I was commiserating with a patient about the cost of parking at our medical center. Depending on the length of a visit, the ticket in the garage here can cost $5 to $10. Not a fortune, but if you need to see your doctor monthly, it adds up. “Ah, doctor,” she said, “this is the problem: It is too expensive to stay healthy!”
Her comment made me think again about co-payments, that $10, $15, or $25 you fork over to see someone like me even before your insurance company decides if it will cover your entire visit and all the tests you need.
The actual charge for the visit and associated tests is much more than that, of course, though people with health insurance rarely see the actual charge for the visit. So why does the co-pay exist, if it’s such a small fraction of the total cost?
Research shows quite clearly that a little co-payment—whether for a medication or a doctor’s visit—leads people to think twice about using medical resources. Higher co-payments (or percentages of the cost borne by the patient) lead to fewer visits.
Some argue this is a good thing: A small co-payment leads to responsible use of health-care resources. If a doctor’s visit were completely free, they reason, the insured might as well go to the doctor with every issue, major or minor, and costs would go up without added value. But co-payments are effective in controlling unnecessary visits.
Others see this as a major inequity, and an expensive one: Poorer or less well-insured people are less likely to be able to afford the co-payment (or may have no insurance at all and fear having to pay even more), and they therefore avoid seeing the doctor until something catastrophic happens. And one catastrophe is far more expensive than a few office visits.
Alas, the second camp is correct. The experiment linked to above showed that, in fact, higher co-payments seemed to lead to poorer overall health in a high-risk population. Other data derived from the same experiment suggest that co-payments may be self-defeating as a way of controlling the cost of health care: Fewer office visits lead to more hospitalizations, and more health-care spending.
So, as I was talking to my patient, I was thinking to myself about an experiment I may propose. I can’t control the co-payment her insurance charges, but maybe she’s not the only patient in our clinic who skips appointments because of the garage fees. The hospital where I work spends a lot of money on advertising, trying to convince people to come to see us instead of the other hospitals in town. I wonder what would happen if my hospital used this as a marketing tool and became the only one in town that didn’t charge patients for parking. The patients would certainly be happier, and maybe they’d come more often—and stay healthier, too.
Comments (10)
Nice to see some business thinking going into this issue. Certainly this is what banks have done: gained a competitive edge by finally breaking out of “bank hours” and offering service early in the morning and in the evening when people don’t have to take time off work just to make a deposit. So i think that’s a great idea: combining a concern for patient’s health with a hospital’s self-interest in drawing customers.
Dr. Rifkin is right. Instead of hospitals spending millions of dollars each year promoting themselves, they ought to pay for parking.
I’m pretty healthy, so I rarely go to doctors – and when I do, they’re in small offices with parking lots.
I thought hospitals were already validating parking tickets. Silly me.
Our local hospital goes a step further-free valet parking! I’ll go there rather than another place because parking is a non-issue.
Also needed to be considered is the overbooking of appointments by doctors which often mean a much longer time away from work by the patients. Emergency patients cannot be prevented, but a call to the patient’s cell phone that “the doctor is running very late” is a nice gesture.
One reason I love Orlando Regional Healthcare System is in addition to outstanding care and service, your parking is complimentary when you use your 55 Plus card. A really great asset to healthcare systems and a convenience to the patient. I keep my 55 Plus card in a pocket on the sun visor. It is convenient to just press it against the window when approaching the attendant and he/she waves you on through. I love ORHS
In about 25 years of visiting my primary doctor, it recently occured to me that he overbooks. Also, in the many years with this doctor, I have never visited his office without witnessing a pharmaceutical salesperson (usually a really good looking female) making her pitch. The doctor has time for her, but will not take my phone calls. This is one of several reasons I am searching for another primary doctor to care for my health needs
IN MY LOCAL HOSPITAL IF YOU ARE PATCIANT I GET A TOKEN FROM THR NURSE WHEN I LEAVE BUT IF YOU ARE A VISITOR YOU PAY FOR PARKING. MY OTHER IS THAT HOSPITAL DO NOT NEED TO ADVERTISE IF YOU ARE IN NEED OF A HOSPITAL IN AN EMERGENCY YOU TO THE NEAREST HOSPITAL AND IF YOU HAVE TO THE HOSPITAL FOR OTHER REASONS YOU GO TO THE HOSPITAL OF YOUR DOCTOR.
I really hate over booking doctors. I use the opportunity to let the receptionist know that I also have many degrees and my time is valuable and I will only wait 60 minutes. I will then leave a bill for the doctor to pay for my missed hours at work and not return. I have had a doctor call me and ask me if I was serious and I stated yes I was his office billed if I didnt cancel before 24 hours and I can only wait 60 minutes before I need to move on. It usually works they get the cranky people in faster.
UAB and The Kirkland Clinic in downtown Birmingham, AL are really wonderful in taking care of you. There is a parking fee but it is not high and yes they validate it to to make it even less. Also the longest I have ever waited for my doctor is 30 minutes. And if they can get me in early they do. Dr. Snyder is a terrific doctor. Who tries to take care of you. I know you pay co-pay but that is the insuranc. But I have also noticed that you pay more if you don’t have insurance. Some how I think the insurance companies work their magic and get a better rate to pay.
if you got 2 insurances like me why to doctors still charge the co pay some doctors office does and some don’t why?