Quora Query: What can you do if you rack up a huge ER bill, make too much money for assistance, and can’t afford to pay it off in the max 24 months? The lady at hospital said I can pay whatever I can afford but when I called, they said no.

Firstly, I’m sorry you have to deal with this. In a rationale and humane society, healthcare is a right. It is funded from general taxes so you would NEVER worry about this.

But we live in a neoliberal America – for now, anyway – and these things happen many times every day.

So here’s how you might handle this:

  1. Call the billing office of the hospital. Tell them you can’t pay the bill and ask if they will write it off – part or all – as charity care. Essentially every hospital in the US does this to some extent, and they may.
  2. If they won’t write the bill off, tell them you’re willing to make monthly payments; these should be only what you can afford. If it’s $5 per month that’s affordable, that’s what you should do. If it takes 15 years to pay it off, that’s just life.
  3. If they make threatening noises, ask to speak to a supervisor; this person may be more rational. If that doesn’t work, write a letter to the Chief Financial Officer of the hospital, explain the situation and tell him/her what you can pay. End the letter with: “I await your reply”. Keep a copy of all correspondence, because on the remote possibility that they attempt to sue, you’ll want to show that you made good faith attempts to pay what you could.

Finally, register to vote and vote for candidates up and down the ballot that support Medicare for All. That’s Sanders or Warren at the top of the ticket. You’ll have to find the candidates for Senate, House, Statehouse. Make. Sure. You. Vote. And do as much as you can to support the person you choose: knock on doors, drive people to the polls, etc.

Since I was a young man I’ve been outraged at the health system of which I’ve become a part. It is wasteful, sometimes of questionable quality, and punishes people who use it. M4A is a step in the right direction.

Again, I’m sorry you have to go through this.

About AJ Layon

AJ Layon was, for 28 years, at the University of Florida College of Medicine, in the Division of Critical Care Medicine, in Gainesville, FL. For the approximately 10 years until September 2011, he was Professor and Chief of Critical Care Medicine at UF; In September of 2011 he became System Director and Co-Chairman of Critical Care Medicine in PA; this ended in 2017. He served as a Physician in the Surgical Group with Médecins sans Frontières (MSF, Doctors without Borders) through 2018 and is presently an intensivist in Florida, struggling through the SARS-CoV-2 crisis. While his interests are primarily related to health care, health care reform, and ethical issues, as a citizen of our United States and our world, he will occasionally opine on issues of our "time and destiny". Follow on Twitter @ajlayon
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