The point is that a "destroyed credit rating" only matters if your credit rating matters.
For many people, their credit rating is irrelevant.
For folks with unpaid medical bills, their credit rating is often in the crapper anyway (because loss of income tends to do that), so unpaid medical bills don't matter.
Large fractions of the US economy run on cash.
Debit cards and secured cards don't require a credit rating but allow access to most of the benefits of credit cards.