No that rarely if ever happens, they cannot touch your credit report or send bill collectors. I have personal experience with this, all you do is call them up and negotiate a cash price and it's usually 80-90% off. You are now required to buy health insurance by_the_Government and there is yearly enrollment windows. If you don't and don't have an exemption, you have to pay_the_government through the IRS a penalty fee. Also you cannot be a dr in the USA without_a_government license. I mean come on I could go on and on and on. It's just a name game the difference.