Getting sick isn’t an adventure

The last time I stepped on a plane for for fun was more than three years ago.

And yet, I'm told, I've been on two journeys: a "traumatic brain injury journey," experienced at Johns Hopkins Hospital after I banged my head and developed trouble with balance and gait. More recently, I've been a traveling companion on my husband's cancer journey at Memorial Sloan Kettering in New York City.

So much of being seriously ill has been rebranded in American health care as a kind of adventure. Experts speak of stroke journeys. Hospital systems invite people on kidney transplant journeys. The heart failure journey even comes with a map.

But on these journeys, you don't get to go anywhere, except maybe the hospital or doctor's office. In the past two decades, American hospitals have gotten into the business of hotel-like hospitality (illness can be fun!) rather than confine themselves to the business of disease (what a downer).

And although the care might stay solid, the focus on luxurious amenities and fancy new buildings that house them is one of the factors that has helped send costs for patients soaring that much higher, to prices well above those in other developed countries.

In this version of health care, I'm no longer a patient. I'm a client, a customer, or a guest. I appreciate a little luxury and privacy as much as the next person. But at a time when Americans' life spans are getting shorter and four in 10 adults say they've delayed or gone without necessary care because of cost, is it worth it?

Tight budgets, staffing shortages and burnout have hit American hospitals. At the same time, many health centers in the U.S. have morphed into seven-star hotels. New hospital buildings, such as recent projects at the University of Michigan hospital system and Valley Hospital in Paramus, N.J., offer all-private rooms with couches and flat-screen TVs. A hospital might boast about views, high-thread-count sheets, and food provided by a Michelin-starred chef.

The industry knows that even small comforts can make us feel better, regardless of whether we're getting better. In 2008, researchers at the National Bureau of Economic Research estimated that a hospital investing in amenities would increase demand by 38 percent; a similar investment in clinical quality would lead to only a 13 percent increase. Hospital executives told The Boston Globe that the main reason hospitals have moved in this direction is that "people's expectations have changed," and it creates a "competitive advantage" that can be marketed to potential customers.

So the Mayo Clinic offers complimentary concierge services, which can help with recommending nearby restaurants and finding pet care. Cleveland Clinic, which employs a team of curators, owns one of the largest contemporary art collections in the region, and its leaders see that collection as one tool for "positively affecting patient outcomes." Patients at Cedars-Sinai can experience its "therapeutic art collection" of Chagalls, Picassos and Oldenburgs.

This transformation from hospital to hospitality has filled up hospital C-suites with chief experience officers, whose function is to " manage patients' experiences throughout their health-care journey," as described by the publication HealthTech. Cleveland Clinic was the first major academic medical center to add one in 2007; some health systems hire for this and similar positions directly from the hospitality industry, picking people who'd previously been managers at a Ritz-Carlton or a Trump hotel.

The American Hospital Association defends the transformation. "These are not just 'nice to haves,'" Nancy Foster, AHA's vice president of quality and patient-safety policy, wrote to me in an email. "Actions hospitals can take to reduce stress and provide other psychological support can have a meaningful impact on one's physical and behavioral health, including the ability to recover more rapidly."

But these amenities have a cost, and are not worth nearly what we're paying for them as we're billed for $100,000 joint replacements and $9,000 CT scans. Room charges in many hospitals can exceed $1,000 a night. A hospital's function is to diagnose and to heal, at a price that sick people can afford.

How about focusing on the basic things that health systems in the U.S. should do, but in many cases do not, like making it easier for patients to schedule appointments? Shortening wait times to see physicians who take insurance plans? Paying for adequate staffing on nights and weekends so patients don't linger in bed pointlessly for two days until social workers return on Monday? Or ending two-day stays in emergency rooms when all inpatient beds are full?

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