Obamacare is the law of the land


That’s not entirely true. Most hospitals will continue to attempt to bill you for the full amount for months, and if you ignore that they may then try enrolling you in their “payment plan” where they send you bills with much lower “monthly payment” amounts. If you ignore everything, they WILL turn the bill over to a collections agency eventually. The collections agencies usually try to settle with you for a portion of the bill, offering anything from a 10% discount to as much as 50% depending on the total amount owed and the length of time it’s been due and the amount already collected.

If you ignore every single attempt to contact you and collect anything, they can report it as an unpaid debt to the credit agencies after 180 days (6 months). It will affect your credit rating, though most credit agencies do not factor medical debt as heavily as they do standard debt when compiling your credit report.

TL;DR - Don’t completely ignore medical debt. Try to negotiate at every step. Even if it ends up going to collections, you can often negotiate a much lower amount with the collections agency, and it won’t end up on your credit report.

Our current healthcare system sucks for everyone who is not a member of Congress. It needs to change.


Listen to me, I’m an expert, and ignore it. It’s the only way we can affect change. Hit em in the wallet.

This comment brought to you by a certified Internet Expert.


Presented just as a single data point and definitively not financial advice, when I worked in a credit department of a finance company we didn’t care too much about medical debt. It was basically used as a tie-breaker: when we were trying to classify a file as a B or a B-, if you had outstanding medical debt you might get pushed down a partial grade. Otherwise it didn’t factor in much.


LOL what income?

SFGH is a state-run hospital. Its mission is to serve as the safety-net hospital for the city of San Francisco. 8% of the patients are homeless, and a majority are on Medicaid or uninsured. Its operating expenses are mostly funded either by the government or by soaking the few patients who can actually afford to pay. And guess what, the government has other priorities.

You want single-payer? SFGH is the closest you’ll find in San Francisco outside the VA. But just like the VA, it’s explicitly not meant for everyone.


While this is true. Medical bills are probably the easiest bills to have taken care of.

Like, for instance, I had an issue with my leg last year, and they wanted to run some sort of circulation test on it, prior to referring me to the neurologist. Even though this hospital system is my “in network” provider, the test they ordered was not covered by my insurance for the diagnosis. My claim was denied by my insurer, and I basically told them, I am not paying for this, you ordered the test for me, and it wasn’t covered. Figure it out. And after a very lengthy chain of phone calls, letters etc. They finally agreed to pay my insurer for the full amount of the test. It wasn’t worth arguing over 500$ (of course not 20k like the story) It all worked out.

TLDR; Maybe you can’t get out of 20k in medical charges, but you certainly can fight medical bills a lot, and most hospital systems will lower charges or work with you to get them paid. Certainly don’t ignore them, just dispute them (publicly if you have to)


People should definitely fight against ridiculous medical bills; I’m just saying don’t simply ignore them; there can be severe consequences.

One of the F’ed up things in our system is we treat medical charges like other prices, as if they were based on what people voluntarily agree to pay, with working market feedback and the ability to walk away from a deal without dying or suffering. We are used to functioning markets keeping prices from being extreme made-up BS, but that doesn’t apply to health care. For example, I doubt very much anyone ever voluntarily agrees to pay the ridiculous out-of-network prices charged by that SF hospital ahead of time with full knowledge of the costs and options. People get taken to the hospital on an emergency basis, get hit with mega bills after the fact, and then we legally treat those prices the same way we treat prices that people voluntarily agree in other markets. We just have a huge systemic blind spot on the issue of inelastic demand in health care.


It’s hard to fight billing when you’re sick as shit.


It takes basically zero effort for them to damage your credit rating.

It takes a LOT of effort from you to fight the charge and dispute its effect to your credit.


Hear, hear.


As a non American I find the concept of credit rating alien and disturbing.

To the extent that I refused to own a credit card for the 6 years I lived there.


You have basically the same thing in your country, in one form or another.
All a credit rating is, is a measurement of your assets vs. your liabilities, and a record of your payment history on loans.

It’s not some kind of nefarious thing.


Of course, but it’s fundamentally different in approach, and much more sensible. It is not centralized and personal credit history is evaluated on a case by case basis, with permission of the person applying, when asking for any credit or mortage. Each institution can apply their own guidelines and there’s interaction.

You can access some data from third parties, but there’s no centralized score and nothing that gets looked at out of context. Certainly not accessible by landlords or stuff like that.

The US credit score system feels a little bit like Nosedive, where you can get fucked accidentally and have little capacity of recourse, because people will just look at the number.


No no, it’s not nearly that bad. You just spend seven years in purgatory and then you can move on with your life. :)


It’s a bit nefarious, in that there’s this huge system going on behind the scenes that you’re not even particularly aware of, but short of identity theft and straight-up mistakes, it’s pretty straightforward.

I understand the need for creditors to have some sort of metric to judge your credit-worthiness, but we’re long overdue for another round of sunlight being shone into the system.

At least now you can get a free report once a year (the reporting agencies used to charge you just to see it) and there are specific mechanisms in place to dispute entries.


To me, the biggest problem with the credit system, is that we have no rights within it as consumers.

I should have to opt in to monitoring of my credit by the credit bureaus. Now, my choice to not opt in could have repercussions… maybe creditors wouldn’t give me money if I wasn’t monitored by some particular bureau. But I should still have that choice.

As it stands, they have ALL of my personal information, and as we’ve already seen with Equifax… they are grossly incompetent when it comes to protecting it. That’s not cool.


You opt in when you give any company your SSN.


It’s amazing how bad the data actually is, given their public and private sources. The list of residence addresses for me are all different from one agency to the next, and they’re all in the wrong (different) order with the wrong dates, and they still include on address from an identity theft attempt I detected and quashed 3 years ago. They still include cars I sold 20 years ago.


Yeah, I’ve given up trying to get a listing on my credit account was from my father. Same last name, but different first and middle. Obviously different SSNs. Also in a town I never lived in. Yet I spent 10 years fighting it on and off, long after my father had died, and it still shows up when I pull a full credit report.


They normally don’t even need to that, anymore. Name and address is typically enough to pull the report. Of course, then we get Benny’s issues when they use fuzzy logic to match stuff.


By the way, all of these “can’t get blood out of a turnip” sort of defenses against medical bills assume you’re broke and have nothing worth going after.

It’s really not cool if you’ve saved up a hundred grand or two by the time you are in your 40s or 50s, and then a medical bill erases 20 years of life’s savings.

We have this bullshit system where people don’t care about the “rich,” but the problem is, the system just assumes that people who are broke might somehow get out of paying because they have nothing to go after, and everyone else who isn’t mega rich can just have all of their assets and life’s work stripped from them because they got sick.

Ability to pay shouldn’t mean that you get gouged.