An investigation of more than 500 U.S. hospitals show that many use aggressive practices to collect on unpaid medical bills. More than two-thirds have policies that allow them to sue patients or take other legal actions against them, such as garnishing wages.This includes high-profile medical centers such as the Mayo Clinic. Kerem Yucel/AFP via Getty Images hide caption
In 2013, Grace E. Elliott spent a night in a hospital in Florida for a kidney infection that was treated with antibiotics. Eight years later, she got a large bill from the health system that bought the hospital. This bill was for an unrelated surgical procedure she didn't need and never received. It was a case of mistaken identity, she knew, but proving that wasn't easy. Shelby Knowles for KHN hide caption
Dr. Eckart Rolshoven examines a patient at his clinic in Püttlingen, a small town in Germany's Saarland region. Although Germany has a largely private health care system, patients pay nothing out-of-pocket when they come to see him. Pasquale D'Angiolillo for KHN hide caption
Lucy Greco (left), a web-accessibility specialist at the University of California, Berkeley, is blind. She reads most of her documents online, but employs Liza Schlosser-Olroyd as an aide to sort through her paper mail every other month, to make sure Greco hasn't missed a bill or other important correspondence. Shelby Knowles for KHN hide caption
Jerry Bilinski, a retired social worker who lives in Fayetteville, N.C., says he deserves a full explanation from his medical team of what led to a small gash on his forehead during his surgery for a cataract. Eamon Queeney for KHN hide caption
Many hospitals are now partnering with financing companies to offer payment plans when patients and their families can't afford their bills. The catch: the plans can come with interest that significantly increases a patient's debt. sesame/Getty Images hide caption
Dr. Nancy Caroline with paramedic Walt Brown in 1975 The National EMS Museum Archives hide caption
Diagnosed with cancer five years ago, Monica Reed of Knoxville, Tennessee, was left with nearly $10,000 in medical bills she couldn't pay. Medical debt is more prevalent among the Black community in Knoxville, than among whites. Jamar Coach for KHN and NPR hide caption
Paul Hinds has navigated the financial maze of health care during treatment for prostate cancer with the help of his girlfriend, Dr. Josie Tenore. Taylor Glascock/Taylor Glascock hide caption
Penelope Wingard of Charlotte, N.C., has survived breast cancer, a brain aneurysm and surgery on both eyes. For the past eight years, she's also been battling tens of thousands of dollars in medical debt. Aneri Pattani/ KHN hide caption
Aerial view of downtown Fort Worth, Texas. Some hospitals in Texas and around the U.S. are seeing high profits, even as their bills force patients into debt. Of the nation's 20 most populous counties, none has a higher concentration of medical debt than Tarrant County, home to Fort Worth. Jupiterimages/Getty Images hide caption
Montana health officials are seeking to increase oversight of nonprofit hospitals amid debate about whether they pay their fair share. The proposal comes nine months after a KHN investigation found that some of Montana's wealthiest hospitals, such as the Billings Clinic, lag behind state and national averages in community giving. Lynn Donaldson/Bloomberg via Getty Images hide caption