It actually took me awhile to respond because I just have to think about this stuff all the time and I sorta get sick of associating with it more than I have to. This is going to be long as many of these responses are and im going to stick to generalities and give multiple paragraph parts.

Most all of this is with my wife and I want to begin with a bit of the generational perspective. He father was a boomer and one of those curmudgeonly misogynists that folks may have known in their lives. Now he was a single income provider but he talked about how originally, before they controlled for it, double income folks were both had insurance could put in for reimbursement from both providers. So like 80% back from both and folks could basically scam a profit from their healthcare costs and get 60% of it keep. I bring this up just to get a feel for how much things have changed.

So we have some idea that doctors have told him that she a variety of things that should be looked into as she grew up but she was a child and is not sure what all those were but she did know her father did not want the expense so did not follow up. This was a man that had enough to pay for college for his kids if he wanted but didn't (her grades were very good btw) and to boot he kept listing her as a dependent after she moved out and she was to mousey (its not quite the right word but its a thing with how he was and how she was raised and how her brain reacted to it). This is just more setup for her life.

So my generation had this thing called insurance roulete which meant you did not have insurance and hoped for the best. Pretty much everyone did that after their parents unless they got a job with insurance because what you could get would be emergency only. During the time before we got together she was in a bad auto accident with a truck where her car was accordianed. In some ways it is amazing she outwardly for a time did not show much damage but there was damage. She also suffered some brutal assaults. Each time she really got just minimum care mostly at home and relied on just being able to get over it.

Now we get to the erra where we met and eventually got married. She now has insurance from my work but many, many issues. Eventually we resign ourselves to paying maximum out of pocket every year. I am in a weird situation which is very akin to being a single parent with a disabled child. She can do some house work and such but is limited. I am desperately afraid to lose insurance. She has gotten mad at me for things like as she says "stepping over her while laying messed up on the floor to go to work". She later apologizes because she does get that I can't lose my jobs even though I do ultimately (generational reality of serial employment/unemployment). These things come back around as her and I go through continous bouts of depression around her health, the us healthcare system we deal with, and our financials. We have to kill ourselves with belt tightening to keep cobra going (a costly option to keep insurance between jobs in the US). We have had multiple denials that we have fought successfully but it has taken over a year of perseverance and is a source of continous stress. These are six figure amounts. Obama care was huge because of getting rid of pre-existing conditions and the biden administration's no surprise billing has been a godsend to. Im currently unemployed and my monthly healthcare costs are over 2k a month now. An amount that unemployment just barely covers so pretty much all other costs come from savings.

Ok as for her health issues. She needs back surgery. Both lower and upper. This is a big thing but we have avoided it. We know it has to be done but what you have to realize is all her medical things have never gone typically. She almost always has "complications". This surgery is one that people will say don't do it till you are in a wheelchair because it at its best is not great. This is one of those things we have over our heads. She has had a knee re-alignment. It never went back to normal function. She had a hip replacement with two or three revisions. I can't remember how many but she had mersa and a pick line and it was enough to have the CDC involved in the middle of covid. Her other hip needs to be replaced but we are putting it off. She had growths in her uterus and got an abilation. They are currently doing biospsies to see if more needs to be done now which is years later. She has a growth on her thyroid and is hypothyroid and has to take thyroid supplement but she reacts to the artificial and we have to continually get exceptions to get animal sourced. [I am at the character length and will have to continue this on a reply to itself.]