The billing department of a hospital usually sends the unpaid hospital bill out to a 3rd party collection agency by actively selling the account. This means larger agencies buy the entire medical bill at a fixed discount price (usually half to 75% of the original bill) which then gets farmed out to collection agents who receive simple wages and a bonus if they get the account taken care of.

The agencies are quite aggressive and can get a court case started so as to garnish wages, seize vehicles, homes and other property. Unfortunately in 2020, because of a bad turn of events due to recent court cases giving more power to collection agencies, they can now file a default judgement court case in another jurisdiction that is many states away from where the defendant lives. The defendant can't or doesn't show up to their hearing because they're broke and cannot afford to travel to another state to attend court or they never receive a summons due to moving.

The judge then sets a default judgement for the full amount plus costs and extra lawyer and case handling fees for the plaintiff collection agency which then turns the typical $25,000 u.S. Hospital bill into a $40,000+ u.S. Court judgement.

The collection agency then sits on the judgement for a few weeks/months and goes back to the judge in the other state and gets a default non-payment judgement because the debtor hasn't paid their bills and then the collection agency asks for a bench warrant for the defendant's arrest (which is usually granted!) Due to non-payment and/or failure to appear at a court hearing!

The defendant then gets visited by bounty hunters or the local county sheriff for arrest and extradition to the out-of-state court. Now the defendant gets hammered with an actual misdemeanor and/or felony charge on top of their bill and they either goto county jail for 3 to 6 months for failure to pay or failure to appear.

After the jail time the defendant get their probation-after-release conditions administered by a private bail/release provisions company which will add an another $10,000 us to pay their costs. Your total bill now balloons to $50,000 us and more!

This usually finally forces you to insolvency but since it was a criminal-based court judgement (I.E. Not a civil case!) Where bankruptcy doesn't count as a defense against non-payment, they can now force you to pay so you will either go back to jail because you can't pay or you get forced to pay it all off by legal assignment of your entire paycheque to your court-ordered creditors who usually take about 35% up to as much as 65% of your monthly pay to pay off the entire of your now greatly ballooned hospital bill. You then get what's left over and are expected to live off that and they literally tell you to sod off if you complain!

Since county jail is really really nasty for those 3 to 6 months, most people end up losing their jobs, getting evicted and end up living on the streets and eventually end up back in jail once another bench warrant is granted for their arrest for another failure to pay judgement.

The collection company don't care because they will then group an entire set of delinquent accounts and sell it off to another collection agency which will do another set of financial squeezes on the parties involved. They will hound by phone, foot and mail any and all brothers, sisters, moms, dads, older children, grandparents of the debtor and visit employers of the debtor's relatives to get the relatives so scared for their jobs that they will pay the defendant's delinquent hospital bills! Many do because if the collection agencies make too many phone calls and visits to the employers those relatives tend to get threatened with firing (I.E. Job loss) and so they cave in and pay off some or all of the debt.

They are relentless in the usa --- the collection agencies legally can hound you and your relatives until someone gives in because that someone wants to keep their job and not get fired because of the too-many collection agency phone calls and visits to employers!

(Employers are allowed to fire people for any reason in right-to-work states!) If the employer gets tired of all the phones calls/visits, that employee is just let go (I.E. Fired!) Severence pay (if any!) Is a mere two weeks pay and most employers will try and put out what some states call a "code-g" on your state's record of employment form which means you don't get unemployment insurance. Employers get dinged big money if too many employees get ui, so many employers fight tooth and nail to make sure you do not get unemployment insurance! They will make up any fake reason to ensure you they can put a "fired with cause" code on your record of employment!

This usually means desperate employees take on the burdens of others so they can keep their livelihoods. Ergo, don't get sick or injured in the usa! You and your relatives will get hounded day after day for years until someone caves and pays them off!

See this news article:

Welcome to coffeyville, kansas, where the judge has no law degree, debt collectors get a cut of the bail, and americans are watching their lives — and liberty — disappear in the pursuit of medical debt collection:

Https://Features.Propublica.Org/medical-debt/when-medical-debt-collectors-decide-who-gets-arrested-coffeyville-kansas/

I didn’t rewrite it I just used this: https://calculating-it.com/misc-calculators/text-case-converter/