Like if you’re awake can you say “no I’d rather die on the street and let the city have to clean up my corpse”?

They will disregard that request and charge you anyway, which has led to people literally fleeing from ambulances to avoid the expenses. But it gets even worse.

Many mental health hotlines will contact the police if they think you present a danger to yourself and others. You can then be taken to a hospital and forced to stay there against your will, and by the time you’re able to leave you’ve accumulated a mountain of medical debt. Which, if you’ve been driven to contemplate suicide due to material circumstances, isn’t exactly going to help things.

However, for anyone thinking of calling a helpline, there are ones that don’t contact the police. You just have to look it up.

Like if you can’t afford any of it? And say you’ve already gone bankrupt and have no assets to seize or no job to garnish wages off of? Is it jail time? Do they just expect you to starve to death after?

The whole thing has gotten so inflated that people not being able to pay is pretty normal. What that means is that it is possible to haggle it down somewhat and negotiate on monthly payments. The actual value of these debts to the companies that hold them is a tiny fraction of the actual dollar amount of the debt, because they know a lot of them won’t be repaid. However, the companies will be try to get every drop they can squeeze from you, and even if you negotiate the payments down to something you can afford, the principal will be hanging over your head, likely for the rest of your like.

If you can’t pay, there’s no jail time, but there’s bankruptcy and foreclosures. If you own any significant assets, like say your house or car, that can potentially be seized in the event of bankruptcy, leaving you homeless or forced to pay rent, which is generally more expensive than mortgage payments, and potentially unable to get to work.

They won’t put you in jail (not until you’re homeless and charged with sleeping in public), but they will drain every drop of blood from your body like the vampires they are. In some cases literally, given that some people resort to selling blood to make ends meet.