How much of a discount that's worth depends on the likelyhood of collecting after the legal process as well as how much of a reputational hit going through the process would be.
I wouldn't negotiate with most things after the service was performed (unless it wasn't to my satisfaction), but most services will have a firm quote before the service (sometimes that's legally required). A mechanic can keep your car until you've paid, but a hospital can't refuse to discharge you until you've paid, so they don't have the leverage to get immediate payment.
(probability of recovery) * (1 - profit margin) * (amount owed)
today, for the right to sue on you behalf?
Note: I think the current debt collection system in the US is terrible, especially for medical debt. I suggest looking at the charity "RIP Medical Debt" if you do too.
At the very least, when selling a debt to a collections agency, the (re)seller of the debt should be obligated to first offer the same price to the person that owes money.
That seems reasonable at first glance, but it would lead to an explosion of people simply refusing to pay and waiting for the 'debt collector price' offer to arrive.
Depending on the debt, getting most of the difference between the legal expenses and the debt itself is in reach, given a creditor who is a rational actor.
Suing people who don't pay their bills is a losing proposition. You will be paying lawyers and getting very little to nothing in return.
In the "of course that exists" category, there are services that give a score about somebody's ability to pay.
I really hate how every business process can be (and frequently is) optimized to the nth degree at the cost of privacy.
Need a hip replaced? Having a child? These things can negotiated in advance at a substantial discount.
https://www.businesswire.com/news/home/20220318005244/en/Equ...
> Effective July 1, 2022, paid medical collection debt will no longer be included on consumer credit reports.
In addition, the time period before unpaid medical collection debt would appear on a consumer’s report will be increased from 6 months to one year, giving consumers more time to work with insurance and/or healthcare providers to address their debt before it is reported on their credit file.
In the first half of 2023, Equifax, Experian and TransUnion will also no longer include medical collection debt under at least $500 on credit reports.
What about before you undergo the medical services? Why is it so damn uncommon to ask for a price before seeing the doctor?
Imagine choosing doctors like plumbers. Do you go with the one with the low initial exam fee? How about the one your family member recommended? Or the one with good reviews on the internet? Then, when they tell you the plan, do you go to another one and pay their exam fee to find out their plan?
I have some experience at this from the veterinary side. Some people do treat us like plumbers. They know there are several points of leverage in the pricing. However, it is a two edged sword. If you decline the plan and renegotiate it, the vet is liable to stop recommending the expensive options because you are more focused on money than health. This happens unconsciously. If you decline a $20 diagnostic after a half hour of haggling I won't have time or energy to try to convince you to spring for a $100 monthly treatment when an inferior but acceptable treatment is available for less. I'll present both options and you will probably choose the inferior one as part of your haggling strategy.
Haggling makes lots of sense when the quality of the commodity is not under control of the salesperson, it is easy to determine, and the salesperson pads your price with lots of margin. In medicine, everything is opaque and haggling is rarely able to take a broad cut on price without sacrificing quality.
The main reason is that, often, the doctor is choosing the specific procedures after you show up, not before. There's not a price for "stomache ache".
For the elective procedures where it is known what is involved up-front, there is some price shopping that does happen.