[toast0]

Third option is pay what you can reasonably pay and file for bankruptcy. Which sucks, but is an option.

Try to get assets into bankruptcy protected holdings when possible (401k, house, etc, depending on state of residence), so you have more flexibility post bankruptcy.

[hypeatei]

Bankruptcy is not an easy path out of debt. I've seen others go through it and it's stressful: they pry into all your finances, you still have to pay it off (just at a lower amount), and it destroys your credit. There are weird restrictions also like not being able to pay it off early even if you're able to.

EDIT: don't forget you have to pay the bankruptcy lawyer too.

[JohnFen]

There's a reason that medical debt is the #1 cause of bankruptcies in the US.

[JKCalhoun]

Another option for the U.S., fly to Mexico and take advantage of the "medical tourism" that is gaining in popularity.