Internationally, it's a different story. At Lufthansa's first class terminal in Frankfurt (yes terminal, not lounge) you have private security and passport control and get driven to your plane in a Porsche across the tarmac. Thai Airway's first class lounge in Bangkok has complimentary sixty minute massages (not that kind). Cathay Pacific's lounges in Hong Kong have full cook-to-order restaurants, foot massages, etc. all complimentary. All Nippon's first class lounges in Tokyo have 17-year-old scotch just sitting out for whoever wants it. Japan Airlines offers a sushi bar—with the sushi chefs right in front of you—and complimentary massages.
Not a bad way to travel. So far I've managed all on award tickets.
Great if you have access, but nothing I'd go out of my way to pay for.
One exception: Showers. Holy hell is it an amazing feeling to take a shower half-way through a 20+ hour itinerary. Worth their weight in gold.
A friend of mine took me into airport lounges a few times, and they were all pretty nice experiences.
In other countries, airports tend to be more spartan, and the lounges nicer. Many of the Asian carriers offer sushi, noodle bars, top-shelf drinks, and showers.