• NICUs cost how many thousands per day? And parents need charities for parking?

    Yeah, I know. The government is set to shut down on Tuesday—by non-coincidence the very day health insurance exchanges open for business for ObamaCare. And I’m about to talk about hospital parking?

    Bear with me. This is actually an important issue: The incredible way our health system so terribly disserves families caring for loved-ones with serious illnesses.

    Today’s Chicago Tribune includes a front-page feel-good story about a new charity’s efforts to making parking free for families with babies receiving neonatal intensive care. The Tribune story notes: “Foundation will cover garage or mass transit costs for parents of critically ill infants.” It begins with a poignant description:

    Wide-eyed Brody Rubenstein, connected to tubes and swaddled in a striped hospital blanket, was born 19 days ago with a hole in his diaphragm and many of his tiny organs pushed upward into his chest.

    His parents, Neil and Amy, have spent nearly every day at his side, and added to their many worries is this: the cost of parking their car across the street from Lurie Children’s Hospital of Chicago. They’ve already spent about $250.

    But starting Monday, the cost of parking will no longer be a concern. The Rubensteins and other families with babies in the neonatal intensive care unit will be handed passes for parking or public transportation that will allow them to come and go for free.

    The Jackson Chance Foundation is stepping in to help. This worthy organization has raised $200,000 to help NICU families with free parking and transit passes. It’s a terrific cause. Yet it’s revealing and pathetic that such efforts are even needed.

    The average daily cost of NICU care in the United States exceeds $3,000. I’m going to go out on a limb and guess that Lurie Children’s hospital –one of the nation’s most prestigious—charges even more. The Tribune reports that the average length of stay in Lurie’s NICU is 27 days. So average expenditures are nearing $100,000. If these infants need MRI scans, intricate procedures and tests, they will get these costly services. NICUs are wonderful places. Showpieces of modern medicine, these are responsible for a marked reduction of infant mortality.

    And herein lays the irony. Alongside these medical miracles, we struggle to find $20 per day so families going through incredible difficulties have a place to park. And that’s only parking.

    I’ve worked with Ronald McDonald House, which happens to have outstanding facilities in Chicago serving Lurie Children’s, the University of Chicago, and other area hospitals. RMHC does a great service for families of critically-ill infants and children. These families often come a long way for specialty care. Families need a place to stay, somewhere to eat so they aren’t spending surprising amounts of money in the hospital cafeteria. They need a place for sanity and sleep when a child has cancer, cardiac problems, or other serious illnesses. RMHC facilities do a great job, though the need is greater than they can fully address.

    Notice something else, too. Charities such as Jackson Chance Foundation and RMHC are worthy ventures for families of cute and cuddly kids. But what about the hundreds of thousands of adults with cancer or serious cardiac disease? What about their families?

    As I’ve noted here, my father was recently sick with a scary cancer. We spent thousands of dollars on hotel rooms, food, laundry, transportation, and more, as we managed the logistics of being there as a family to help with his care. He got excellent and humane care, and these expenses were not a serious hardship for us. They certainly would have been for many other Americans.

    Our health care system—particularly our leading academic medical centers—often do a great job providing expensive, high-tech medicine. These same institutions and the wider health care and social service system do a horrible job addressing the economic, logistical, and other life challenges that predictably confront patients and their families given the practical realities of serious illness. (I’m not even considering even more challenging situations, such as indigent patients with HIV or other ailments who require costly emergency department visits and costly nursing home services made worse by their lack of much-less-costly secure housing.)

    I’m glad that families such as the Rubensteins can get free parking. It’s pathetic that they even need to ask. It’s a depressing commentary that this obvious bit of humanity merits a newspaper headline.

    @haroldpollack

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    • Just wanted to echo your comments about RMHC. Both of my kids were preemies (we got free parking). Since the NICU is 90 miles from our home, the RMHC was crucial for us. Not even to even think about lodging or meals during that time was a blessing.

    • C’mon Harold, how do you expect the poor hospital to survive if they don’t extract $20 a day in parking from families dealing with sick relatives?

    • Cincinnati Children’s: Largest children’s hospital in the country; parking is free for anyone who does business with them.

    • Lord knows, if they included the parking in the charges it’d be probably be $4,000 a day — the hospital would be loading the cost of parking for every darn staff member onto that’s patients parking space.

    • In all your concern for families, do you have no concern
      for the magnified problems of the single and childfree patient,
      whose friends, lovers and informal family might even be denied the
      rights of visitation? Why the hell should families get special
      attention and privileges?

    • My sympathies flow freely to the people who must take on the burden of those costs, but…what’s the alternative? Housing, food, laundry service, transportation – these things cost money to provide.

      Should the hospital provide them, and pass the cost along to the patients? Even assuming they take no profit (not even return on the capital investments), it’s dubious that a hospital can match the prices of the industries that specialize in those goods. So instead of a $100k medical bill and a $5k family/friend sundries bill, you have a $110k medical bill that includes (hospital-grade) hoteling and meals. How’s that better?

    • Hospital parking costs are an issue in Canada too. The problem here is that the facilities use the revenue (from both visitors and staff) to finance crucial non-insured (non-care) areas such as equipment maintenance and purchases, and it’s impossible for visitors to observe how much worse most facilities would be without that injection of cash.

      I agree with you on how pathetic this is. It’s also a disturbing reminder of the absolute power of rent-seeking and its contribution to poverty.

    • It is common for parking structures to be owned separately from hospitals, which creates complicated business relationships for discounting parking. Hospitals, however, have definite medical reasons to comp parking for NICU parents because they are needed daily for kangaroo care for the infant. You make the case for humane reasons the hospital should waive parking fees, but there are evidence-based medical reasons that a hospital would want to make sure there were no barriers, such as parking fees, for NICU parents.

      Another administrative issue that NICUs highlight are the lack of flexibility in maternity policies. I haven’t seen any statistics on this but most maternity leave clocks start on the birth date with no options to stop or delay once started. This means that leave can expire before the baby is even discharged. Several friends have had to deal with this headache. One had an HR person that allowed her to accumulate flextime by working half days so she could be home the first week following her son’s NICU discharge (but then swore her to secrecy because the HR person thought she could be fired for allowing this exception. ??). Another was lucky that her husband’s paternity policy didn’t have automatic start dates so he was able to start his paternity leave clock the day of their daughter’s NICU discharge. Anecdotes don’t suggest patterns or trends, but it seems that as the number of infants born early and requiring NICU stays have increased that maternity leave policies have not kept pace and adjusted to the possibility of this reality.

    • We see this every day, our nonprofit (Miracle Babies http://www.miraclebabies.org) has been providing assistance to families with NICU babies since 2009. The importance for babies who are in the NICU to see their parents, especially the mother are health related and greatly increase the chance for survival and earlier release from NICU. The mothers need to come daily to breast feed, breast milk is proven to increase health and recovery. Touch factor is also a major issue, these babies are struggling the need for skin to skin contact. I empathize with other patients and the high costs of parking and other related barriers. There are hundreds of nonprofits dedicated to cancer patients and those with heart disease. There are very few dedicated to the underserved NICU families and that is because less families than the other categories but that doesn’t mean they are any less deserving.