I learned these lessons thoroughly when my father was dying of COPD. He worked hard all his life and enjoyed a nice little pension on top of his social security. He had Medicare, plus supplemental insurance.

Despite all that, he literally could not afford the medication he needed to stay alive, medication that outside the United States costs a small fraction of what it costs here. When he had severe crises, we thought long and hard before calling an ambulance, because we knew the bill would be crushing.

Visiting my sister once a couple hundred miles away, he had a breathing attack that required a 2 hour visit to a hospital ER to clear his airways and restore his ability to breathe. He was slammed with a bill approaching $5,000. Yeah, they treated him without questioning his ability to pay, but they hounded him after, even sic-ing a law firm on him to try to collect.

I called them up and told them neither Dad nor I could possibly pay them and continue paying for his medications, and that if we didn't pay for his medications he would die.

The response boiled down to, See you in court. Well, they threw in expressions of sorrow for Dad's circumstances but they still demanded their money and they did sue.

It gave me a certain amount of bitter pleasure to eventually call up the law firm and advise them they should sue the estate because Dad was dead, but that they might as well write off making any money for their two years of hounding, that they wouldn't even be getting pennies on the dollar.

Sadly, I know they really don't care. It's all in numbers game to them, and as long as some people pay up, as long as somebody gets paid, the wheels keep turning.