Say that a John Doe case (i.e. someone whose identity is unknown and the patient can't tell them) comes into the hospital and collapses, becoming incapacitated. They receive treatment yet ultimately die.

As the hospital staff doesn't know the identity of the John Doe, they can't tell if they have insurance to pay for the coverage, nor do they have any known next of kin. So who is ultimately responsible for their medical costs?

This question was inspired by the 2016 Doctor Strange movie where Strange brings the Ancient One into the hospital yet she dies, then Strange leaves without identifying her.

  • In practice, in the United States, the hospital and the health care providers who work on a contract basis would not be paid for that work (although if caused by a crime the guilty party might be forced to pay restitution to them if convicted). In many other countries which have universal health care, the government health care program would pay without regard to John Doe's identity.
    – ohwilleke
    Commented Dec 1, 2016 at 6:48

3 Answers 3


In the United States, Medicare and Medicaid pays for indigent patients in hospitals, via Disproportionate Share Hospital programs. This is not a direct reimbursement but a program based on certain qualifications and the ratios of indigent patient days to normal patient days in periods.

Medicare link

  • How would this translate into the federal government paying the bill for an unknown person?
    – user6726
    Commented Nov 30, 2016 at 23:45
  • 3
    John Doe's care would be added to the indigent patient care total used to figure out what percentage of care was to indigents which would be used to increase the payments that the hospital gets under the program relative to what it would get if John Doe had never showed up.
    – ohwilleke
    Commented Dec 1, 2016 at 6:51

From the legal perspective, Doe has incurred a debt which would be paid from his estate. But in this case, we don't know who he is, so we can't "find" his estate. Suppose that in reality he is billionaire Bill Smith, who disappears without a trace (he's actually dead and buried in Potter's Field). His family starts the process to have him declared legally dead, and eventually they divide up the estate. Meantime, back at the hospital, there is an unpaid bill, which the hospital writes off as a loss: nobody pays the bill. Likewise the taxi driver who didn't get paid.

  • "the hospital writes off as a loss". Whether or not they write it off is dependent on jurisdiction, if user662852's credible answer is to be believed... Commented Mar 14, 2023 at 0:58

In brief, the dead person or, more precisely, their estate. If the estate is bankrupt (in this case because it has no identifiable assets) then the hospital writes off their losses just like every other creditor.

  • "If the estate is bankrupt (in this case because it has no identifiable assets)" Actually, there's no estate without a positive ID of the body. And whether or not they write it off is dependent on jurisdiction, if user662852's answer is to be believed. Commented Mar 14, 2023 at 0:56

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