Health Care Dilemmas
22/01/12 05:50
There was a time when a stay in a hospital meant a bed in a ward with several other patients. There was little privacy, but the hospital was not about privacy. It was about providing the care necessary to get one well enough to return home. However, things began to change. By the 1960’s the industry standard in hospital care was the semi-private room. Usually two beds were in each room with curtains to separate. Ambulatory patients shared a bathroom and there were more than a few awkward moments when sound traveled between the halves of the shared room. Too many visitors to a roommate could challenge optimal conditions for recovery. Snoring or other conditions could lead to loss of sleep and slow healing.
The move to private rooms began in intensive care units. The extra equipment, the need for more stringent infection control and other factors meant that each patient needed a separate space in order for care to be provided. Private rooms, however, are now becoming the standard of care in many hospitals. Here in Rapid City, our regional hospital now has two full floors of private rooms. In competition with that hospital is a private hospital with private rooms called guest suites. Part of the competition is played out in increasing amenities for those who occupy the rooms.
Our community hasn’t quite escalated to the level of hospitals in some urban areas. At New York-Presbyterian/Weill Cornell hospital there is an elite wing on the penthouse floor with bed linens by Frette, Italian purveyors of high-thread-count sheets. The bathrooms gleam with polished marble. The huge windows display panoramic views of the city. And each patient is assigned a butler dressed in a black vest. The menus are elaborate and if the rooms are too small to accommodate the desires of the patient, they can be combined.
Hospitals are competing for high-end patients who are willing and able to pay $1,000 and more a day for heightened luxury during their recovery. In some cities luxury hospital rooms can go for as much as $4,500 per day.
Hospitals justify these extravagant units because they produce income that can be invested in other areas of the hospital. Not every service provided by a hospital will break even. But luxury rooms can pay big.
It is a world that I will never occupy and one that I do not understand. I’ve never developed a craving for mushroom risotto with heirloom tomatoes as a menu when I’m feeling ill. I’ve never believed that I deserved a higher level of luxury than other people. I think it simply makes sense to choose a hospital because of the quality of the clinical care rather than the amenities. I am capable of getting well without chocolates on my pillow and fresh roses on the table.
Having said that, if I were to need hospital care, I would be taken to our local hospital that would appear to many of the people in the world as a bastion of luxury. There are plenty of people in the world who have to rely on family or friends to bring their food to them when they are in a hospital. There are plenty of doctors and nurses who struggle to provide care in settings of crumbling buildings, unreliable water sources, and limited resources.
Hospital care, like many other things in life, is not evenly distributed among the people of the world.
The name of the institution, hospital, shares its roots with the Christian discipline, hospitality. Most hospitals have roots in people of faith who were motivated to help others because of their need, not because of their ability to pay. The first hospitals were free charitable institutions founded to provide care when no other care was available. The phenomenon of paying patients in hospitals began in the 1890’s and was slow to take hold.
These days, successful hospitals seek paying patients. Even those who provide services to those who cannot pay need income from those who have insurance and private sources of payment in order to stay in business. There are very few hospitals in the United States that are strictly charitable organizations, deriving their income from donations alone.
The result is a building boom for designers and remodelers. The best in hotel amenities are now being built into many modern hospitals.
The communities, and sometimes the boards of directors of hospitals, are left with a conflict. On the one hand, health care professionals are asking for tax dollars and medical charities are canvassing neighborhoods for donations based on their charitable mission to serve those who are suffering. On the other hand they are spending huge amounts of money to create luxury suites to attract wealthy private patients. The two sides of hospitals come into conflict. There are plenty of stories of a patient lying in pain for hours or even days on a gurney without the most basic of care in a hospital emergency room while elsewhere in the facility there is a patient listening to a Bose stereo and watching a flat-screen TV while eating chef-prepared kosher food served on fine china. It is hard to explain an institution that offers minimal care to one patient while offering five-star comfort to another.
I am no expert in the field of health care. I do not have legislation to propose to the government or even policy to offer to hospital boards of directors. Like many others, I can sense that there is something wrong with our health care system. Like generations of faithful people who have gone before, I can see the need for compassionate care to those who have no money to pay. There have been times when I have been persuaded that hospitals need to generate revenue from high-end patients in order to subsidize the care of others. There have been times when I have been persuaded by the argument that non-profit hospitals should sell of their luxury suites to private companies and focus their attention on care of those who cannot afford to pay thousands of dollars a day. I can see both sides of the argument and I suspect that there are additional perspectives on this complex question.
But, for what it is worth, if the time ever comes when I am admitted to the hospital in a moment of illness and pain, I hope that I wake up in an ordinary room. A roommate is fine with me. A little discomfort is OK. The food need not be stunning. I can share a bathroom. Save the luxury for someone else. Because in my case, if I spend less on my own luxury there will be more to share with those who have genuine need.
The move to private rooms began in intensive care units. The extra equipment, the need for more stringent infection control and other factors meant that each patient needed a separate space in order for care to be provided. Private rooms, however, are now becoming the standard of care in many hospitals. Here in Rapid City, our regional hospital now has two full floors of private rooms. In competition with that hospital is a private hospital with private rooms called guest suites. Part of the competition is played out in increasing amenities for those who occupy the rooms.
Our community hasn’t quite escalated to the level of hospitals in some urban areas. At New York-Presbyterian/Weill Cornell hospital there is an elite wing on the penthouse floor with bed linens by Frette, Italian purveyors of high-thread-count sheets. The bathrooms gleam with polished marble. The huge windows display panoramic views of the city. And each patient is assigned a butler dressed in a black vest. The menus are elaborate and if the rooms are too small to accommodate the desires of the patient, they can be combined.
Hospitals are competing for high-end patients who are willing and able to pay $1,000 and more a day for heightened luxury during their recovery. In some cities luxury hospital rooms can go for as much as $4,500 per day.
Hospitals justify these extravagant units because they produce income that can be invested in other areas of the hospital. Not every service provided by a hospital will break even. But luxury rooms can pay big.
It is a world that I will never occupy and one that I do not understand. I’ve never developed a craving for mushroom risotto with heirloom tomatoes as a menu when I’m feeling ill. I’ve never believed that I deserved a higher level of luxury than other people. I think it simply makes sense to choose a hospital because of the quality of the clinical care rather than the amenities. I am capable of getting well without chocolates on my pillow and fresh roses on the table.
Having said that, if I were to need hospital care, I would be taken to our local hospital that would appear to many of the people in the world as a bastion of luxury. There are plenty of people in the world who have to rely on family or friends to bring their food to them when they are in a hospital. There are plenty of doctors and nurses who struggle to provide care in settings of crumbling buildings, unreliable water sources, and limited resources.
Hospital care, like many other things in life, is not evenly distributed among the people of the world.
The name of the institution, hospital, shares its roots with the Christian discipline, hospitality. Most hospitals have roots in people of faith who were motivated to help others because of their need, not because of their ability to pay. The first hospitals were free charitable institutions founded to provide care when no other care was available. The phenomenon of paying patients in hospitals began in the 1890’s and was slow to take hold.
These days, successful hospitals seek paying patients. Even those who provide services to those who cannot pay need income from those who have insurance and private sources of payment in order to stay in business. There are very few hospitals in the United States that are strictly charitable organizations, deriving their income from donations alone.
The result is a building boom for designers and remodelers. The best in hotel amenities are now being built into many modern hospitals.
The communities, and sometimes the boards of directors of hospitals, are left with a conflict. On the one hand, health care professionals are asking for tax dollars and medical charities are canvassing neighborhoods for donations based on their charitable mission to serve those who are suffering. On the other hand they are spending huge amounts of money to create luxury suites to attract wealthy private patients. The two sides of hospitals come into conflict. There are plenty of stories of a patient lying in pain for hours or even days on a gurney without the most basic of care in a hospital emergency room while elsewhere in the facility there is a patient listening to a Bose stereo and watching a flat-screen TV while eating chef-prepared kosher food served on fine china. It is hard to explain an institution that offers minimal care to one patient while offering five-star comfort to another.
I am no expert in the field of health care. I do not have legislation to propose to the government or even policy to offer to hospital boards of directors. Like many others, I can sense that there is something wrong with our health care system. Like generations of faithful people who have gone before, I can see the need for compassionate care to those who have no money to pay. There have been times when I have been persuaded that hospitals need to generate revenue from high-end patients in order to subsidize the care of others. There have been times when I have been persuaded by the argument that non-profit hospitals should sell of their luxury suites to private companies and focus their attention on care of those who cannot afford to pay thousands of dollars a day. I can see both sides of the argument and I suspect that there are additional perspectives on this complex question.
But, for what it is worth, if the time ever comes when I am admitted to the hospital in a moment of illness and pain, I hope that I wake up in an ordinary room. A roommate is fine with me. A little discomfort is OK. The food need not be stunning. I can share a bathroom. Save the luxury for someone else. Because in my case, if I spend less on my own luxury there will be more to share with those who have genuine need.