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Healthcare has often outpaced GDP growth [1][2], putting a continuous strain on hospitals and other healthcare service providers. This in turn leads to less money being spent on non-essential parts, or at least the ones that are deemed to provide lower ROI for stakeholders (E.g. personnel, patients, family of patients, etc).

It is also worth noting that the trajectory that the company you work for in terms of office change is likely to be an outlier and (in)directly creates an skewed perspective of things, which when brought back to the average environment, creates a 'shock'.

[1] US: https://www.healthsystemtracker.org/chart-collection/u-s-spe... [2] CAD: https://secure.cihi.ca/free_products/NHEX-trends-narrative-r...

> Are we, as a society, investing in the right things?

This kind of question can be tricky. It biases the answer. The answer is usually "No, but it's hard to agree about what the right things are."

But in a lot of cases, how is as important as how much.. and related. Are we doing this the right way? Are the right people making the right decisions?

A hospital or an industry is also a culture, and they often do things for cultural reasons.

The "fast-growing software companies" have a culture of nice offices. The economic rationale is that it's cheap, helps recruit, and possibly adds to moral or productivity or somesuch.

Hospitals have a utilitarian culture, austere at times. Older culture, more complicated reasons. A lot of the difference (since we're talking about appearances) is down to what they want to project and to whom.

> I know that there are countries where it is worse, I am happy that everyone in the country had free health care. But, it could be much better.

Doctor's offices in the US look nicer than those in Italy, where I lived for a number of years. But ultimately, patients pay for that, and overall the US health care system is reaaaallllly expensive.

See this NPR interview with a healthcare expert from the Kaiser Foundation:

GARCIA-NAVARRO: I mean, why do people get hundreds of thousands of dollars in bills for staying in a hospital?

ROSENTHAL: Well, the first thing I tell people when they ask me this question is to go into your local hospital and look around. And the marble lobbies, the art, the concierges at the front desk - our hospitals look like not five-star hotels - seven-star hotels. I mean, I think the most stark thing when people go overseas is hospitals in Europe, which deliver really high-quality care. They look like junior high schools. You know, they're not fancy, but the care is good.

https://www.npr.org/2017/07/02/535240692/the-call-in-your-qu...

That's not to say there's not a happy, affordable balance.

> They look like junior high schools. You know, they're not fancy, but the care is good.

Yes! That's exactly what my (limited) experience of hospitals in Italy was like. They're very plain, but the doctors know their stuff.

> And the marble lobbies, the art, the concierges at the front desk - our hospitals look like not five-star hotels - seven-star hotels.

Is there specific examples of these hospitals? I've never seen anything that extravagant in any of the hospitals in Pittsburgh.

Living in California I can tell you that there is free parking with valets. You can charge your electric car and the lobby is definitely not looking bad at all. In one hospital, in Washington, there was a super high ceiling with a piano where a musician comes sometimes during the day to play. It's not everywhere like these two examples, but I've seen a couple where the level was way higher than in Canada or Europe.

Living in SF I can tell you there are hospitals that charge $35/hr to park there while in the ER

Edited to correct typo

Not the case in Mountain View or Los Gatos. Neither the case in Seattle or Kirkland.

I've seen some pretty flashy lobbies and interior spaces in Boston (Brigham and Women's) and Providence (Lifespan) where you get the hotel impression. I could not find easy-to-point-at pictures, but there are some littered around (best I can show is http://www.discoverbrigham.org/2017-discover-brigham-photos-... which looks like a convention hall but is actually shot at the hospital). As soon as you get past them though to the functional spaces it usually turns into the traditional easy to clean hallway systems, but some of the lobbies have that marble, high ceiling, hotel lobby kind of look. There are plenty that I have been to that haven't exuded that kind of feeling however (or were an alternate entrance).

The new PAMF clinic in San Carlos, CA looks like a 5 star hotel. I was shocked when I went there.

You might’ve been in the ECT treatment area, I was shocked when I went there.

Patients are usually an inconvenience to the good running of a healthcare system.

In other words, incentives aren't aligned. The people with the power to make decisions have little or no forces making things better for healthcare consumers, outside of boutique private healthcare.

The Disneyland-like software companies you describe are that way because they must signal success, coolness, etc in order to attract employees to hire, investors to write checks, customers to sign up, etc. In another word, it’s a cost of doing business.

Hospitals (I’m assuming you’re describing public European hospitals) aren’t subject to those pressures - instead, they have to fight for the tiniest bit of budget to replace/fix things that should have been replaced years ago, or to hire enough staff.

If you go to fancy private American hospitals, you will also find that they have the latest TVs/trendy furniture/etc, because they have to signal to wealthy people that they are worth giving their money to.

When you look at how inflated costs are for the latter, I’m not sure it’s a desirable thing.

The mention of Spain reminded me of the Sant Pau hospital, which Domènech i Montaner designed in contrast to typical hospitals with the idea that beautiful places could be more therapeutic. It's a restored UNESCO site now that hosts events rather than patients (it stopped functioning as a hospital a decade ago). It being built 100 years ago, I imagine it may fall short in suitedness for medicine today, but the conversion of beautiful place to museum/event venue aligns a bit with your sentiment.

https://www.barcelonas.com/hospital-de-sant-pau.html

> Austerity in Spain means that there is no money for hospitals

Sorry where are you getting this information from? I have family in Spain that is expecting to get excellent healthcare from their supplemental health insurance.

Printing a some posters of public domain art should be fairly cheap.

Sure, you'll still need to do it and put them on the walls.

It seems likely that the emphasis on judging the aesthetic values of work spaces may itself be the issue, not that our hospitals and other public facing facilities are depressing.

The point of the article was that aesthetics have a quantifiable and measurable impact on health.