Which is good, for patients with insurance.

Those without, aren’t so lucky. Some of the amenities rival 5-star hotels, as a new suburban Detroit hospital illustrates, with a former Ritz-Carlton executive in charge.

Atriums costing in the hundreds of millions contain stores resembling an upscale mall. Patient rooms are wired for high-speed internet access and adorned with flat screen televisions. Some have patient concierges able to buy groceries or run errands. Others have almost half a million dollars in artwork on the walls.

The tiering arises from Medicare and Medicaid ratcheting down hospital and physician payments. This increases the pressure to attract those with private insurance, to make up the shortfall that is caused by government stinginess.