‘Land of the free, and home of the medical bankruptcy’: Ex–surgeon general blasts health care system after getting $4,896.43 bill for dehydration

Surgeon generals. They’re just like us. Dr. Jerome Adams, Purdue University’s Health Equity Initiatives director who formerly held the title of the nation’s 20th U.S. surgeon general, proved as much when recounting his unpleasant bill after visiting instant care.

Opening up on Twitter about his medical trip to an out-of-town ER facility, Adams posted a picture of his bill of $4,896.43 simply for the ailment of dehydration. After getting some lab tests and three IV bags, Adams was hit with a multiple-thousand-dollar bill post-insurance. “Yes folks. THIS is America. Land of the free, and home of the medical bankruptcy,” he said, noting that he opted for a monthly plan to manage tackling the large payment.

In a subsequent interview with Business Insider, Adams describes how “mentally taxing” it was, trying to figure out the reason for his bill. “If I’m in this situation with my knowledge and with my financial resources and with my bully pulpit, then the average Joe doesn’t stand a chance. The system is just broken,” Adams told the outlet. Going on to explain that his stay was deemed a Level 5 visit, the most extreme classification that requires more intensive care, Adams said he contested the bill in part because he thought his visit should receive a lower-level code.

Adams noted that his struggle with the health care system is a sign of a larger problem posed to most Americans. “While I can manage this, even as a physician, a $5K surprise bill is unsettling, and such an expense is financially crippling for most Americans,” he tweeted, adding that it’s no surprise that medical debt is “the top cause of bankruptcy in the U.S.” Indeed, almost half of U.S. adults (41%), or more than 100 million people, have been burdened with medical bills they can’t foot, per analysis from a KFF Health News investigation with NPR and CBS News. While pervasive, the debt isn’t spread across the nation equally, as Black Americans are “50% as likely as whites to owe money for medical care,” according to the investigation.

The health care system isn’t just pricey, it’s also confusing. More than half (51%) of adults with insurance say they’ve experienced “some difficulty understanding at least one aspect of their health insurance,” per a 2023 KFF Survey of Consumer Experiences With Health Insurance, based on responses from more than 3,600 participants. It all means that some Americans postpone important visits for fear of medical debt. “People are so scared of these bills due to lack of transparency. They actually just don’t go in at all until it truly does become an emergency,” Adams said.

The Consumer Financial Protection Bureau (CFPB), a regulatory group which in part polices said debt, is looking to introduce rules that remove medical debt from American’s credit scores. “The fact that the CFPB is involved in what seems like a health care issue is because our system is so dysfunctional that when people get sick and they can’t afford all their medical bills, even with insurance, it ends up affecting every aspect of their financial lives,” Chi Chi Wu, a senior attorney at the National Consumer Law Center, recently told KFF Health News.

Even people with insurance, like Adams, find themselves swimming in oversized medical bills. The former surgeon general lambasting the system he was once atop of explains that like those in many middle- to high-income households, he has a high-deductible plan.

“The bottom line is high-deductible plans are the least worst option for most people in a broken system. But health care coverage in the U.S. is a gamble, and the house always wins. I didn’t drink enough water while traveling, and I crapped out,” he tweeted.

This story was originally featured on Fortune.com