The woes of the American health system have reached one of its former leaders after he received a high medical bill following a visit to the emergency room.

According to Fortune, Dr. Jerome Adams, the former 20th U.S. surgeon general and Purdue University’s health equity initiatives director, took to social media platform X (formerly known as Twitter) to share the details of his medical trip to an out-of-town ER facility in Scottsdale, AZ, due to dehydration. The trip resulted in a hefty post-insurance bill.

“Yes, folks. THIS is America. Land of the free, and home of the medical bankruptcy,” Dr. Adams told the outlet about the posted photo of the bill.

The medical invoice ultimately totaled $4,896.43 after he underwent a few lab tests and three intravenous (IV) bags during his visit, though it’s unknown what was being administered to him in the IV.

What’s more, he mentioned that he opted for monthly payments to tackle the large bill, but Dr. Adams knows this is not always an option for the average American, per the outlet.

“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 wrote on X, Fortune reports.

When Dr. Adams recalled the incident, he shared in a statement how “mentally taxing” it was trying to figure out the reason for his bill, as reported by Business Insider.

“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,” Adams said to Business Insider. “The system is just broken.”

Examples like this shed light on a more significant problem in this country, and Adams believes that it is no surprise that medical debt is the “top cause of bankruptcy in the U.S.,” per Fortune.

The high cost of medical bills is not the only thing Americans, including Adams, question regarding the health care system; there are also challenges to understanding health insurance and what it actually covers.

A 2023 report from the KFF Survey of Consumer Experiences with Health Insurance revealed that “about half (51%) of insured adults report some difficulty understanding at least one aspect of their health insurance…”

“People are so scared of these bills due to lack of transparency,” Adams noted to Fortune. “They actually just don’t go in at all until it truly does become an emergency.”

Healthcare coverage will continue to be a topic of discussion for Americans as the country maintains its physical and mental health. However, Adams admits that others within similar tax brackets as his have high-deductible plans, per Fortune.

“The bottom line is high-deductible plans are the least worst option for most people in a broken system. But healthcare coverage in the U.S. is a gamble, and the house always wins,” he wrote on X, according to the outlet.