We hear so much about the medical deprivations of the poor in the United States: more than 43 million without health insurance, millions more with skimpy insurance. But what about the rich? They have needs, too, including the need for better than soggy meals and dowdy rooms when illness necessitates a hospital stay.
Fortunately, the marketplace is responsive to wealth, which is only proper in a nation where politics has consigned health care to the marketplace. A number of America's premier hospitals, in competition for patients, have begun to advertise resort-like facilities along with boasts about their medical skills.
Thanks to a recent report in the Wall Street Journal, we now have an independent, nationwide view of hospitalization on the luxury scale. After a survey of 10 hospitals, the newspaper bestowed its highest award, five stethoscopes, on the Memorial Sloan-Kettering Cancer Center in New York. Atop regular room rates, the premium for "special suites" in that institution ranges from $525 to $2,800 a day, charges rarely covered by insurance.
"Open just a year," the Journal reported, "this was the most over-the-top facility we visited. . . . The nurses' station is paneled with rippled mahogany from a single distressed tree. The furnishings are English and Italian mahogany antiques and reproductions." The chef's specialty is butternut-squash ravioli, but there is also "all of New York from which to order."
As experts warn us, while hospitals heal, they are also dangerous places, and Sloan-Kettering goes to great lengths to protect its wealthy patients. For those whose struggle with cancer is compounded by the threat of assassination, Sloan-Kettering not only screens visitors but, the Journal notes, "If that fails, there is a bulletproof wall." At Johns Hopkins Hospital in Baltimore -- four stethoscopes, meaning "posh" -- "armed guards" are among the amenities. At the Washington Hospital Center, also rated posh, security in the luxury suites relies on locked doors and buzzers, but the ambiance, for a premium of only $365 a day, was likened to "a swank hotel, right down to the embossed stationery in the rooms."
In luxury hospitalization, as with other goods and services, the wise shopper must recognize that high cost does not necessarily equate with quality. Despite a $662 daily premium, the lowest rating among the surveyed hospitals, one stethoscope -- signifying "don't bother" -- was awarded to Cedars-Sinai Medical Center in Los Angeles, where, it was noted, "Elizabeth Taylor checked in last week, and so did Frank Sinatra before his death." The chef's specialty is lobster tail with drawn butter, and, uniquely among the hospitals, "pet therapy" is listed as a "special feature." But the surveyors found it "a shock to peek inside one of the famous luxury suites and find the hospital equivalent of a Holiday Inn."
Befitting our free-enterprise health care system, luxury hospitals differed in their souvenir policies. Mt. Sinai Medical Center in New York -- rated posh -- charges patients $100 if they wish to take home their hospital robe, whereas Sloan-Kettering offers the robe and slippers without charge. On the other hand, the chef's specialty at Mt. Sinai is "grilled rack of lamb with rosemary scented jus."
Despite health care's inequalities, egalitarianism still pervades the industry's rhetoric. And so it is not surprising to find hospital administrators insisting that "the level of medical care itself is no higher in the luxury wings than in the rest of the facility," according to the Journal.
Perhaps. But in researching the outcomes of medical services, it might be enlightening to compare the fates of luxury patients, ordinary patients and the uninsured. For all we know, lamb with rosemary scented jus might be detrimental to health.
Daniel S. Greenberg is a science journalist.