If you don’t have the money you get debt. At some point in a hospital visit a person swings by to get your financial information. They can’t refuse care, but they can demand your info.

If you can’t pay your bill that’s totally ok, it’ll sit there waiting as debt collectors hound you every few days. Or you can reach out to a hospital run charity program to prove you’re sufficiently poor and get a reduced cost payment plan.

It’s dystopian, yes, but more in the “a lot of Americans go into medical bankruptcy” way than the “you’re forced to give birth out back” way.