Patients must either accept the insurance company's quick and guaranteed payment, or fight on through debtor-protection laws to get at the doctor's personal assets.
And this was a world that controlled its poor through debtors' prisons, workhouses (sweatshops for the destitute) and harsh sentences, from flogging to prison to exile to death, for stealing even life's basic necessities.
On 27 January authorities in the city of Ulyanovsk said a collector chasing down a 4,000-rouble 4,000-roublehrew a firebomb through a debtor's apartment window, badly burning a two-year-old boy.
It was, for example, very hard in the fall of 2011 to know how the ECB would respond to the escalating financial crisis in Europe; failing to predict that Mario Draghi would find a way to funnel vast sums to debtor nations through discounting would have lost you a lot of money, but wasn't really a failure of the economic model.
They cannot agree on who should bear the cost of today's crisis: should it be creditors (through a write-down), debtors (through austerity) or the Germans (through transfers to the south)?
The second-largest debtor through municipal bonds in the country is New York City.
But around £8bn a year escapes them, and it is these hardcore cases that are written off by selling the debt on to the highest bidder, who buys it at a reduced price, then puts the debtor through the wringer once again.
Collectly attempts to shorten those cycles by tracking and learning about a debtor through each interaction.
But the majority of the student's loans were private, leaving his father in the midst of relentless phone calls and berating by debtors through his grief.
"Instead of a small debtor going through the whole rigmarole and expense of a bankruptcy or IVA they can enter a DRO".
On the contrary, there is every chance that such strategies will make things worse, for the debtor and (through higher credit costs, for everyone else) the wider economy.
