Medical debt in the US is unlike other debt. Amounts are declared post-factum and a patient doesn't have total control over the process in reality. The most important and visible choice is whether the provider/facility is in-network or out-of-network, but even that is not bulletproof cause no one discusses the exact billing codes with their providers and cross-checks with their insurance. As one example, sometimes pre-authorization is needed but not given and you're SOL. No Surprises Act took off some edge off this atrocity but the system remains unforgiving.