One important reason to obtain health insurance is not to go to a doctor but to protect wages and other assets. When patients receive care at a growing number of hospitals, and don’t or can’t pay, their bills often end up at collection service companies.

And if those patients don’t meet collection demands, their debts can make another, final stop: the County Courthouse.

A majority of U.S. hospitals, have a history of aggressive debt collection. From 2009 through 2013, one hospital in the Midwest filed more than 11,000 lawsuits. When it secured a judgment, as it typically did, the hospital was entitled to seize a hefty portion of a debtor’s paycheck. During those years, the company garnished the pay of about 6,000 people and seized at least $12 million—an average of about $2,000 each, according to an analysis of state court data.

No one tracks how many hospitals sue their patients and how frequently, but one source found hospitals that routinely did so in various parts of the Country. The number of suits is clearly in the tens of thousands annually.

In one Midwest state, hospitals and debt collection firms working for them filed more than 15,000 suits in 2013. But if patients don’t obtain health insurance or enroll in MediCal or Medicaid, hospitals must take action.

As one spokesman for a hospital stated, “the services were rendered, and the hospitals have to figure out how to get them paid for”.

*Article modified, and data obtained from Propublicia.org, NPR, and other sources.

For more information, please call the author John W. Barrett at (626) 797-4618.