May 23. Last June, Jay Comfort flew to the United States from his home in Switzerland to attend his only daughter’s wedding. But the week before the ceremony — on a Friday evening — Comfort said he found himself in «excruciating pain.»
«I tried to gut it out for three hours because of the insurance situation,» said Comfort, a retired teacher and American citizen who has Swiss insurance.
When the pain became unbearable, Comfort called his brother, who drove him and his wife, Nazuna, a few miles to the nearest emergency department, at the University of Pittsburgh Medical Center’s hospital in Williamsport, Pennsylvania.
At the hospital, Nazuna Konishi Comfort handed over her husband’s Swiss insurance card, which confirmed coverage by Groupe Mutuel. Jay recalled the staff making copies of his insurance card and then treating his acute appendicitis. Doctors performed emergency surgery to remove the inflamed appendix.
Diagnostic tests confirmed he had a rare cancer, which doctors in Switzerland later removed with another surgery after he returned home. «It was a miracle,» Comfort said, adding that the cancer was completely removed.
After his appendectomy, Comfort recalled vomiting and then waiting in a recovery room. In all, he spent about 14 hours at UPMC Williamsport before being released. He attended his daughter’s wedding and, eventually, traveled back to Switzerland.
Then the bill came.
$42,156.50, covering emergency surgery, scans, laboratory testing, and three hours in a recovery room. His insurer has said it will pay him about $8,184 (7,260.40 in Swiss francs), which is double the procedure’s price in Switzerland. This left him to cover the remaining roughly $34,000.
With what is considered an excellent health system, Switzerland has the highest prices for medical care in Europe. As in the U.S., the country relies on private insurers and hospitals. But the cost of care in Switzerland is substantially lower than what is charged in the U.S., so the reimbursement his insurer offered is a fraction of what Comfort owes the U.S. hospital.
Though the Affordable Care Act was meant to provide insurance to more Americans and bring down the cost of care, hospital bills remain extraordinarily high and highly variable.