<prompt> Human: My wife and I recently had our third child.All 3 were c-section. Given that, the out of pocket post-insurance costs have always hit our annual max, 4k to 6k per person 10k - 15kish family max a year. Yeah, all this for the low low cost of well over a grand a month for insurance, lovely! Thats the smell of freedom right there!. Her surgery and recovery costs always bumps us into her individual max, and the care for the newborn plus all the follow ups always hit the newborns max out-of-pocket. Couple the older kids having their usual problems tumors, seizures, standard-issue ailments, bumps and bruises, and each year we always hit our family limit. In the past Ive let the hospital bills pile up, then call them and offer to pay a 1 time in full payment for a certain percentage discount. With child 1 it was around 13 off, child 2 was 25 off. Child 3 was interesting- all the best major hospitals by us in-network were acquired by a single company since child 2s birth. As such, costs have increased and when I tried the same discount for paying in-full on child 3 I was told they no longer offer discounts for paying in full. Theyd let me spread out the payments, interest free, for a couple years but no discount for paying in full.Obviously worst case scenario I would take their interest free loan- why not? It doesnt hit my credit and I have no reason to pay in full at todays dollars when I can pay over 2-3 years for a lower NPV.But I got thinking- what if I simply refuse to pay unless they offer me a discount? I spoke with multiple people and I was assured they cant offer a discount for paying in full minus discount. I asked what happens if I refuse to pay anything? I was told they would send it to collections. I asked what they would get for my debt and offered to pay more, but they wouldnt tell me. What is that usually, 50? Less? Pennies on the dollar? Its fresh debt, so probably at least 50, right?Heres my understanding- collections agencies, especially when dealing with medical, are happy to negotiate. So, I threatened to let the items under my wifes responsibility which was around 10k go to collections. Heres the key: My wife doesnt work. All credit we need is under me. Its tied to my steady income. Her credit score could be 0 and it doesnt impact anything. Her income adds nothing to the rate Ill get when we refinance next- its all under my name and credit score. And please, pause here- dont judge me as short sighted- I understand that I could drop dead tomorrow and shed need her credit. But heres the rub- We joke all the time that my dying is the single best financial decision she could make. Im stupidly over-insured a whole different topic for this sub. I drop dead due to a heart attack tomorrow and shes got a couple million to pay off our mortgage and send our kids to school and spend the rest on a beach house. I get hit by a truck or die in a car accident on the way to work tomorrow or accidentally fall down the stairs due to a well placed laundry basket? Well then damn, the accidental-death-and-dismemberment kicks in and they have more money than I can imagine.In other words- My credit is all that matters. Anything that doesnt impact that is as expendable as some random local politician on House Of Cards that gets in Franks way. I explained my understanding of our options to the hospital- I offered them to pay in full for a discount- far more than theyd get selling her debt, but they refused.So I pulled the trigger, and told them Im not paying.This was over the summer. It finally went to collections. I got the collections notice today, called up, and they are willing to let me pay in full for a 30 discount. If I spread it out, I get the same interest free loan the hospital was offering over more time though, sweet NPV!As far as I can tell, I just saved 3k by letting it go to collections rather than deal with the pain in the ass hospital monopoly that refused to budge. No credit hit to either me or my wife. In fact, because shes making some payments the laws here protect it from ever touching her credit record.What am I missing? What downside was there to telling the hospital to f-off and deal with the much much more flexible collections agency? Now that Im doing business with a collections agency I feel like Im, going to be blindsided at some point. But as far as I can tell there was no financial downside to what I just did.  <response>: yeah medical bills in collections that are being paid or being paid off stays off the three credit bureaus. FICO two years ago made it so that medical collections stay off 180 days for insurance to pay it off and the item goes away completely once its paid off. It does not stay on your report for 7 years like regular debts. Since this is a fairly recent development, I think this particular hospital will catch on if they start seeing it become a trend since most people will either just pay the balance, have their insurance pay it or file for a medical hardship for low income families. Most arent as adventurous as you and risking their account to go into collections. 