By the time Astra Augustus left Virtua Memorial Hospital in New Jersey after the last of four surgeries, she'd run up about $255,000 in bills. At first, Augustus said, she thought she was lucky. Virtua gave her a charity discount, to $30,530. Then she got statements from the doctors who treated her in the hospital, adding $18,000. "I didn't know who to pay first," Augustus said. Virtua sued last month after she fell behind in her $400-a-month installment plan. While the nonprofit hospital had been generous, she said, the debt is still overwhelming for someone with a monthly income of $2,200.