You tell the hospital to pound sand when they send a five or six figure bill. Very few in the US have $20,000 or so just lying around. The hospital knows that, the court knows that, even the latest version of FICO knows that.

You can ask for an itemized bill, amd usually a bunch of stupid charges go away. You can try and arrange a payment plan.

But really, after a certain point, it doesn’t matter if the bill is $10,000 or $1,000,000, there’s just no money, and there will not ever be that money, and they can cry wage garnishment until their ears bleed but it almost never happens - because there’s no money.