You see these stories often about every industrialized/wealthy country in the world providing some type of universal medical care for their citizens…except the United States. According to the CDC, an estimated 28 million US Americans do not have health insurance. That means that one major health issue can bankrupt these people. Sometimes it does not necessarily have to be that major.
I am a US citizen and own a home there. However, I spend much of the year overseas. After 14 years, I no longer have doctors in the country. Nor do I have an overpriced private healthcare policy based in the US (it would not make fiscal sense). I do have access to universal health overseas, and I have a private healthcare policy for major medical issues no matter where I travel. However, the policy has a high deductible. I am too young to qualify for Medicare.
In autumn of 2025, I returned to the States from an Eastern European trip with a COVID infection. Having an upcoming trip on the books with my husband, I did not want to cancel our plans. After reaching out to my local friends on socials for advice, the nearly unanimous suggestion was “Get a prescription for Paxlovid from your doctor.”
Hmmm, my doctors overseas could write one, but it would not be honored in the US. One friend suggested, “Go to the Heart Hospital. They will see any kind of illness, and there is rarely a wait.” Since it was close by, I decided to don my mask, take proof of my positive COVID test, and see if I could get a prescription for this supposedly magical drug.
There was no wait, and the facility was sparkly clean and efficient. I was a little stunned at check-in to be asked if I was a US citizen and what my religious affiliation was. Extremely off-putting – this has never happened to me before. I was ushered quickly to an exam room and my blood pressure was taken. A doctor came in, and I explained the situation. I was only there to get a Paxlovid prescription and showed her my positive test. She was with me for approximately 4 minutes, asked a few health questions, and used no testing equipment.
She wrote the prescription, and I was on my way. At checkout, I explained that I do not live in the US full time and that I wanted to close out this visit with a full payment. “I will charge you $350,” she said. I was assuming that would cover it. I thought that was expensive for a 10-minute visit. But I paid it and headed to the pharmacy.
I submitted the prescription and waited. The pharmacist asked, “Can I have your insurance card?” I replied, slightly exasperated, “I don’t have insurance that covers prescriptions.” I waited some more. When it was ready for pickup, I nearly fainted. $1526.05 for a 5-day treatment. That is $305.21 per day! I was feeling so jet-lagged and sick that I began to cry.
“The previous administration used to cover the costs, but that has been cancelled now. You might want to go online and check with Pfizer (the drug manufacturer) for discounts,” the pharmacist suggested. Unable to find anything online at that moment, I paid the bill and slinked to the exit, teary-eyed and angry. As a follow-up, I found an online form and sent it with my original receipt to Pfizer’s program for the uninsured. But for some ridiculous reason (which I do not know), I was denied.
I figured that was the end. Hard, expensive lesson learned. Paxlovid is magical. Compared to my difficult first COVID experience, this was truly a walk in the park. Barely a side effect (just tired) and a negative test after just 4 days.
Then, before I left the US, a new bill from the Heart Hospital appeared at our PO Box for $614. “What is this charge for?” I inquired. “I already paid my bill last month.” The accountant’s reply: “Oh, that was the doctor’s bill.” FOUR minutes max. FOUR minutes she spent with me. That is $153.50 per MINUTE. That is one hell of a nice salary. I should have gone to med school.
Are we done yet? I thought so.
Sometime in May (7 months later), I began receiving harassing credit collection agency calls/messages about an unpaid bill for the Heart Hospital. I was in a time zone across the world, so the timing caused late-night sleep disruption. I figured their books were wrong because I knew I paid all my bills. So, I ignored the calls. But they kept coming. Even whilst on a ship off the coast of Africa.
I finally called these jokers. Evidently, I was sent the FINAL bill from the ER to my US PO Box – not an email, not a text, not a call. I had no idea that happened. After several months, the bill was turned over to a collection agency. I asked the harassing credit people the amount of the bill. Drumroll: $969. I explained the situation: I had paid everything already, but I did not have my paperwork with me on a boat off the coast of Africa. It was in a folder in the US. Closed, completed, done.
The collector gave me their portal information and the case number to research it. However, their firewalls do not allow IP addresses from outside the country to log in. So, I endured the barrage of calls for a few more months since there was nothing more I could do until I verified the bills and payments.
When returning to the US in late August 2026 (nearly one full year later), I called the Heart Hospital to see what we could do to negotiate the ridiculous payment down from nearly $1000. “We can’t help you or do anything after the bill has been turned over to a collection agency,” snapped the surly hospital accounting representative.
They want you to get so tired of them you pay to make them go away. So I did. That is the end of my tale.
10 minutes in the ER to get a prescription. 4 minutes with an MD. $3186.05 later. Dear USA, your system is broken.
