Jay Comfort was looking forward to attending his only daughter’s wedding in Pennsylvania last June. But a week before the ceremony, he found himself in excruciating pain.
Comfort, a retired teacher and American citizen who lives in Switzerland, had acute appendicitis and needed emergency surgery. He had Swiss insurance, but he soon learned that it would not cover much of his hospital bill in the U.S.
“I tried to gut it out for three hours because of the insurance situation,” said Comfort. “But when the pain became unbearable, I called my brother, who drove me and my wife to the nearest emergency department.”
Comfort spent about 14 hours at the University of Pittsburgh Medical Center’s hospital in Williamsport, where doctors removed his inflamed appendix and diagnosed him with a rare cancer. He said the staff made copies of his insurance card and assured him that he would be covered.
“It was a miracle,” Comfort said, adding that the cancer was completely removed by another surgery in Switzerland after he returned home.
But then the bill came. Comfort was shocked to see that he owed $42,000 for his appendectomy, scans, laboratory testing, and recovery room. His insurer paid only $8,000 and he was left with a balance of $34,000.
“I couldn’t believe it,” he said. “I had no idea that U.S. hospitals charge so much more than Swiss ones for the same services.”
Comfort is one of many Americans living abroad who face high medical bills when they visit the U.S. According to a report by NPR and Kaiser Health News, more than 9 million Americans live outside the country and many of them have foreign health insurance that does not cover much or any of their care in the U.S.
“The U.S. is really an outlier in terms of how much we pay for health care services,” said Gerard Anderson, a professor at Johns Hopkins Bloomberg School of Public Health. “We pay two to three times more than most other countries.”
Anderson said that U.S. hospitals have more bargaining power than foreign ones and can charge higher prices to insurers and patients. He also said that U.S. hospitals often add fees for services that are included in other countries’ prices.
Comfort said he tried to negotiate with the hospital but they refused to lower his bill. He also contacted his insurer but they said they could not pay more than their contracted rate.
He said he feels trapped and frustrated by the situation. He does not want to ruin his credit score or face legal action from the hospital. He also does not want to pay such an exorbitant amount for a service that would have cost much less in Switzerland.
“I don’t know what to do,” he said. “I feel like I’m being ripped off by a system that is unfair and unjust.”