What do i do about $43,000 hospital bill that i cannot pay?

What state do you live in? Keep in mind that the Statute of Limitations for collections appearing on your credit report is 7 years; what you should be concerned about is the collection company for this bill taking you to court. Check with your state to see what the SOL for judgments are. As you said this incuident happened several years ago, therefore it may already be out of SOL for them to try and sue you for.

First...how old is this debt?

If they are aggressively coming after you for this debt then filing Chapter 7 Bankruptcy may be your best bet, as $43K is a lot of debt relative your income.

Don't let anyone smear you if you have to do this....Corporate America uses bankruptcy all the time and no one smears them. Do what's best for you and your family. There are certain people on this board who seem to get off on judging people for filing for bankruptcy. In certain cases filing for Chapter 7 can be the best move you can make.

- Remember that once you file for Chapter 7, that you won't be able to file again for eight more years...You can't file for Chapter 7 every time you get into financial trouble...so if you file make sure that you have some sort of heath insurance plan to cover you..as you don't want another expensive medical emergency right after you've filed for Chapter 7 as the new debt could not be discharged again.

Have you bothered to make some type of payment arrangement with the hospital? If not then call or visit them in person to work out a payment plan.

Bankruptcy

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Thanks for stiffing another hospital --