I've heard it often remarked in my circles (wryly and bitterly) that "bankruptcy and gofundme are the American health care plans of choice". So yes, it would seem that for a lot of stuff the plan is just to let it go to collections and then default for as long as you can get away with it.

(n.b. I have some relatively significant physical health issues, so if I can't afford medical tourism and/or get on an absurdly good plan before I'm 26, I may end up being forced into a strategy like this)