New York sparkles in winter sunshine, the Christmas playlist is on at McDonald’s, and America enters its favourite time of year: health insurance renewal time! A flurry of communications from my insurers informs me that every one of my family’s doctors may have to be changed, as they are deadlocked in negotiation with New York’s leading hospital network. Cheers!

Both parties in this exchange are multibillion-dollar entities, and it is hard to know who to hate most, although a letter from the hospital puts its back into blaming the insurers. They have, I am informed, adopted various “unreasonable demands” – including asking for “deep cuts that would slash more than $200m (£160m) in payments, all while the insurance giant generates billions in profits for its major shareholders”. It concludes by encouraging me to spend what remains of the holiday season seeking out new health insurance.

Short of a dire prognosis, or some kind of #MeToo-related exposure, this is one of the most panic-inducing communications one can receive in the US. Finding new health insurance means scouring hundreds of pitiful options, riven with hideous exemptions and yet still painfully expensive. One policy, I noticed last year, had a $5,000 maternity provision, which in New York wouldn’t get you through the first trimester, let alone the birth – and that was with a $900-a-month dividend.

As it turns out, irrespective of who breaks the deadlock, I will be needing new insurance anyway. With a few weeks left until the policy expires, my insurers write to inform me that – sorry! – they will not be renewing policies to those living in expensive metropolitan areas such as New York City and Washington DC.

Sky-high prices of everything make US healthcare the world's most expensive Read more

“Do you have another address you can use in the US?” asks the broker, not very subtly. “One not in the state of New York?”

I think of my cousin in Chicago and various friends in LA. “What do you think?” I ask a friend, later that day.

“What – to committing insurance fraud?”

“It’s not really that, is it?”

“Um. Yes?”

“Yeah but they deserve it. And anyway, everybody does it.”

After a recent communication went viral between a woman from Michigan needing a heart transplant and her hospital – which informed her that, owing to her poor insurance, she would need to contribute $10,000 towards her operation and should open a fundraising page – none of this should surprise us. Still, it does. How many more ways can US healthcare find to be punitive, bankrupting and dysfunctional?

Every year, friends and I brainstorm ways to find loopholes in the system, and every year it fails to work out. (Although, apparently, there’s a thing you can do with your freelance friends, which is to form a fake company to get small business rates with the big insurers that don’t hand out single-payer – oh God kill me now.)

So anyway, I need a new policy; preferably one that, as with my current insurance, routes through Bermuda to keep dividends down, while remaining, in the broadest sense, legal. (Ahem, I’m not doing the fraud thing. Obviously.)

• Emma Brockes is a Guardian columnist