Or pay them $10 per month.

Don't let it destroy your life.

If you pay them even a tiny amount each month the bill never goes to a collection agency, which means it never hurts your credit score.

Also, do some research and find out the medicare rate for your procedure, and never pay more than that.

This doesn't follow - I am pretty sure that institutions can report things without a collection agency being involved. Which isn't to say it might not be a good strategy nonetheless - an institution like a hospital might be less inclined to report things if they are still receiving checks from you, whereas I don't see a collection agency giving the same leniency.

Unpaid ones are reported sometimes, but not overdue ones.

This is because a medical event is not considered as your fault, so if you can't pay it it's not because you are a poor credit risk for other things.

What is this distinction?

Medical providers don't report to credit bureaus, but collection agencies do.

In my opinion each of these factors are your very own choice. There is not a single accidental factor involved in in this and you had the choice to change each of these factors. I just don't think that society owns you the ability to study full time while at the same time financing a dependable adult (incl tuition?), a $900/m apartment and a car. But fortunately things turned out great for you. Congrats to your successes!

I agree and disagree. If you want to follow that logic to its conclusion, everybody incurs costs from simply living. They choose to stay alive when suicide would simply free them from that burden.

Getting married, trying to improve oneself and not leading an itinerant life should be among the basic affordances society can guarantee to any person.

But I also will concede that I could have dropped out of school and lived a marginally better life in perpetuity until I was too old to continue to do heavy manual labor, then died in poverty.

This may not be a very popular position, but I disagree. I don't think society owes a single one of us anything. By what possible mechanism could they be said to incur that obligation anyway?

Now, you could argue that it's in the best interests of society-as-a-whole to provide those basic affordances, and I think certain results in game-theory would support that argument. But, to my way of thinking, there's still no reason to expect that "society" will guarantee anything for any one individual.

Maybe I'm just weird in this regard, but at nearly 40, I'm still unmarried... biggest reason? I grew up dirt poor, never felt like I could afford to start a family, and so never seriously pursued marriage... and I was obsessive about spending my time trying to ramp myself up the socio-economic ladder so that one day I could do things that mattered to me.

Now at this age, whether or not I ever do get married is a whole new question, for a variety of reasons. But the point is, I - for one - never had any expectation that society should provide for me to an adequate level that I could marry and skimp out on hard work.

All of that said, I received various random acts of charity throughout my younger years and, looking back on it all, I think I agree with the gist of TFA. Some of those random acts came at critical junctures and probably made a huge difference in me achieving what I have achieved, and me having committed suicide out of despair and depression 20+ years ago. Somebody gave me a car once, when mine had broken down. That enabled me to keep working and keep going to school, when the alternative would have been a complete shuddering stop to my progress.

But, as appreciated as that was, I appreciate it as a gift and see no reason to believe that anybody owed me that.

Consider this, because somebody gave you a car, or somebody gave me a $1000 check, it kept us on the upwardly moving socioeconomic ladder, ensuring that our taxes would become many times what they would have been had we stayed working hourly low waged jobs. Consider if those things had been paid for out of the tax base, thus putting a net positive back into the system.

For sake of comparison, a few friends of mine from where I grew up could't stick with the living hell of it all and didn't finish college (those that tried) for a wide variety of reasons (very few of those reasons were laziness), I paid around the same in taxes each year over the last five years than any of them made in salary during the same period. They're effectively making the same wage working today as they made in their early 20s, thus greatly lowering the tax base that they could have provided back into the system.

I can't say that a single pivotal act of state-sponsored charity would have turned their lives around and made them into vastly more productive citizens, but a few dollars here and a discount there could have been all it took. Who knows?

I think my point is that putting it in terms of who "owes" what, is probably not the right model. If the system isn't dysfunctional, you can trivially calculate what the average family of n requires, and make sure that the working adults in that family, working a full-time job, can earn enough to make that if working full-time is what they choose to do. A medical surprise or an auto repair or what have you shouldn't be something that derails their entire lives.

In my case, we were both living spartan, but comfortable, lives after college for around $40k per year combined (my first job after graduating). This is with a $900/mo apartment, one car payment, and no children. We ate out once or twice a week, and cooked in the rest. We had enough to clothe ourselves professionally and keep the lights on when we wanted them (not when we needed them), not eat absolute garbage three meals a day, and a few hours at the end of the day in "free-time". It works out to about $20/hr.

And turns out that the literature shows that in my area, a living wage for 2 adults is shown to be $19.25 [1]

Now there's an argument that there should be jobs that aren't living wage. Unskilled, extremely low end jobs, like fast food restaurants, they should pay enough to get people into the work force, but motivate them to move up and above that. It's an interesting bit of social engineering. But it has a problem that's not always overcome. That's because the minimum wage is like a speed limit. It's the default setting unless some other factor causes you to deviate from it like a lack of a hiring pool.

[1] - http://livingwage.mit.edu/

and me having committed suicide out of despair and depression 20+ years ago

Obviously should have a "not" insert in there. That or I'm posting from The Other Side... :-)

There a millions of students who live on campus at a cheap dorm room, have no car and get around on a budget where $900/m sounds like a life of luxury. If you decided to life in one of the very few inner-city metro areas where this is the norm nothing forced you to stay there. This is your lifestyle choice, not a poverty choice.

Include in it a location: It must be on or near an accredited university. Find housing that is magically "super cheap" or not a "luxury". Specify the costs. The housing must allow for no deposit (don't have the money) and nonexistent credit and allow for a married couple to stay there - dorms obviously won't work. Scans of local newspaper clippings from around the country will suffice since Apartments.com didn't exist back then.

A money ($) budget: Include all relevant transport costs, food, clothes, tuition, etc. Every single thing that costs money. These have to be real costs and not a WAG. If you pick a school, include tuition for two and all relevant fees exactly.

A time budget: Map out what my day-to-day life should have been according to your omniscience. Include every minute from wake-up to sleep. Include all travel times to and from work, home and school (I'll allow shopping time to be ignored). This probably implies that work, home and school are within walking distance, large isolated land grant universities won't work since available jobs centers are obviously too far.

A job or two: They must pay in isolation or in combination enough to cover the budget above, while allowing time to go to school, and they must be able to be done at different times. No time travel! Remember no college degree or other relevant qualifications. Jobs must be both available and plentiful. Just putting out "work at Costco" won't cut it, one actually has to get hired. I can tell you that my hit rate on job applications was less than 10% (I received 1 job based on over 100 applications).

Add in a $10,000 medical bill due in 45 days.

Describe a way to relocate two cars and an apartment full of stuff at zero cost to this magical valley of freedom (as in beer) and plenty.

Having said that, as a college student myself I have much fewer expenses than you. I live in a room about a hundred square feet in size, I walk or ride my bike anywhere I need to go, and I buy cheap food to prepare at home to save on food costs (I eat for under $5 a day). If a college textbook cost over $100, I simply don't buy it.

My non-tuition expenditures total under $700 a month including food and rent. For two of my three years in college, I did not have a job.

I happen to be very lucky in that I received excellent scholarships (well, that wasn't luck, but not everyone goes through high school thinking about college) and help from my family. If I had medical expenses, I would have had to take out loans to pay them. I think, if I were in a situation with no help from family, I would have still been able to attend college, but I would have graduated with over $50,000 in student loans. Your situation sounds very difficult, but you should seriously consider how many of your expenses were/are necessary.

But let's break your situation down with some questions.

I walk or ride my bike anywhere I need to go

Do you walk or bike on the freeway, or rather do you happen to live in an area with accessible walking and biking lanes? My area does not.

My non-tuition expenditures total under $700 a month including food and rent. For two of my three years in college, I did not have a job.

I checked, non-tuition rates at all of the schools in my state cost ~$800/mo for dorms. The dorms appear to be single occupancy with no affordance for a married couple, they do not allow year round occupancy, that means we'd be out $1600 a month for worse living conditions and still have to figure out what to do during summer break.

That being said, we did have an opportunity to rent a room in somebody's house and saved $100 a month (sublet rooms in my area run between $600-700/mo), the tradeoff was around 2 more hours a day in transport time by car + fuel costs. Doing the math and the money worked out about the same, but then we'd have to spend more time on the road instead of working or studying, and we'd have less privacy. We seriously considered the local homeless shelter, but they charge $20 a night per person, or $1200 a month for the both of us to be itinerant.

I did a breakdown somewhere else in this thread on what our costs were, it was only because of some grants and a few student loans that we could even pay for school at all.

One thing we didn't expect was that it would take two years for my wife to get her work permit. But 9/11 happened and fucked up immigration royally for a long while. It meant she couldn't work at all during that time. Once she started working things eased up quite a bit.

but you should seriously consider how many of your expenses were/are necessary.

So what was unnecessary?

At the time we had no car payments to make (the vehicles were owned outright), food was the cheapest garbage we could find in the "discontinued" bin at the dollar store (literally), clothes were what we started with (I didn't purchase a single article of clothing for 2 years), our #1 expense was housing, which short of couch hoping for years on end there simply wasn't anything we could do about. We had no furniture, at all. We didn't even have dishes for most of the first year! We both ate on around $5-7/day. There literally was no other expense that was possible to cut by our reckoning.

Nothing makes you think about what every...single...thing...costs than being poor. We even knew, down to the item, and sometimes to the ounce (since different packaging formats make direct comparisons hard), what we could buy for cheaper at the grocery store vs. the dollar store. We reused cooking oil in an old coffee can I took from my work when it was empty. A package of instant noodles and 20 ketchup packages made 4 servings. We used to go to our local grocery and argue with the manager when the sell-by date on canned goods got too close so we could get case of canned green beans for a dollar, then eat only green beans for a week. I can tell you that a package of one day expired hotdogs and 20 more ketchup packages can make an extravagant stir fry that lasts for four meals. Add half a chopped onion and it becomes 4 star. It's not possible to eat cheaper than that without going completely free.

We didn't have cable, a land-line or cell phones (I used AOL and other free internet CDs and a long phone wire to one of my neighbor's land-lines if I needed to get online at home, or just used the school's computer lab when it was open).

We actually sold one of our cars during the second February because there weren't enough work hours in the short month to both pay rent and buy groceries.

What where was the extravagant and unnecessary thing that we could have cut?

For two of my three years in college, I did not have a job.

And yet tuition, rent and food materialized?

With that said, I think you could have saved money on several things. $900/month is a lot for students. I decided to go to school in small city instead of a large one because I knew it would be cheaper to live there. By sharing rooms with 4 other students, I only paid between $325/month to 375/month. This was including, heat, water, power etc. Did you have cable TV or internet? Cut it. You spend minimum $40 on it. Did you ever eat out? Never do it. You can save $1000/month there. You mentioned that you drove. Sell the car. Car costs much more money that you think.

$16000 is not a lot, but that's actually enough for many students. I made less than that during 4 month summer internships, and I paid my tuition and living expenses without any problem.

I'll break this down one by one.

$900/month is a lot for students. - I agree, had I been single I would have split a room like that with somebody else for $450. However, I wasn't and my "roommate" wasn't allowed to work the first two years we were married.

I decided to go to school in small city instead of a large one because I knew it would be cheaper to live there. - You don't always get a choice where to go to school, sometimes you have to go where both of you have been accepted. I've broken how tuition worked for us down elsewhere https://news.ycombinator.com/item?id=3753975

By sharing rooms with 4 other students, I only paid between $325/month to 375/month. This was including, heat, water, power etc. In theory, it doesn't sound like where you lived was all that much less expensive than where I lived per person.

Did you have cable TV or internet? Cut it. You spend minimum $40 on it. - Agreed, we had no cable, no internet, no phones of any kind for the first two years.

Did you ever eat out? Never do it. You can save $1000/month there. - Agreed, when we ate out it was unavoidable, and it was taco bell, the cheapest thing on the menu. Elsewhere in this thread I've given some sample "recipes" of what we ended up eating when times were a rougher than normal. I still don't really like ketchup to this day all that much.

You mentioned that you drove. - 100% paid for, unavoidable, public transport wasn't good, was expensive, and biking/walking would have eaten up hours per day that could have been used for working/studying.

Sell the car. Car costs much more money that you think. - We sold one of them the second February to make rent and buy groceries. When my wife got her work permit, we had to limit where she could work to sync with where I worked or we'd spend too much time driving around and eating up fuel.

We would have sold furniture too, but we didn't have any :( Other than a used mattress somebody donated to us, we had a couple frying pans, some old clothes and an old computer. When we got married we had about $150 in the bank.

Moving is expensive, and would have required both him and his wife to transfer schools. That requires long term planning and isn't a feasible option for an immediate crisis.

After she got her permit, she started working and things improved quite a bit.

http://www.time.com/time/magazine/article/0,9171,2136864,00....

The USA medical system has broken also PEOPLE THAT WERE HAVING HEALTH INSURANCE, and it is a wrong as the story conclusion to look at charity as the solution for fixing problems that were brought upon a previously prosperous family in the first place.

I agree completely that the medical system is broken. I was expecting a $2k bill for the level of treatment I had that night, not $10k.

However, there's an understanding of being poor that can never be explained to somebody who never has been poor. There's a quality of the thing that can never really be conveyed (all personal true stories): The near monthly 3am panic attack that wakes you up even though you're 20 hours behind on sleep for the week, deciding that "no, the $1.50 menu items are too expensive", buying food by weight/cost with considerations made for non-perishability, wearing the last pair of pants you have left and hoping they last for 3 more months because you passed out from exhaustion and tore your other pair beyond repair on the way down. It means never taking a sick day, because the $40 you'd lose that day would mean you couldn't pay rent -- even though your cough clearly lets you know it's pneumonia. It means that you save every piece of plastic container you can get your hands on because you can't afford dishes, or dashing out of a fast food restaurant with handfuls of plasticware so you can stop eating your oatmeal with your hands. It means using the remains of your second to last pair of pants as reusable napkins over your dinner of canned corn (discontinued 20 for a $1!) and half of the ten pack of Ramen you scored at the dollar store that you're trying to stretch with more water. It means seriously considering stealing enough ketchup packages on your way out with the plasticware that you might be able to get a tomato soup broth going. Being poor is not having a TV and digging through your apartment complex's trash to find furniture you can patch up. It means that for the first year of your marriage you have a mattress, and no other furniture, you spend your nights sitting on the floor trying to keep your 7 year old discount computer alive with spare parts and literal duct tape or you'll fail school. It means not buying any textbooks and then scouring campus for lost smartcards so you can copy the relevant readings out of somebody else's book...it means not having a cell phone or a landline phone, it means paying an extra $100 a month in rent so you have a place to live because your credit score is abysmal and the property manager thought you looked honest and he'd make an exception this time, it's trying to find a way to score a bottle of free modafinil from a friend with sleep apnea so you can take a night shift at the local grocery loading dock twice a a week...it's having a guy almost murdered in the apartment below you buy a homeless man he invited in to drink and do drugs in exchange for sex, and thrice weekly police showing up at your building, it's hearing shots fired on the other side of the firewall in the building next to yours, it's picking through slices of cheese or fruit to cut out the moldy bits so you can still eat it, it's getting a $.50 an hour raise an thinking immediately about how you might be able to buy a new pair of pants a month earlier, and calculating how many hours you have to work to make up for what each and every meal costs.

That was my life for about two years and most of it stayed true for another four after that.

In my area a $900/mo apartment was the cheapest possible option short of renting a room out of somebody's home (which ran around $500-700, but afforded no quiet place to study, no private restroom and were all an additional 10-20 miles from school and work. Crunching the numbers and the additional fuel cost, plus the driving time (which simply didn't exist) would have almost equalled out. My other choice was homeless shelter, but it cost $20/night or $600 a month and there was no place I could store my books or computer.

One thing I hear a lot of is that poor people should go to school or improve themselves so that they don't stay poor. It took round the clock discipline, 7 days a week, for 6 years to make that happen in our case. I doubt that most people could do that on such a sustained basis.

I know that I couldn't have done it on my own. There were many dozens of times that I almost threw in the towel, and my wife almost did the same -- but we picked each other up when we needed it and made it happen.

In the end I only did it because I was tired of growing up poor and living poor, and getting shitty jobs and..just...being poor and watching others get opportunities I would never see just because I was born into the wrong family...indignant rage carried me through.

I have permanent scars from those days. My lungs are permanently scarred from a case of pneumonia I carried around with me while working for six weeks before my wife finally forced me to go see a family doctor (who gave me free antibiotics and an almost free visit out of the kindness of his heart) -- I pretty much can't do cardio exercises. The stress was so bad that it weakened my immune system, and gave me some mild nerve damage in my face and problems with my pancreas I'll carry for life. I have night sweats most nights, and recurring nightmares of suddenly going bankrupt and being poor again. I had two mild untreated breaks in my hands that didn't heal quite correctly, leading to permanent pain and reduced mobility. I have ulcers making coffee and other acidic drinks painful to drink. I had an untreated stye in my left eye that left my eyelid permanently thin, meaning when I close my eyes, I can still see light in that eye.

Nothing I've ever experienced since can hold a candle to the stress of that time, not being in warzones, not having friends die, not even living the life of a startup.

As a society, why do we allow situations like this to persist?

http://www.pbs.org/wnet/frontierhouse/ http://en.wikipedia.org/wiki/Frontier_House

It's an amazing show that really goes into how hard subsistence, self-reliant living is. At one point one of the families becomes so desperate for some relief that they sneak in a box spring mattress.

Most of the people I know who have very poor opinions of the poor could probably learn quite a bit by spending 4-6 months living on a poor person's time and money budget without the safety net of their otherwise prosperous lives. I'm sure some of them would sneak a credit or ATM card into production.

It'd actually make a great TV show I'd bet.

Those that tried and didn't, shouldn't be looked down upon.

Crawling up from a poor rural kid to working professional with a degree (or two or three) is hard. I'm the fourth person in my family to ever attend college, the third to graduate with an undergrad and the first with a graduate degree. I was helped by many uncountable people along the way.

And, student loans are available from the government. Use them!

That's some of the worst advice I've seen. Toss them in the trash and the debt will keep growing, whether through interest or collection fees etc., and you will keep garnering ill will to a point where resolving the problem later will become substantially harder.

On the other hand, most creditors will be prepared to cut your bills substantially if you demonstrate to them that you genuinely can't pay. Generally you can negotiate frozen interests, substantial cuts in the bills and payment plans very easily. This applies both to your personal circumstances, and your business. You have substantial leverage because they know they risk getting peanuts in a bankruptcy.

My first company had a really tough period due in part to changing market circumstances, and in part due to our lack of financial control in the beginning (none of us had business experience when we started... Hard learning curve). When I started cleaning house, one of the first things I did was to establish a list of all our debts, and call each and every creditor to describe the exact situation - how much we owed in total, our current revenues and projections and expenses, and made them an offer:

They'd cut their debt to 25% of the original claim, and freeze interest, and we'd resume payments. In some cases we'd convert assets we'd bought into leases with the same company, but at similar rates. Some argued. Some were angry - for good reason (some had been subjected to the "toss them in the trash" idea by guy who looked after the finances before I took that task on too, on top of managing our servers, and were furious they'd heard nothing). Some tried to get preferential treatment.

But in the end every single one accepted, because they could see from the numbers that it was the most we could afford and because they knew we were treating them fairly from our insistence on , and they also all knew that a customer in a tough spot that cleans house and makes a best effort offer like that will be damn grateful, and if they make it through, will keep bringing them business.

(We did make it through, and most of those creditors made a good chunk of money on us in the long run.)

Dealing with commercial lenders and banks is different. But consumer debt is another animal.

and those kind people each pitched in a few dollars to help people they'd never met before

That’s the best thing about anonymity in charity; you remain in debt – forever. And the best thing you could do in return is help those whom you don't know (or those who don't know you).

The urban poor are in a far more desperate position than the rural poor, regardless of their country's development. Compare Depression-era Kansans to the inner-city poor of today and you'll see a large disparity in just about every metric. The one that jumps out at me the most would be nutrition. It's a lot easier to eat well with no money on a farm than it is with no money surrounded by convenience stores and Taco Bells.

Which is irrelevant since the $2 a day figure is adjusted for purchasing power parity.

In the U.S. poverty is defined as earning less than $23,050 for a family of 4 or $14,657 for a family of 2 (in 2011). My average yearly take back then was around $13k. My best year was $16k. The difference materially for us was that I paid more taxes at $16k than $13k, and we ate something other than Ramen and Taco Bell once a week.

Despite being eligible for welfare, we chose never to take it since we were both healthy and could (theoretically) work and if we watched out finances, make ends meet. It was hard, but we did it until I got sick.

Even in 1990, $14,000 was 'only' 3700 hours of minimum wage work, that's not 2 full time jobs, never mind 100 hours a week (I would think it fair to include school time as work, but it would also be fair to mention it). If this all happened before then, the 2011 poverty line isn't a very interesting point of reference.

For money: let's start with your $14k/yr. Now deduct witholdings, then $900 a month for rent. For fun I checked, in the area I lived in back then, there are 0 apartments under $1200 a month today. Housing is expensive.

So say 20% disappears for witholdings ($2800) = $11,200/yr less $10,800 for rent = $400 to do everything else on for the year. Or about $33 a month for food, fuel, clothes, transport, etc. It's about a dollar a day. Good luck. Hope you don't also have car payments.

For time that's also easy. There's about average 30 days to a month or 720 hours. That's your time "budget". You can never have more or less than that.

Minus a full-time job, 40 hours = 548.

Minus 2-4 hours a day during work weeks taking either the car or the bus depending if you want time or money. So around another 40-80 hours a month disappears (you can't get to work in zero time). leaves you with 468-508 hours left

3-4 hours a day eating..~120 hours a month. 348-388 hours left.

You gotta sleep. Lets say you're generous and give yourself 7 whole hours a night. 228-268 left.

Now if you're going to school like I was, you're in class 12-16 hours a week with about 3x that much out of class work. So 124.3=51.6 leaves you with ~177-216.

1234.3~155 hours leaves you with 22-61 hours.

Let's say you go to school 3 days a week. Take out 1-2 hours (car or bus) for transport per school day or about 13-25.8 hours per month leaves you with...well pretty much not enough hours to do anything else.

So you stretch, you knock off an hour or two a day for sleep, leaving you chronically sleep deprived. If you decide that you can't afford the time, you drive everywhere, which drives up your fuel costs. But it leaves you enough time during the week for a second full-time job and maybe some extra work on the weekends when you can get it. But you're so tired you can't focus on what's going to get you out of this mess, your school work.

So you work two part-time jobs so you can keep your grades and studies up. But you're still sleep deprived. If you don't get work one weekend, you might sleep through the entire weekend in one stretch. A side benefit is that you didn't have to pay for food while you were sleeping (a strategy you'll see among many of the homeless population in most urban areas).

Or you work one full and one part-time job and go to school less than full-time, but you lose one of your grants and can't afford school that way anyway.

It's a very* hard multi-variable equation that you have to balance, minute by minute, and hour by hour.

Heaven forbid you have a bad day and need a couple extra hours, or want to spend a couple hours unwinding in front of the TV. You can't get more time.

There were many times that I looked into getting illegal modafinil because I heard you could go without sleep for a couple days at a time. It would "buy back" 20-30% of my monthly hour budget letting me work more...or giving me time to study.

Trying to understanding being poor without understanding time budgeting will give you a very incomplete picture. There's a reason so very few people go to school and work at the same time even though a naive look at their hours makes it look trivially possible.

In 1990, with $3.80 minimum wage, that would have been 7904. I think your calculations are wrong.

"'only' 3700 hours" probably wasn't the best way to phrase it, but I was trying to establish that it would have been possible to earn $14,000 at low wage jobs in 1990, and it seems like it would have been.