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Comment by joenathanone | Hacker News Reader

>Many, many medical bills go unpaid.

Several years ago I ended up in the ICU, no insurance, got a ridiculous bill that would have taken the majority of my lifetime to pay down. In the end I decided not to even attempt to pay because it was so ridiculously high, decided to just wait the seven years for it to fall off my credit.

If the price had been reasonable I would have paid outright or gotten on a payment plan.

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What was the impact on your credit score? I imagine that had an effect on other parts of your life no?

It hurt my credit score(as in the number quite a bit), but not as much as I thought it would, I was really worried I wouldn’t get approved for things, but I was informed that when underwriters are reviewing credit reports, medical debt doesn’t carry much weight, as ‘everyone’ has it and it doesn’t reflect on how responsible or impulsive the debtor is.

My worry is that as this happens more and more, the health care industry will come up with their own score, and will refuse to serve people that don’t pay their medical debts.

A law signed by Ronald Reagan prevents denial of treatment based on ability to pay.

However, it doesn't specify what treatment will be provided, so more likely, hospitals would use that sort of information to limit treatment to ER-level interventions and then recommend a wait-n-see approach as followup.

The Emergency Medical Treatment and Active Labor Act prevents any hospital which accepts Medicare/Medicaid from turning away patients in critical conditions. They have to at least provide stabilization and some kind of basic medical screening services to everyone who arrives.

https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an...

As for other doctor's offices or planned procedures, I think they already can decide to not work with you if you don't pay them. Maybe there's something similar for general practice stuff related to Medicare/Medicaid as well but for exclusively private pay practices I can't imagine something forcing those providers to offer non-emergency services.

As a non-US citizen, the more I read this thread, the more bonkers the whole system is. How the fuck does healthcare even work at all?

>How the fuck does healthcare even work at all?

It doesn't, unless you are wealthy, otherwise you try and 'walk off' any issues until they become obviously life threatening, then you go to the hospital and if you have insurance, you hope the insurance will approve the operation you need, and if you don't have insurance you hope the cost wont bankrupt you.

There comes a point where your credit score isn’t useful anymore. If you have a good house with a good mortgage and the best credit cards and have taken any other long term loans you need, then you’ve reached the end game. After that point maintaining a high score is just for bragging rights. It makes no sense to pay a massive hospital bill the rest of your life instead of just letting it fall off your credit reports in 7 years.

Jobs will also look at your credit score, but for a retired person it can quickly become meaningless.

Why do employers care

Employers are looking for stability, so a poor credit score is a proxy for a risky hire (in their minds). Even if 50% of the low scores are due to either medical debt or student loans, it helps them weed out "undesirables."

You might abuse your position for illicit gain in order to pay off debts.

So they have an excuse to not hire minorities and people of color who have lower scores on average.

What does falling off your credit mean? Do you no longer owe anything? Did you go through bankruptcy?

It means it no longer appears on my credit report or effects my credit score.

You still owe the money though? Do they just stop chasing you after a while?

All US states (I think) have some statute of limitations on debt collection, although each state is different. After this amount of time has passed (assuming that no court case has been filed), the courts can no longer be used to demand payment of a debt and the debt effectively ceases to exist legally. (Whether it ceases to exist morally depends on your personal moral system.)

Interesting, thanks. 3-6 years seems common.

But they will send collections after you long before that no? It happened to me (Scrips, CA), while we were trying to negotiate payment with the hospital and the bill was only $500 - I didn't want to pay it out of principal because we were told it was $150 flat rate at the time of service... they were very quick to pull the trigger.

Is it at all advisable to ignore collections and risk court appearance?

When the collections company called me I tried to negotiate a reasonable price with them but they wouldn't budge, I told them that I wouldn't pay and would just wait for seven years.

Next time they called I told them they had the wrong number and not to call again, and I never heard from them again, no letters, no calls, nothing.

Although I'm in Arizona, I don't know if laws are different in CA.

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