This in reference to the old woman analogy...

The failure in the descriptive power of the analogy is that the person giving the payment, the woman is wealthy (period)

in health care, though a given hospital/insurance company may be wealthy persay and can give lots of money in a settlement, it's not "their" money persay... medical dollars belong to people who pay for health insurance/coverage

so for a better picture your question would have had to go something like

if a wealthy old woman offered you lots of money for mowing a yard, but she is wealthy because she serves as sort of a bank for a village with thousands of poor people who make 5 dollars a year...
It's really hard to understand all the factors that go into treating patient now that medicine has been heavily legalized, politicized, regulated, and economized...
medical BUSINESS aspects suck... I'm in for a life of headaches... haha but it's the only thing I wanna do