For California consumers facing hospital bills of thousands of dollars, especially those with no insurance or with high deductibles, the old Jack Benny line is no joke. Hospitals here and across the country routinely charge self-pay patients consumers three or four times what insurance companies and government programs pay for the exact same treatments. In many cases, these bills send patients and their families to collections, to court, and to bankruptcy. After several years of news stories and legislative efforts, California hospitals adopted “voluntary guidelines” in February 2004 on their billing and collections practices for uninsured patients. In late August and early September, volunteers fanned out across California to determine how hospitals treat the uninsured financially, and to measure compliance with key, measurable elements of those guidelines. This paper reports on the results of that survey.