If trend-setting California is any indicator of what will eventually happen in Ashtabula County, the day is coming when your dentist will offer you a credit card with that shot of Novocain.

Jen Flory, a staff attorney with the Western Center on Law and Poverty, said in a conference call Thursday that the medical

industry is developing “strange new ways” for consumers to pay for the services they receive, including credit cards. While those cards can be of benefit if they offer a zero rate for an introductory period and the patient pays it off to avoid fees, they can also create scenarios of abuse.

For example, she says there have been cases where patients unknowingly signed up for the card, or the provider pushed the card as an easier, faster way to receive payment than processing an insurance claim.

The card is just one of many pitfalls Americans face as they struggle with the rising cost of health care and medical debt. According to Families USA, which arranged the conference call with Flory, more than two out of five working-age adult Americans in 2007 were having trouble paying their health-care bills, were already paying off medical debt, or both.

It’s not just the uninsured who face mountains of medical debt after surgery or treatment for cancer or other major illness. Mark Rukavina, director of The Access Project, which helps consumers find sources of funds for medical expenses, said two-thirds of the 49 million Americans with medical debt have insurance.

He said one of project’s clients was a young adult who had insurance, but still ended up with $10,000 in debt after being hospitalized. Her carrier denied the expense, saying that she had exceeded her policy’s cap for miscellaneous expenses.

What she didn’t know is that consumers can appeal an insurance carrier’s decision to a state office. In this patient’s case, the state office ruled in favor of the consumer, and the insurance company paid the claim.

Rukavina said there are also numerous programs that can be tapped to help patients faced with bills from catastrophic illnesses. And some low-income patients can be assisted by qualifying for Medicare, even if it is after the treatment has been provided.

The high cost of health care is a growing concern for both families and employers. Low-income workers are especially hard hit because health care costs end taking such a huge percentage of their income. More than three out of five (62.8 percent) people in families that will spend more than one-quarter of their pre-tax income on health care in 2009 are from families earning less then $30,000 a year.

Families USA has released a consumer guide to help Americans become better equipped to deal with their medical debt. “Your Medical Bills: A Consumers Guide to Coping with Medical Debt,” is an online resource that provides tips for negotiating with providers, verifying charges, dealing with mounting debt, prioritizing payments and understanding your rights as a consumer. It is available at http://www.fam lies usa.org/assets/pdfs/coping-with-medical-debt.pdf.

Ron Pollack, executive director of Families USA, described medical debt as “a stealthy fiend, striking unexpectedly and feeding on both a family’s rising health care expenses and what may be a growing inability to pay because of a loss of a wage-earner’s income.”

He said the debt can lead to homelessness if payments are not prioritized or if a homeowner taps the equity in their home to pay off the debt and then finds he can’t repay the loan because of the higher payments.

Pollack said consumers should avoid using secured loans to pay medical bills, and called doing so akin to writing your “ticket to eviction.”