You just go into more debt. They can do stuff like sue to garnish wages or put a lein on your property, but mostly it just ruins your credit score.

Most non-profit hospitals have a budget for indigent care, though. And many hospitals will settle for a much lower amount if you just go talk to them.

I knew someone who racked up over $300k in cancer treatment, and when they talked to billing to set up a payment plan the hospital was so surprised someone actually wanted to pay that they dropped it to $10k.

The reason that health care costs are so high is because hospitals jack up the price so they can “negotiate” with insurance and everyone feels like they won. A lot of the massive bills you see are what hospitals send out before even billing insurance.