Fee vs. free

The Compass - - EDITORIAL -

There’s also the rev­enue in­volved: in 2015-16, East­ern Health’s gross rev­enue from pa­tient and vis­i­tor park­ing fees was $1.57 mil­lion.

In Prince Ed­ward Is­land, it was the $250,000 ques­tion. But in the end, the prov­ince’s min­is­ter of health, Robert Hen­der­son, said the an­swer was a mat­ter of fair­ness.

“We de­cided that this was an is­sue that we think that will help im­prove ac­cess to ser­vices and not be an im­ped­i­ment, es­pe­cially for low in­come Is­lan­ders who do have fi­nan­cial challenges here in the prov­ince. So this is a way to level the play­ing field,” Hen­der­son told the CBC as, on July 1, that prov­ince dropped park­ing fees at the Queen El­iz­a­beth Hos­pi­tal for guests and vis­i­tors.

Can­celling hos­pi­tal park­ing fees is up for dis­cus­sion in Nova Sco­tia now, too, where a much big­ger fig­ure is in­volved - park­ing fees at hos­pi­tals in that prov­ince bring in al­most $10 mil­lion an­nu­ally. While long-term pa­tients and out­pa­tients re­ceive spe­cial rates, other vis­i­tors and pa­tients cough up a daily park­ing max­i­mum of $14.50 a day.

The Nova Sco­tia Health Coali­tion told CBC Nova Sco­tia that it’s just plain wrong.

“One of the cor­ner­stones of Canada’s pub­lic health-care sys­tem is the fact that you should be able to ac­cess it equally re­gard­less of where you live or how much money is in your pocket,” the coali­tion’s provin­cial co-ordinator, Chris Parsons, said on Sun­day. “It’s a bur­den that we think is re­ally un­fair to put on fam­i­lies.”

So what about this prov­ince? The ar­gu­ment has been made here be­fore: can­cer sur­vivor Tom Bad­cock even took East­ern Health to court in 2013 over park­ing fees and tick­ets, say­ing the fees are es­sen­tially a charge to see a doc­tor, and are there­fore a violation of the Canada Health Act. That’s a po­si­tion that the Cana­dian Med­i­cal As­so­ci­a­tion Journal (CMAJ) agreed with: in a 2011 ed­i­to­rial, they sug­gested the fees are a bar­rier to health care, and a not-so-well-hid­den user fee.

More re­cently, the fees in St. John’s have been in the news as pa­tients who have to re­turn to the hos­pi­tal reg­u­larly for treat­ment - es­pe­cially can­cer pa­tients - have ar­gued they de­serve easier ac­cess to hos­pi­tal ser­vices be­cause of their in­abil­ity to walk long dis­tances.

There have been sev­eral reasons given over the years for keep­ing the fees in place - one reason, in fact, for an in­crease in prices was the need to keep the spa­ces away from other peo­ple. That is, to keep Memo­rial Univer­sity stu­dents from fill­ing up cheaper park­ing spots in Health Sci­ences lots.

There’s also the rev­enue in­volved: in 2015-16, East­ern Health’s gross rev­enue from pa­tient and vis­i­tor park­ing fees was $1.57 mil­lion. Its es­ti­mated gross rev­enue in 2016-17 is $1.39 mil­lion. The au­thor­ity says park­ing-fee rev­enues will be put to­ward up­grades of park­ing lots and roads at East­ern Health fa­cil­i­ties.

Crit­ics of the CMAJ ed­i­to­rial pointed out that, in On­tario, only about 74 per cent of hos­pi­tal costs are cov­ered by the gov­ern­ment. The rest comes from rentals, fees for pri­vate rooms and, yes, park­ing.

Those who would have the fees dropped - and those, like Hen­der­son, who are mak­ing sure the fees dis­ap­pear - cer­tainly have a valid point.

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