Want to speak to an American? That'll be $39.
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I stumbled upon this while looking at Dell's website today. If you're buying a new PC (at least on the business side), you can upgrade to "gold support", which lists "North American-based support" as one of its perks. I get the impression that Dell's losing business over their crummy overseas tech support, which is why they're offering it. I just don't think you should have to pay for the privilege.

Dell?! Ahhhhh. The horror! The pain...
Gold Support is based out of Austin, TX (Round Rock). They're still follow a script, and they will argue with you a lot of the time. But, at least you can understand them. *shrug*