The Hidden Burdens of Long-Term Inpatient Treatments: Hospital Parking [Part 1 in series]

Cancer and other diagnoses are stressful enough to receive on their own. However, one overlooked aspect that often causes distress for patients is the burden of parking fees. A recent study published in the Journal of Medical Imaging and Radiation Sciences reveals that these charges go beyond mere annoyance and actually impact the financial well-being of individuals, particularly those battling cancer who require frequent hospital visits for treatments like radiation and chemotherapy.

Mustafa Al Balushi, a radiation oncology resident at the University of Alberta and one of the authors of the study, is beginning his fellowship at the Dana-Farber Cancer Institute and Brigham and Women’s Hospital in Boston, where validated parking fees can reach up to $20 per day. While discussing radiation treatment plans with patients, Al Balushi often witnesses their distress not only over having to pay for parking but also the recurring nature of these expenses, which may be unaffordable for some. This is happening in Canada, a country with a publicly-funded healthcare system where patients typically incur minimal out-of-pocket costs.

The study examined parking rates at cancer centers across Canada, finding that the median daily cost was approximately $7 in U.S. dollars. Researchers then analyzed whether these prices correlated with a city's cost of living, available public transportation, and average median household income. The findings revealed that cities with higher costs of living and better public transportation options tended to have fewer free parking spaces. As a result, individuals driving to larger cities for specialized cancer care had to bear even higher parking expenses.

Similar research conducted in the United States has demonstrated that hospital parking prices contribute to what is known as "financial toxicity." This concept encompasses the idea that dealing with a serious illness like cancer is already stressful and costly, and the situation is further exacerbated when individuals must manage additional expenses such as travel, potential work absences, and loss of income.

While many community hospitals in rural and suburban areas of the U.S. do not charge for parking, individuals seeking specialized care in larger cities with limited parking availability often encounter parking fees. Furthermore, if a loved one remains hospitalized for days, weeks, or even months, families and visitors can accumulate hundreds or even thousands of dollars in parking costs.

Echoing the findings of the Canadian study, parking fees in U.S. cities tend to be higher in areas with a higher cost of living. For instance, New York hospitals often charge $30 or more per day for parking. Houston Methodist imposes a fee of $7 for visits under three hours and a maximum of $13 per day. Indiana University Health's main hospital in Indianapolis charges $5 for visits under two hours and $18 for a full day. The University of California Irvine Medical Center charges $1 for every 20 minutes, capping at $16 per day. Meanwhile, Baylor University Medical Center in Dallas has a daily maximum fee of $5, and parking is free at Detroit Medical Center. These costs listed are for general parking and don't include valet prices. Public transportation is great, but the stops are not always close enough for people who have difficulty walking or are fatigued.

Recently, Rush University Medical Center in Chicago raised its parking prices, stating on its website that the slight increase would contribute to enhancing the parking experience for patients and visitors. Overnight parking at Rush now costs $20, and stays of less than two hours incur a fee of $10. The website mentions the possibility of special parking arrangements for long-term patients.

One cancer patient I spoke to in writing this said that her parking fees are added to her medical bills. The cancer center she is getting treatment at has a payment plan and parking is a miscellaneous expense that is added to the bill. This might be convenient at the time, but does this system cause patients to overlook requesting vouchers or the actual price that they pay?

According to Al Balushi and his colleagues, potential solutions include screening patients to determine their eligibility for travel vouchers or waived parking fees, services that some nonprofit organizations offer. Given the numerous challenges patients already face in accessing treatment, parking should not be an additional burden. "It's ridiculous," emphasized Al Balushi. Some hospitals, clinics and physicians are registering with Uber Health. They provide paid for rides to and from non-urgent appointments, prescription pickup and grocery services for patients. Check with your provider to see if you are eligible for this service.