How Healthcare Charges Drive Us Crazy and What It Means for Your Health
Many years back I was part of a team that built a hospital in Glasgow Scotland. It was the product of US and UK innovation built on a contaminated site used for shipbuilding in past decades. The project was a lot of fun and to this day many of the lessons learned remain relevant. Sadly it never fulfilled its dream of being a center of excellence and international hub for treatment and was ultimately sold to the NHS to become the “Golden Jubilee Hospital” and its associated 4-Star Hotel now the “Golden Jubilee Conference Hotel”
Parking
One of the many arguments that took place between the various leaders was around parking. My American colleagues had come from a world where parking was seen as a source of income. In the UK the vast majority of healthcare facilities provided free parking to their patients and their employees. There were exceptions in high-density areas – the hospital where I trained was in Hampstead, London, and parking was always at a premium so the limited parking available was carefully controlled, and that included charging. For most of us, patients and staff alike, parking had to be found in the surrounding streets.
I remember clearly one animated discussion between our (American) CEO, Jim, and our (British) CFO, Andrew on parking. Jim had been exploring vendors to install parking barriers and controls in the facility. Andrew was having a hard time explaining to Jim that the visiting patients and public would not tolerate paid parking and the expectation was for free parking. Jim was unconvinced. It was a standard form of additional revenue and quite profitable from his experience in the US. Even with outsourced management of the parking. Ultimately the local customs won out – although from what I hear the UK has veered away from this in recent years and paying for parking might be a more frequent occurrence.
Separate Charges for Everything
Living in the US I find myself constantly frustrated by the high charges for parking at healthcare facilities. More often than not designed to maximize revenue. While I recognize the need to run a business the costs mount up in every direction you turn and parking is just yet another. On the one hand, I have adjusted, or at least I thought I had, right up until a recent visit for an appointment where I found his sign outside the parking garage of the healthcare facility
Parking Charges Suspended
“Please pardon our appearance as we work to upgrade our parking equipment
Pull forward
There is no charge during this upgrade”
My mood lifted and I thought I had won the lottery! We are not talking a lot here – the maximum charge is $12 for this facility. Even though I have never been for an appointment that lasted more than an hour I am always close to this maximum based on the way the time is priced at $9. A small amount of money but a big lift in mood and general outlook. I felt energized and happy!
But it got me thinking. If such a simple gesture made such a difference in my mood. What did it do for my health, my recovery, and general well-being? Given that I visit the facility for the purposes of taking care. of my health, the negative impact of yet another bill slapped on right as I leave the facility is clearly having a negative impact.
I understand the economics here but does nickel and diming patients to squeeze additional revenue really make sense and could it be harming outcomes through negative perception and mood? That cost could easily be absorbed into a general overhead and if rationing the available space is a problem there are other easier ways. Validation comes to mind. In the interim, don’t be like Pipeline Health, an operator of safety net hospitals that viewed available parking at its Louis Weiss Memorial Hospital as a liquidation asset to sell off and develop into luxury apartments.
Patients need easy access to the facilities they have to visit. Driving is one of the main forms of transportation and that makes parking essential services. How that’s made available to patients can make a big difference not just in mood but perhaps also in clinical outcomes. I left the facility with a spring in my step. My mood lifted and feeling very positive. Was it all because of the parking “win” – I doubt it but that certainly was a big contributor.
As another data point, the same thing happened at the Clane Hospital in Ireland – a small regional facility that was the anchor to the community. My mother-in-law has been visiting this for years – recently taken over by an American company and privatized. Not only have they raised all the fees but they have also introduced parking fees making it difficult and more expensive for patients and visitors. Everyone in the community is upset and the community feeling has been lost. Did that really help?
Am I wrong – is it just my Britishness that has me balking at the charges for parking or is this something that everyone feels but just silently accepts as yet another aspect of the healthcare service that continues to fail to meet the ultimate goal of servicing their customers, the patient?
What do you think?
