I've heard that medical bills are the leading cause of bankruptcy, and I need people in-the-know to help me understand this. Because I think I have been living in the dark. How does one accrue medical bills? I have been under the impression that an uninsured person who cannot pay for medical care, cannot get medical care. This is because I thought one had to pay for medical care at the time of service, excluding hospital emergency rooms. Something happened recently that brought this to my attention. A friend of mine, who has two kids and no insurance for herself or kids, was sick. The kids were sick too, and were seen by their pediatrician. My friend has a friend with some real poor skills and knowledge, and that friend told her to go to a particular medical group. She went and was given a doctor, and told that there is a 33% discount for payment at the time of service. She was seen and given a prescription. She was not asked to pay and did not pay. She has no intention of paying. Now, if she returns to that doctor the next time she needs medical care, will she be refused service for not paying? Is this an example of how a person accrues medical bills? Can people actually get medical care without having to go to emergency rooms?