The Aug. 18 front-page article “The ‘follow-up appointment’ ” described, viscerally, the carnage of corporate-run health care in rural America.

Yes, rural hospitals are going bankrupt, hundreds more “buckling” under bad debt — but first they ruin the financial lives of the small-town patients they treat. The article included interviews with some of the dozens of patients in court one Wednesday in Poplar Bluff, Mo. (Mondays it’s Kirksville; Tuesdays it’s Bloomfield), some of the thousands of lawsuits brought by the county hospital, which has buried 35 percent of the county’s 43,000 residents in medical debt.

The article told the story of rural champion Daniel Moore’s heroic pro bono efforts, helping patients fight unconscionable hospital bills typical nationwide: $75 per surgical mask; $23.62 for two ibuprofen; $592 to culture strep throat. Why so much? Corporate-run insurance wastes about 30 percent of our health-care dollars. Profits drive prices — and profits increase with hidden waste. For-profit health care prioritizes shareholder value over Americans’ health. It kills hospitals, doctors and patients.

Medicare-for-all would protect patients and providers — and stop the financial carnage.

Barbara L. Estrin, New York

The article “The ‘follow-up appointment’ ” highlighted the crisis of rural health care and high costs driving patients to collections court and bankruptcy. In states that expanded Medicaid, rural hospitals have been surviving. Missouri did not expand Medicaid.

The featured hospital is for-profit. It is not required to have a financial-assistance program under the Affordable Care Act, as nonprofit hospitals are. Patients who may not be able to pay based on their income have no way of getting those bills written down. They are forced into debt collection and court.

Several of the patients in the article had high bills from emergency room visits. These are often the result of balance billing, which makes the patient responsible for what the insurance plan does not cover. Though Missouri has protections against the practice, they apply only if the provider and insurer agree to participate.

The high costs of care often drive patients into collections court or worse, bankruptcy, eviction and foreclosure, which is rightly cited in the article. However, there are more complex systems operating under the radar of most that should have been explained.

Tracy Douglas, O'Fallon, Ill.

There is a Kafkaesque tone to the tale of providing health care in southeast Missouri. Otto von Bismarck was able to inaugurate a workable health-care system in Germany in the 1880s that is still going strong and costs a fraction of the U.S. effort.

But in the 21st century, the Americans soldier on, alas, perhaps hoping against hope that someday they will get it right and be able to provide the necessary care for their own population. Let us wish them the best of luck.

Wayne Bert, Arlington