop giving spaces away for free. But it’s one thing to price some drivers out of a movie theater lot. If patients can’t afford to pay to park at the doctor’s office – well, that’s a public health problem.

Scotland and Wales have already banned parking fees at National Health Service hospitals. And an editorial [PDF] this week in the Canadian Medical Association Journal forcefully lobbies for the same policy in Canada. Hospital parking fees, argues interim editor-in-chief Rajendra Kale, are nothing less than health care user fees.

Almost every hospital doctor in Canada would be able to narrate anecdotes of patients being preoccupied with parking fees. Such distraction interferes with the clinical consultation. For example, some patients (who have often waited several weeks to see a doctor) try to end a consultation abruptly when they realize that they will have to pay for an additional hour for parking. This is parking-centred health care, which is not compatible with patient-centred health care.

Kale estimates that the net income from parking is likely only about 1 percent of total revenue for most hospitals – a sacrifice he says Canadian hospitals can afford to make in the service of meeting the national health plan’s mission to “facilitate reasonable access to health services without financial or other barriers.”

Of course, this is an idea that’s more workable in countries with nationalized health care than in places like the U.S., where the federal government struggles to keep tabs on the cost of care itself, let alone what people pay to park to get it. England, though, has declined to follow the example other British outposts (and reportedly makes millions in the process). Politicians there have warned of an unseemly hospital free-parking free-for-all.

Kale implicitly indicts such countries in his stinging conclusion:

A more civilized society might offer volunteer-run valet parking services for patients, but I admit that we are far from this utopia. Let us start by validating our patients’ parking. This would be an important step for patient-centred health care.

Photo credit: Phil Noble/Reuters

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