J-pouch surgery in the US is ridiculously expensive, and is now usually two or three separate surgeries, separated by months. I’d be surprised if many folks here paid full price for it out of pocket, but others can correct me if that’s wrong. One reason insurance is so critical is that costs can balloon if anything goes differently than planned. Sometimes the intestines take a while to get moving again, as a very small example, and that can lead to longer (and more expensive) hospitalizations. I think my single surgery (and 10-day hospitalization, including a day or two in the ICU) cost about $45,000 seventeen years ago, but it’s actually hard to find out the prices here until you in incur the expense and receive a bill.

It’s well worth your while to find out about obtaining insurance that will cover a planned procedure for a preexisting condition. I know how to do that as a resident, but hopefully others can advise you how to do it as a visitor. Obviously this is a terrible product for an insurance company to sell, so they will try to avoid selling it if they can.