I think it works that way, you think it doesn’t work that way. So in that sense there’s no way to know based on “trusting random commenters.”
But I can tell you this: there aren’t a lot of ways in which that debt collector can collect. They can’t take your home, they can’t take your car (as if the uninsured person even owns their car outright), and I don’t even think they can garnish wages.
The statue of limitations on debt is as short as 3 years in some states, and it won’t even affect your credit score beyond 7 years.
If that person never answers the phone and never admits to the debt, it basically just goes away on its own from my understanding.
Even if they decide to settle, that debt collector purchased the debt for pennies on the dollar. That person settling is not paying anything close to the full cost. The hospitals know that a bill going to collections is already a lost cause, and is basically written off as charity care.
Unfortunately a credit report can be a part of some jobs. I found this out the hard way when I tried to do what you said - ignore the calls - and there was an unpaid debt from 6 years ago on my credit report anyway when I had to get a clearance.
Many people frame this as a "say this magic phrase to get your bill reduced" and I just don't think it's that simple any more. Some of the consequences from not paying just come back down the road.
I don't think it works this way that often. It might just get sent to a debt collector. They might give you a lower fee, but it won't be by that much.