Social Question

tom_g's avatar

Why is this considered acceptable?

Asked by tom_g (16638points) October 8th, 2012

Recently, a family member gave birth in a local hospital that had recently undergone remodeling. In fact, the entire wing of the hospital, including maternity, was new. Following her birth, she spent a few days in one of the maternity rooms. The room was huge and included a gas fireplace, flatscreen tv, a seperate section for the husband, which included a bed/couch, chairs, privacy curtain, a desk , and an additional flat screen tv.

The room next door was less than half the size and had none of the amenities. Of course, my initial reaction was one of disgust. This is clearly unfair to anyone who happens to get stuck in one of the smaller rooms. After some digging, I discovered that about half the rooms are the luxurious monstrosity that I was able to experience. The other half are cramped. According to the staff, it’s just pure luck and birth order that drives the room assignment.

So, my question is this: How can a hospital justify this? They had the chance to build a maternity wing from scratch, and decided to build 2 different experiences – for no apparent reason. The obvious solution (from my perspective) is to build all rooms the same.

My wife is a lactation consultant at a different, older hospital. There are big differences in the size and quality of the maternity rooms, but the building was built so long ago. Many of the smaller rooms were originally something else that was co-opted later on to accommodate more people.

Anyway, can anyone describe a reasonable explanation for such difference in services? Maybe I’m overlooking something. Is it possible that it’s not just luck? Is it possible that the hospital really does charge insurance companies a higher amount for the fancier rooms, so determination of room is based on health insurance (or lack of)?

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24 Answers

janbb's avatar

It sure seems unfair and unnecessarily unequal. I can only surmise that they are anticipating a way to make more profit on the luxury suites at some point down the road if they are not already.

marinelife's avatar

I am surprised that it is luck who gets them. Other hospitals charge for this like Cedars-Sinai.

tom_g's avatar

Wow. Thanks, @marinelife. I had no idea. This raises a ton of questions. “From our elegant accommodations to the extra personal care we provide, we know how to pamper mothers and their new babies.” How exactly does this work? Do they provide extra staff that are designed to cater to these wealthy new moms, or does the staff make care for these people a higher priority.
Admittedly, I am hung up on fairness. I think it’s a good thing. But I suppose I see no harm if people want to blow extra money such things – as long as it doesn’t affect the level of care the hospital provides to other patients.
Maybe…just a maybe here…the hospital usually does charge more for the huge room that my sister received. But since her birth was extremely difficult maybe they made an exception because the room had opened up. I don’t know. They were assured there is no additional charge.

sinscriven's avatar

Hospitals are for-profit entities, so makes sense they’d have “upgrades” to milk more money out of affluent patients or really good health coverage.

everyone else on crappy PPOs and on state funded medi-care? To the closet!

Coloma's avatar

It doesn’t bother me, it seems each family can choose for themselves if they want to accept or reject the nicer birthing digs.
Maybe their reasoning was to build a few luxury rooms and use them on a first come, first serve policy which allows any expectant mother to potentially get the royal treatment depending on availability.

Really, it’s not any different than choosing a basic room or the nicest suite available in a hotel. I see nothing wrong with offering a little extra luxury to those that want or can afford it. It’s just another option.

tom_g's avatar

@Coloma: “Maybe their reasoning was to build a few luxury rooms and use them on a first come, first serve policy which allows any expectant mother to potentially get the royal treatment depending on availability.”

I think there must be something else at work here, like @marinelife pointed out. If it were just a matter of first come, first serve, though – I have a definite problem with that. If I’m paying the same money as the family next to me, how could this not create some resentment. Include the knowledge that this unfair situation was the result of people making a decision recently to inject unequal service into a brand new wing of a hospital.

Facade's avatar

I don’t know why people are surprised by this. In the US, you only get the type of care that you can pay for. Quality “things” cost money in every area of life.

SpatzieLover's avatar

One of my SIL’s gave birth in what appeared to be an awkward shaped closet (sort of pie slice shaped). She had to give birth in said room, then stay in said room for over a week. We went to visit her over 24hrs after the birth of this child. The room floor still had dried blood bubbles (I nearly fainted and vomited…had to leave)...

The irony of the above story^^^^ She was in a hospital well-known for their birthing rooms. It had supposedly just been remodeled with the supposed same amenities you listed in your details above, @tom_g.

CWOTUS's avatar

It’s elementary economics. It’s why filet mignon costs more than hamburger, and why a Mercedes costs more than a Chevy.

The hospital can’t make all of their rooms luxury suites; they simply don’t have the resources to devote to that (and all of the more Spartan rooms may have been designed simply as “overflow”, to use on the “birthing spike” days of the year – which can be planned for to some extent) [I’m pretty sure the chart is in there somewhere, but I don’t have the time to look it up with certainty.]

So they make an educated guess as to which rooms will be in more or less continuous use and plan that for their 80% utilization. The others they have so they don’t have to leave maternity cases in “other wards” or in the hallway, or turn the cases away completely.

Coloma's avatar

@tom_g Who knows, but yes, luxury options are options, not really good or bad, just options.
I gave birth in a regular birthing suite and was treated to a steak and champagne private dinner with my husband at the time, it was part of the package and I was not charged extra for the celebratory meal. Personally I think it’s silly, who the hell wants to watch TV when they have a new baby to entertain them and when in the middle of labor a woman is hardly concerned with the ambiance of her room.
When I was in the final stages of labor I could have been in a tent in the weeds and would not have given a damn about my surroundings, only to be done with the process. lol

tom_g's avatar

@Coloma – I agree that the luxury suite is silly. In fact, not to sidetrack, but in most cases going to a hospital at all for birth is the hamburger. But back to the topic. Just to be clear, this isn’t the delivery room – this is the room used by the mother and spouse during “recovery”. While my brother-in-law was working from his in-room office, the people next door were unable to have 3 people visit at the same time because there was hardly enough room.

I think I need to stop letting this bother me, because I’m now convinced that they just gave her an upgrade without charging her for some reason. I can’t stand the thought that she paid the same as those people next to her. Admittedly, I’m a socialist, and fairness is pretty darn important. Much of my disgust with this whole thing is really disgust about our healthcare system.

janbb's avatar

@tom_g Yeah – I got that.

glacial's avatar

Personally, I don’t think this is acceptable. Why don’t you phone the hospital and ask? If they really are charging more for the luxury suites, then it wouldn’t make sense for them to keep it a secret.

Alternatively, perhaps they did plan to charge more for these rooms, then a change in management or the composition of the board inspired them to allow anyone to experience the nicer rooms at the same rate. It’s still an unfortunate use of space and resources, though.

Pied_Pfeffer's avatar

It sounds like a case that has occurred in many hotels. The building’s owner(s) look for ways to increase revenue. They know that providing a diversity of products, even if just two, can generate more money based upon demand.

Where it can fall short is if the owner(s) really don’t know the market and the business on a day-to-day operational level. The architect hired to plan it out usually doesn’t either. Feedback from the people who run the facility isn’t asked for or taken into account. Thus, the facility ends up with a room configuration such as this.

How is a hospital staff to manage who gets what room? There is little to no wiggle room for strategic planning. I feel badly for the staff who have to deal with the complaints. It’s the last thing that they need to be handling.

Jeruba's avatar

I had the option of pricey “birthing suite” as opposed to the standard delivery and recovery rooms. I was pretty sure I wouldn’t care. And indeed I could have been in the Oval Office or a broom closet and I don’t think I’d have noticed a thing. My sensory apparatus was pretty much focused on one thing.

In general I tend to assume that for any product or service I use, there’s a nicer alternative for those who are willing and able to pay a premium price. But I don’t gain anything by thinking about it. The only time it demands attention is when I deliberately go looking for the best of something (usually something whose quality has significantly deteriorated—where what used to be “standard” is now better than the best I can find) and it doesn’t seem to exist. That’s when I ask “Where do rich people shop for this? Do they have to settle for this quality, or is there a better variety out there somewhere?”

Ron_C's avatar

Our hospital has “birthing” rooms that are specially outfitted but not exactly luxury suites. Now that hospitals have to make a profit you should expect more luxury rooms for the well insured and nasty wards for those without premium insurance. It’s all about attracting business and making a profit. You only see this type of thing in American and middle-eastern hospitals that cater to royalty. I agree that it’s disgusting but vote Republican and this is what you get!

Shippy's avatar

Life is unfair and unreasonable.

Earthgirl's avatar

Nothing surprises me after the Beyonce story Talk about “special treatment”! If you can pay, the sky’s the limit!

Nimis's avatar

I think they want to advertise that they provide these amenities. Yet they can’t afford to provide it for every room.

So long as it’s completely arbitrary, I don’t think I would care if someone who was paying the same was getting a better room.

So long as my Wonka bar is tasty, I wouldn’t begrudge anyone their Golden Ticket.

Also, statistically, if they’re usually only 50% booked, putting money where it will get the most use makes sense (to me).

I’m usually all for being fair. But I’m also for getting the most bang for your buck.

glacial's avatar

I think you have something there, @Earthgirl – the hospital is staging an elaborate smokescreen for the next Beyonce birth!

Nimis's avatar

Whoops. Should have read everyone’s response first. Could have just written What CWOTUS said.

JLeslie's avatar

@tom_g I thought all the newish hospitals have the baby born in the same room as the labor and recovery, unless it was a c-section, which would happen in an OR usually.

Were the not so fabulous rooms all full? Very possible she was upgraded (as you have said) simply because the other rooms were not available. Like when you rent a car and they try to get you to ugrade, and then when you reguse you still get the better car for the cheaper price. Or, if she has insurance, the hospital might know they can sting that particular insurance for more money, because of the coverage it offers. Or, the person who chooses where a patient winds up is friend with the nurse on the floor, and the nurse prefers to work in the bigger rooms, and the hospital doesn’t give the staff a hard time about where the patients are placed. I find it surprising if there are not pricing difference. I too think it would be better if all the rooms are the same and a medium size between the two offered now. Possibly their were construction constraints for where to build the walls?

fluthernutter's avatar

It really is arbitrary—at least in our case. We were offered the fancy room with the hot tub. But we passed it up for the more modest room. (My water was already broken and I couldn’t have used the hot tub anyway. Figured someone else would appreciate the hot tub more.)

For the record, I’m not a wealthy celebrity. ;)

wundayatta's avatar

It strains credulity to think they would charge the same for both rooms, unless insurance pays for it. Then I guess they could charge the luxury price for the suites and then if they have so many babies being born at once, they do have overflow rooms to put them into, which have a lower room rate. If that is the plan, then it might make sense, although they probably have too many overflow rooms.

But if they don’t charge differentially for those rooms, then something is badly wrong. I can’t imagine an insurer paying the same for rooms with such different amenities and capabilities and staffing needs. As an insurer, I would sue the hospital for misrepresentation of what they provide. I’m not paying the same.

Perhaps they charge the same, but besides being unfair, it is also a ripoff for whoever is paying the same price for half the room. I demand a discount!

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