Quote from AAAintheBeltway:
I don't think it's quite that simple, unless you are an illegal alien. If you have assets, they will come after you, with bill collectors, lawsuits, etc.
You are correct, it's not that simple at all. However, they are willing to work with you. If you show that you are actually willing to pay, that your going to make good on your debt you they will reduce your costs substantially. A lot of doctors are also willing to make private deals with you, I've had a surgeon who has waived all of his own fee's, and a pharmacy who is charging me cost for my medications. I'm probably lucky to be in a small town where everyone knows everyone though.