May 10, 2007 - The Stupidest Tea-Party

“There was a table set out under a tree in front of the house, and the March Hare and the Hatter were having tea at it.... The table was a large one, but the three were all crowded together at one corner of it. ‘No room! No room!’ they cried out when they saw Alice coming.”

– Lewis Carroll, Alice in Wonderland, chapter VII, “A Mad Tea-Party”

Today I read an article about a situation that’s just about as unhinged as Lewis Carroll’s famed Tea Party. According to a recent study, “U.S. hospitals are charging uninsured patients about two-and-a-half times more than those with health insurance....”

Think about that, for a moment. What sense could it possibly make to charge MORE to people who have no insurance – to people who are not only financially strapped, but sick besides?

“‘The mark-up on hospital care for these individuals, especially for those who can afford it least, is unjustifiable,’ said Gerard Anderson, director of the center for hospital finance and management at Johns Hopkins University's school of public health, and study author.”

Thank you. It’s nice to hear SOMEBODY making sense.


‘Have some wine,’ the March Hare said in an encouraging tone.

Alice looked all round the table, but there was nothing on it but tea. ‘I don’t see any wine,’ she remarked.

‘There isn’t any,’ said the March Hare.

‘Then it wasn’t very civil of you to offer it,’ said Alice angrily.

‘It wasn’t very civil of you to sit down without being invited,’ said the March Hare.

Now, here’s something even more bizarre. Hospitals are billing the uninsured at a rate of two and a half times greater than they bill the insured, but they realistically expect to collect only about ten percent of what they’re billing:

“But patients without health insurance, about 45 million people in the U.S., lack the ability to negotiate. As it stands, hospitals only collect about 10 cents on the dollar charged to uninsured patients, Anderson said.”

So, every time a hospital bills a patient – EVERY time – the amount billed has NO relation to the real cost of the services provided. If the patient’s insured, the hospital bills for the amount the insurance company says it can bill. If the patient’s uninsured, the hospital jacks the sticker price up to an impossibly high amount, an amount the hospital knows it’s not going to get in a million years. It’s an amount calculated to strike terror into the heart of the hapless, uninsured patients – who slit open their window envelopes, weeks later, and instantly have visions of losing home, car, livelihood, everything.

I was at a meeting last week, where I learned that unpaid medical bills are the leading cause of homelessness among the working poor.

Is it any wonder that, the next time these patients get sick, they will do everything possible to avoid seeking medical help? Is it any wonder that a certain percentage of these uninsured patients will DIE as a result of that desperate decision – as more than 18,000 uninsured Americans do die needlessly, every year?

“‘Take some more tea, the March Hare said to Alice, very earnestly.

‘I’ve had nothing yet, Alice replied, in an offended tone: ‘so I can’t take more.’

‘You mean you can’t take less,’ said the Hatter: ‘it’s very easy to take more than nothing.’

‘Nobody asked your opinion,’ said Alice.

‘Who’s making personal remarks now?’ the Hatter asked triumphantly.

“The real problem of course, is that we live in a country where we don’t guarantee coverage for everybody,” [AHA policy analyst Carmela] Coyle said."

THANK YOU! It’s nice to hear somebody else making some sense, for a change – so very refreshing. But, the strange creatures gathered round the table aren’t hearing. They’re still not pouring any tea.

“This piece of rudeness was more than Alice could bear: she got up in great disgust, and walked off: the Dormouse fell asleep instantly, and neither of the others took the least notice of her going, though she looked back once or twice, half hoping they would call after her: the last time she saw them, they were trying to put the Dormouse into the teapot.

‘At any rate I’ll never go there again!’ said Alice. ‘It’s the stupidest tea-party I ever was at in all my life!’”