Monday, January 25, 2016

Hospital Parking: Is this a Big Issue for Patients/Caregivers?

A couple of years ago I was asked to participate in a consultation as part of the Patients First initiative conducted by Alberta Health Services.  I participated with a group of patient families.  Many familiar themes were heard.  Being involved in Family Centred Care for several years, you start hearing the same issues over and over.  Parking costs are a subject that usually comes up with people who have spent significant amount of time at a hospital.  I have some theories as to why parking is often raised as an issue by families, and I don't think all of it is financial (something I may address another time.)  The fact remains that for many patients and caregivers this is a real issue.  In our own situation it is not hard to rack up costs of over $100 for a 3 day hospital stay.  Two parents doing overlapping shifts at a hospital is a very costly proposition if you plan on parking.

So let's make parking at hospitals free.  Good idea?  Let's think about that for a second.

Given the location where most hospitals are located, parking is expensive.  Something that requires a great deal of infrastructure.  Free parking is just not realistic.  Many argue that patients and their families don't chose to be sick but pay exorbitant hospital parking costs out of necessity.  They feel like they are being taken advantage of.  The reason for this is not because people have a problem paying for parking, the problem is how the fees apply to patients.  The way the fee structure works is set-up for long term "parkers" like staff; not for infrequent uses like patients.  The fees are also set-up to maximize profit.  I have no problem with profit, but if it unfairly targets patients I do think that is a legit issue.  I don't believe parking was intentionally set-up to target families, I just don't think how families use parking is something anyone ever thought of.  Like many things in health care.

Patients feel ripped off because often times they go to the hospital and wait.  While they wait for whatever appointment or procedure is being done the parking fees are mounting.  A patient does not control how long they have to wait.  What they pay for parking is just one more thing in the health care system that they don't have control over.  Loss of control is a huge issue to patients, and their families, and parking represents another thing they have no control over.

The other issue related to parking is that hospitals generate a significant amount of revenue from parking which helps support hospital operations.  How significant are these revenues.  In Ontario, parking fees represent $100 Million dollars annually.  That is important revenue that pays to support parking infrastructure and other hospital services.  For government to subsidize parking just takes health care funding from one bucket to another.  It doesn't really accomplish anything.  I take issue with health care funding being used to support non-health related costs. There has to be better ways to address this issue.

So how can we help patients and their families?

This is where I have a confession to make.  I can afford to pay for parking.  It isn't going to compromise my lifestyle to pay for hospital parking.  When my son is in hospital, and my wife and I park two vehicles we pay a ridiculous amount.  Notice what I said..."we take two vehicles."  If we can afford to own, operate, and insure two vehicles we should be able to afford to park them.  I don't like it but we should be honest about this issue.  Also, we qualify for the Disability Tax Credit which saves us a huge amount on taxes.  The purpose of this credit is to acknowledge that people with disabilities incur significant costs related to how they manage their disability.  We have absolutely nothing to complain about. That is "our" situation, that is not true of all families.

My proposal to offset some of these costs would be to change how some parking costs are charged to recognize how families use parking at a hospital differently than staff or other people who go to a hospital for work/business.  Here are a couple of family friendly ideas; I am sure there are others:

In/Out Privileges

In/Out privileges would be a huge plus.  When you are staying with someone at the hospital you need to leave and come back to deal with other life issues that are going on. Sometimes it is just a good thing to get out of the hospital to get a dose of fresh air and a home cooked meal.  Perhaps, you are balancing work and being a caregiver.  You could be going to the hospital a couple of times a day.  Each time starting a new tab.  The first hour in the parkade will be your most expensive.  Which brings me to my next point.

Change Fee Structures

My issue with the way parking fees work is that they unintentionally target patient families.  Many times we go to hospital for clinic appointments or blood work.  Often times I am there just long enough to incur the half day rate; which kicks in after 60 minutes.  I end up paying for 3 hours of parking that I don't use.  Using meters aren't a great option either because patients have no control over how much time they are going to spend.  You may have to run out and plug your meter or risk a parking ticket.  Not easy to do if you are their by yourself with a toddler and waiting for a Doctor. You don't want to miss your turn.  Some suggest that having day/weekly passes may help.  One of the problems with this scenario is that our visits to the hospital are often unpredictable.  Length of stays can vary dramatically.  Again, something patients have very little control over.


My previous two suggestions do require a loss in parking revenue, albeit not a huge impact, but it is a loss.  That is an important consideration.  My third  suggestion involves using modern parking technology.  Hospitals do seem like they are still stuck in the technological back woods at times, an industry still dependent on fax machines.  My technological solution is to use pre-paid parking passes that could be pre loaded and used in any hospital parkade.  That is not a cost saving but it allows some interesting possibilities.

There are many friends, supporters, and charities that could help with parking costs for people who legitimately can't afford it.  Many charitable organizations are realizing the extensive non-medical costs related to health care.  The David Foster Foundation is an organization that was set-up exclusively to address non-medical costs incurred by families going through the organ transplant process.  An absolutely fabulous organization.  When we were in hospital for 157 days there were many times that we were approached by concerned friends wondering if they could help us out financially.  There are people willing to help but the way parking at hospitals are set-up it makes it difficult to address.  Having pre-paid passes could allow charitable organizations or concerned friends to purchase passes for a patient or their family.  It would be a meaningful and tangible way to help.  I am aware of at least one organization that has tried to help out families with parking costs but there was no effective way of doing it so the project was abandoned.  Pre-paid cards could make this a really easy process.  It would just require a change in parking technology.  The key benefit is that this would not effect health care funding.  The other benefit is that this is a direct benefit to families who need it.  It is time for all of us to realize that there are many costs in health care that are not covered by our government systems.  We need effective ways to offset these costs.  This is just one way of doing it.

These are just a couple of ideas that can make a difficult time for families a little easier.  I am sure there are many other ways that can help, we just need to be a little bit more creative.

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