A couple of years ago I was in Washington DC visiting friends. We had a merry enough time at first but then things took a turn – or rather I did.

I developed a griping pain in the stomach which, because I am a man, was agonising. I retreated to the loo where dark things happened that must never be spoken of. After a couple of days of my not being able to eat, my host drove me to Sibley Memorial Hospital whilst my wife held my hand and tried to stop me fading away.

The hospital was quiet and clean and, with a single exception, stunningly efficient. The exception was that, having been asked for and having delivered a “stool sample” they managed to lose it on its way to be tested. Goodness knows how you lose a cardboard tray of poo. Goodness knows what became of the person who eventually found it. Anyway, since there was plenty more where that came from it wasn’t really a problem.

Exceptionally cheerful nurses launched a sustained vampirous attack, siphoning off blood and returning (and this never happens in the UK) within the hour with a full set of results which I was allowed to keep. I have them on display in my home.

Anyone who has visited a British ER will appreciate the difference. I once managed to nearly hack off a finger getting out of the bath (it’s a long story) and was only permitted to talk to triage when the cleaners complained that my profuse bleeding was making the floors sticky.

The other difference I noticed a month later when a bill for $1078 arrived. I made a half-hearted attempt to get my UK insurers to pay but they just laughed at me down the phone. “Have you never read your policy?” they asked cackling like witches. It turned out that poor attention to detail on my part had meant that I had signed up to a policy that, boiling matters down to their essentials, required me to pay them money if I incurred medical expenses. I paid the hospital and abandoned my insurance claim.

Today I got a letter from a company called NCO Financial Systems Inc. It was two and a half pages of intemperate threats coupled with an invitation to call them and make payment immediately. They had acquired a “debt” from NES District of Columbia which, Google informed me, was the DC Emergency Health Service.

Several long phone calls to very charming people later it emerged that in addition to the $609 ER charge that had appeared on the original bill, I had been billed a further $241 by the ER Doctor herself (although that bill had never reached me). So the grand total (including payment charges) is $1327. That must surely be the most expensive shit anyone has had in all recorded human history.

Just to underscore the point: if I were to turn up with diarrhoea at a London hospital they would poke through my stool sample for nothing. That’s no pounds and no pence. Admittedly, they would take days and probably surgically remove my leg by accident once I had nodded off in the waiting room, but $1327 would leave me enough money to get a gold-tipped crutch and a physiotherapy massage from the Queen. I am amazed so many Americans are still alive. What is the break even point? How close to death do you have to be to make it worthwhile actually setting foot in a hospital?

On the subject of poo – this is one of the funniest things I have read in ages.