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Are hospital parking fees a barrier to health care?

Hospital parking fees are essentially user fees in disguise that act as a "barrier to health care," according to a new editorial in the Canadian Medical Journal.

"Parking fees amount to a user fee in disguise and flout the health policy objective of the Canada Health Act," Dr. Rajendra Kale wrote in the editorial, published on Monday.

The primary objective of health policy under the act is "to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers." Having to pay for parking is inconsistent with that objective, Dr. Kale argues.

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He added, "Those opposed to scrapping parking fees for patients need to recognize that such fees are, for all practical purposes, user fees and a barrier to health care. Using revenue generated from such surrogate user fees for health care is against the health policy objective of the Canada Health Act and could become the subject of a legal challenge."

Parking fees are not only a barrier to health care, they can also interfere with the work doctors and nurses are trying to do for their patients, Dr. Kale writes.

"They can and sometimes do interfere with a clinical consultation, reducing the quality of the interaction and therefore of care. Almost every hospital doctor in Canada would be able to narrate anecdotes of patients being preoccupied with parking fees."

But just how much money would hospitals lose if they stopped charging for parking?

Not that much, Dr. Kale argues. He cites the example of The Ottawa Hospital, where "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-centred health care."

Canada should follow the example of National Health Service hospitals in Scotland and Wales, where parking fees were abolished in 2008, Dr. Kale writes.

He concludes by suggesting it would be great to have "volunteer-run valet parking services for patients," which is nice to dream about. But there is a step we can take while we wait for such a glorious day: "Let us start by validating our patients' parking," Dr. Kale says.

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Are hospital parking fees a necessary evil or a barrier to health care?

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