Joyful memes, novelty merch, gushing support: it’s undeniably callous, but points to a deeply dysfunctional systemFor the almost two decades I lived in the US, my approach to medical bills was always the same. First invoice, ignore. Second invoice, ignore. Third invoice, written entirely in capital letters and in red, kick back to my insurer to buy another month of non-payment before receiving a fourth invoice, which I would also ignore. After that, the bill would go to a debt collection agency in the midwest, which would send me an extremely unfriendly letter threatening court action if I didn’t pay up. I paid up. Ha! That’ll show ’em.This is the rigmarole that millions of Americans go through every single time they visit a doctor for anything beyond routine maintenance. It is simultaneously a standard experience and a trigger for the most overpowering, cortisol-releasing emotions. Dragging my heels until the final notice was a pathetic gesture that achieved nothing, but it was the only mechanism I had for expressing the unadulterated rage caused by a basic fact of life in the US: that – and there’s no other way to word this – you pay these fuckers enormous amounts of money each year and still they fight you on everything.Emma Brockes is a Guardian columnistDo you have an opinion on the issues raised in this article? If you would like to submit a response of up to 300 words by email to be considered for publication in our letters section, please click here. Continue reading...