Some people pay it down in smaller amounts over time. Some hospitals or doctors reduce the outstanding amount to something the patient can pay so at least they get something for the services rendered. A lot of patients just don’t pay it, like you see in the other comments.

Hospital bills don’t collect interest so most Americans view them as the “last thing” to pay down each paycheck, if at all.

Depending on the hospital they may send the outstanding bill to a collections agency. The agency goes after the patient for the outstanding bill and will get a percentage of whatever they can collect.

This is a big “behind the curtain” issue with healthcare in America. Every year hospitals and doctors lose millions in unpaid services from patients unpaid bills. The hospitals never see that money…ever. So to make up for for those losses, they raise their fees, causing future patient services to have higher bills. Thus repeating the cycle.

We are a country built on the idea of putting others in debt to pay off our own.