She went to the ER in Spain. The bill made her question everything about U.S. healthcare.

When Ana Ochoa’s 83-year-old father fell on a sidewalk in Madrid, her heart sank. He had tripped outside a restaurant, hit the pavement hard, and couldn’t get up. Paramedics arrived quickly and rushed him to Hospital Clínico San Carlos, one of Spain’s top hospitals.

At the ER, doctors immediately began treatment. They performed X-rays and diagnosed him with a fractured humerus, a painful break in the upper arm. He was bandaged, stabilized, given a prescription, and released.

Ana was grateful for the care—but, like most Americans, she was dreading the bill.

Medical billCanva

“It was a pretty big hospital visit, you know, with all the things,” she said in a TikTok video.

Ana, who had moved from California to Spain less than a year earlier, shared the experience with her followers. In the clip titled “When the ambulance bill is cheaper than an Uber ride in LA,” she holds up the invoice to the camera and asks, “Can you see it?”

Emergency roomCanva

The total cost for the entire emergency room visit? €185 euros. Roughly $194 USD.

No ambulance fee. No itemized charges for the X-rays or diagnostics. Just a flat, modest bill for high-quality care.

Ana’s video quickly went viral, drawing over 1 million views across TikTok and Instagram and sparking a conversation about how different healthcare systems operate around the world. Many commenters from Europe were shocked—not at Spain’s prices, but at what Americans endure in comparison.

Madrid, SpainCanva

“In Belgium, we have something called ‘gemeentebelasting,’ city taxes that cover services like ambulances,” wrote Vanessa Neetesonne. “My last surgery cost me €75 ($81).”

“I live in the U.K., had an operation, stayed in hospital a few nights, had biopsies, etc., and paid nothing,” added another user. “I have lifelong medication for free, too.”

Emergency roomCanva

“In Europe, health is a right, not a business,” read one comment that Ana herself liked. It had over 13,000 likes.

In a follow-up video posted in May 2025, Ana clarified that the ambulance ride itself was completely free. The €185 bill only covered the ER visit and imaging. “People take Ubers to the hospital in the U.S. because they’re afraid of ambulance costs,” she said. “And in Spain, it’s free.”

Since the initial post went viral, Ana has continued documenting her family’s life in Spain. She's spoken more openly about the cultural adjustment, her children’s language skills, and the unexpected joy of living somewhere where medical care feels humane and accessible. She hasn't posted a follow-up about any additional medical expenses from the visit, suggesting that €185 was, in fact, the final bill.

For those wondering: Ana's father recovered well and has appeared in her videos smiling, sling on his arm, enjoying his time in Madrid.

Off the coast of ItalyCanva

It’s clear the family has gained more than just great memories abroad. They’ve gained a new understanding of what healthcare can look like. And that realization, more than any bill, is what’s stuck with Ana the most.

This article originally appeared earlier this year.