Monday 16 March 2009

Pros & cons

There's been a lot written here about the length of time we've had to wait for the croc sporting doctors to step in and intervene.

Twenty four failed attempts, currently in the twenty fifth, must seem like marijuana rooted madness to those of you looking on. In the United States particularly.

While I certainly haven't enjoyed the wait, I do understand it, from a health service point of view at least. The Netherlands has thousands of couples in the same situation walking through it's hospital and clinic doors every year.

It's a tiny country, with a relatively huge population. Four times smaller than Ireland, yet four times more inhabitants.

The Irish health service is groaning, creaking and ready to burst at the joints under the weight of mismanagement, and insufficient funding, both capital, and operational.

The Dutch service, while it may well be lacking a personal attention element, seems to be running like a well oiled machine. A slow one perhaps, but one that I am glad we have at our disposal. State of the art facilities, modern techniques, and some of the most highly skilled staff you are likely to find anywhere.

The patience of patients, is rewarded. They operate a system of mandatory health insurance where each individual is responsible for arranging their own health cover. The choices of provider run into dozens, with all standard basic care being covered. This leaves you to pick and choose the extra elements of cover that suit your needs, alternative medicine, dental, psychological etc.

I would estimate that regardless of which cover they take, an individual should be fully insured for all eventualities for about €1200 - €1400 per year.

We have just confirmed, that ET's insurance alone will fully cover the six IUIs that the hospital are willing to try, plus fully, yes fully, cover up to 4 IVF cycles that the hospital would then be willing to offer.

Everything, from here on in, is covered by our insurance. Every penny.

I stand to be corrected, but to the best of my knowledge, no Irish health insurance provider will offer any cover for artificial reproductive treatments.

None. Nothing.

So, in this, a one-off special entry praising the organisation and procedural focus of our hosts, I can tell you I wouldn't prefer to be anywhere else as we face into the coming weeks and months.

Now, if I could only get the fuckers to crack a smile.


Anonymous said...

Smiles cost extra and require a 36 month wait. Silly Irishman.

Lea said...

Well, I am thoroughly envious. I'll never understand why we (in the US) don't have universal health care yet. We've been on our own from the beginning, even with my husband's fabulous health insurance through his employer. What a relief it must be to know that you have all those chances and all the support to succeed! Hopefully you won't need it all. ;)

You know, I do have dutch ancestry. Hmmm... :)

Mr Lady said...

Maybe you should let them read your blog. ;-)

Angie [A Whole Lot of Nothing] said...

I'm sure you know, but DO YOU REALIZE HOW LUCKY YOU ARE??

Anonymous said...

Good, I'm glad.

I think you're being a bit unrealistic if you're hoping for smiles though.

Anonymous said...

Waddya want? Smiling or efficiency?

Maybe you will get a great big smile out of them when ET pisses on a stick and the double lines show.

It's St. Patrick's Day here in Australia. May the luck of the Irish be with you both.

Be screwed if I'm going to raise a Guinness, though. That stuff tastes like ass.

Anonymous said...

I was talking about your case to my Mum (who works in a major hospital in London as a nurse in the AF clinic) When I mentioned that you were in NL she said that you would have far more cycles offered than you would ever get over here, unless youwere prepared to pay each time.
I hope it doesn't take 6! (Well, you knew that.)

Mick said...

Jesus you're lucky! Try coming to Poland for a while.

It's so different, it's unbelievable!

Kori said...

So when are you going to chase your neighbors out of their digs so I can move in? I am seriously going to start the paperwork. though hey, do the red-light-district workers qualify as "employees," so I could get a work permit?

Anonymous said...

They may be grouchy croc-wearers who make you WAIT, but, hey, you could wait just as long in Britain and get one, maybe two, 'free' cycles out of it.

Not that I'm envious. Well, I am envious. But I'm glad it's you I am envying. And I am seriously hoping I get to envy you even more very soon.

(Did that make sense? It made sense to me. But then, so do marmalade and peanut-butter toasties, so...)

Ms. Moon said...

Oh, Xbox- you have no idea how lucky you are to have what you have as to health care. Or maybe you do.
But really- forget the smiles. They will come when you conceive.

Ms. Moon said...

And I've just posted a recipe for Irish soda bread on my blog. It may not be authentic, but it is delicious. Here's to the Irish!

mammydiaries said...

Didn't you know that Artificial Reproduction is obviously the work of the devil and in the wrong hands could lead to such catastrophic results as homosexuals and single women being aloud to reproduce and raise children? (shock! horror!) In Holy, catholic Ireland, this is most definitely a no-no! Blaspheme my good sir! Blaspheme! lol

P.S Whoops on the mammy front, I actually thought of that as I was typing but my quickly dissolving brain did not retain the thought and before I knew it, you'd been published as a mammy:) Loving your blog and your article in the times was great!

Russ said...

That's not bad! I'm paying $3600/yr here with copays and a hefty deductible (that is for me and the two kids, it was still cheaper doing that as opposed to adding us to the Wife's company plan.)

Sarah said...

WOW. That is a serious silver lining! We will be paying for our one IVF for years to come. NOt that it makes the 25 months easier, but now taht they are done and you get the treatment, it makes it seem worth it

Anonymous said...

Seems that you have turned the corner-20 bucks says the first try is successful. Wanna bet? I'd gladly pay that-with a baby shower gift to boot.

WhatAboutNovember said...

Wow. Awesome!

battynurse said...

Wow thats fantastic. Insurance here in the states is nothing like that. I have a $3000 lifetime maximum for everything. Hope there is soon a little one in your future.

James (SeattleDad) said...

We waited two years for IUIs also - because any health care provider makes you "try" for one year, then you get testing to make sure you are infertile. After a year we were informed we had unexplained infertility (you've heard that before).

After the testing however, here in the States, nothing is covered . . . unless you work for the federal government (no kidding) or live in certain states (Illinois, we think).

So, we had to pay all fertility treatment ourselves. We got the drugs overseas, because they were less expensive, but that's the only break on cost we got. And, our single failed IVF (with no embryoes to spare) cost us $15,000 US.

Oddly, all the weird complications that Mrs. LIAYF had with the two years of fertility treatment (like the ovarian cysts and the uterine polyp surgery) were all covered by insurance. These were considered women's health issues, but our infertility was not.

Luckily, some of those special overseas drugs must have kick-started her ovaries. Because just two months after our failed IVF, when we were told we probably never would get pregnant and they didn't know why, we did just that!

Good luck! And, lucky you to have such good coverage!! We just finished paying off our IVF loan last year.

James (SeattleDad) said...

Oh, and all our fertility doctors were grouchy. Maybe it's the profession?

Robin said...

Niiiice! Boy, universal health care... why doesn't someone here think of that? Oh, wait...

Jill said...

Wow - IUI's covered - as well as IVF? Sonofabitch! Not only do I pay a hell of a lot more than you do for insurance (AND my hubby works for the Gov't), quite a bit of my infertility workup was NOT covered.

And IVF - even the US Gov't insurance doesn't cover that... (sorry James).

Of course, I live in India now where I've had a majority of this pregnancy... and my doctor's visits - including sonograms cost a whopping $8. Though I'm not bragging... 'cuz at the end of the day I still live in India.

Sending good wishes!

BABY STEPS said...

Fully cover? All that? No more whinging posts then, that will be saved for us poor folks in countries where our insurance wont cover ANY fertiltiy stuff.
I am raising a green cocktail for luck (yuck arse gunisses I agree) as my husband is of Irish decent, something about code or shield or some shit with a severed hand and raping and pillaging history.......

Proseaholics said...

You wanna see em cracks or a smile?

Can't have em both y'know?

Jason Roth said...

That's great, because those kind of procedures here in the US are usuallynot covered and are awfully expensive.

River said...

Every penny covered? Completely? Well, congratulations. At least that's one thing you now don't have to worry about.

Korie said...

Belgium is pretty similar. CB's sister had problems conceiving and the invitro was only a couple hundred euro per attempt.
My mom actually told me to stay here till we conceive or can't, just in case. Then we can get the services to help for a lot cheaper than in the US.
The woman likes to think ahead.

Anonymous said...

Come now, you can't have everything!

Oh God, I said 'come'. *splutters*

Liz said...

That's no bad at all.

Though, whilst there is nothing better than making sure you get your full moneys worth from all the insurance you have paid for over the years, here's hoping you won't need all that.

Veronica Foale said...

Thats fantastic!!!

And Hockeyman's comment has me giggling.

Jenni said...

i'm glad to see this post. you are indeed fortunate to have such great health care in a world where so many can't even afford or don't have access to the most basic, life-saving medicines and services.

and, now that project hump'n'hope is being supplemented, will there be a new name? project spin'n'squirt?

Susanica said...

Dang. That's awesome X-box. Do you know that an IUI (natural with no Clomid etc...) runs around $500 a pop? With Clomid (or other drugs)more than $1000 per try? IVF runs around $12,000 per try-- (yes 12 thousand dollars) in the area of the US where we live.

And at least for us, because we are a lesbian couple, insurance pays not a dime. (I guess it's because it's not a question of infertility--just a question of having a doctor help introduce the donor sperm that we've chosen to a woman with no known fertility issues.)

Of course, once the fertility treatments work though and a woman is pregnant, 100% is covered.

Oh, by the way, I think that I much prefer the term alternative methods of insemination to artificial. There's nothing artificial about creating life, even if assitive means are required to do so.

So...luck of the Irish to you this fine St. Patrick's Day??? ;-) -Monica

Anonymous said...

The Dutch system of healthcare is something we in Ireland, can only dream about. If you want to avoid MRSA when in hospital, Holland is the place to be!

Enjoy the Pros, you've done your time with the Cons.

And may the luck of the Irish be with you in the days ahead!

Anonymous said...

I hear you, Xbox!

Italy has an ancient paint-peeling-from-the-walls system, but it's 100% free. It took ages to get anything done, but done they did it and we didn't pay a dime!!

Luckily we didn't have to do IUIs or IVF, but all other treatments including the lovely saline roto-rooter blasts which cleared my tubes cost my pocket nothing (but still cost me an enormous amount of heartache and anxiety with the two-years of waiting grrr).

full steam ahead, kids. not having the money issue is a HUGE IF problem you will luckily never have to face!!

Martin said...

@Hockeyman - hee hee

@Lea - I know the US situation is a huge source of debate, so I ain't going there!
But yes, there is a world of difference.

@Mr Lady - The mistake was letting ANYONE read it ;-)

@Angie [A Whole Lot of Nothing] - Absolutely.

@bsouth - might be pushing it a little alright.

@Anja - Murphy's. A million times better.

@Penelope - Yep, big differences.

@Mick - I can safely say, no thanks!

@Kori - and have you bring down the tone of the neighborhood?

@nutsinmay - It made perfect sense, just not the marmalade bit.

@Ms. Moon - I know how good it is, trust me!

@mammydiaries - I'm already hell-bound anyway, so, fair game!

@Russ - Not a penny co-pay!

@sarah - We'll take it!

@NukeDad - but we wouldn't get our money's worth!

@WhatAboutNovember - Yep!

@battynurse - wow, thats harsh.

@James - Sounds very complicated.

@Robin (a.k.a. Toasty) - hee hee hee.

@Jill - Nothing wrong with India!

@Paint it Black - Cheers!

@Joe - No kissing on the lips

@iVegasFamily - The prices I've seen quoted for there are scary.

@River - Completely!

@Lilacspecs - Your mum lol.

@Tracey - Filth, utter filth.

@womb for improvement - We'll just aim for 6 first time successes!

@Veronica - make me chuckle!

@Jenni - Yep, I've no misgivings how lucky we are in that respect. hump n'hope isn't abandoned yet tough...

@Susanica - Yeah, I know the costs are insane. Incidentally, the cover is arranged based on the prospective mother's insurance here, the presence or existence of a walking father doesn't come into it. All equal.

@Steph - As one eager devoted reader pointed out to me today, the Netherlands is ranked 1st in European health services, Ireland 11th. And I think they were lucky to get that!

@geeksinrome - Yep, I do wonder if it will ever be accepted in the states, but for now, I'm happy.

Elf in Amsterdam said...

Yep I need to talk to you about what health care in this polder covers.

It seemed simultaneously ingenious and unfair that I had to have health insurance before I could get a tax registration.

It is a great system, as you say, when it works, but even though I have paid it for a year I still have no idea what I'm actually covered for.


Anonymous said...

::packing my fucking bags::

Missives From Suburbia said...

Wow... My IUI was not covered, and there was no way our insurance would have covered IVF. We have what most Americans would consider gold-plated health insurance, too. My son saw a series of specialists for just over a year, and every month, I paid bills that totaled around $300 to cover the costs our insurance wouldn't. It made me wonder how people survive when they don't have $300 in disposable income or they have lousy insurance. You live in a wonderful place. I hope the U.S. can make it happen someday.

Anonymous said...

So you think if you let them advertise their services here they might chuck in a smile or a giggle or two?

Anonymous said...

That sounds very similar to what we have in Sweden (where we come from and had our IVF, before moving to Italy). Very fortunate indeed. Except for the bloody waiting. And the no smiling. What's up with that? Oh wait - free healthcare, it doesn't come with smiles.

Cheers! Raising a Guinness - delicious piece of heaven in a bottle.

Mo said...

put that way it makes a lot of sense. things may move faster in the u.s. but it is pricey (~$22,000 an ivf cycle at my clinic). here's hoping you won't need all those now free options. let the first iui do the trick.


Martin said...

@Elf in Amsterdam - As long as you have a basic cover here you really are good to go, the tie in with them being happy to fire away with IUI is that the couple is forced to put in their time trying, no short cuts.
In your situation I don't know how that would come to pass, for obvious reasons.

BUT! I do have the details of a clinic near here, that specifies that it deals with single women, gay couples, and donor, or bank sperm. Their prices are also specified, and are reasonable I think, should you need to go out of pocket.

Let me know if you're interested in the info.

@Christa - :-)

@Missives From Suburbia - Something is very wrong there, not sure what though.

@Kelley - That goes against procedure.

@expatswede - Sweden is ART heaven as far as I'm aware. Forget the guiness, try a Murphy's.

@Mo and Will - Sweet adorable, 22k a shot?
Wow. and more wow.

Anonymous said...

Its about damn time for some good news!!!

A Free Man said...

I'm thankful every time one of us has to go to the doctor that I left the U.S. It amazes me that my fellow countrymen haven't figured out that they're getting sodomized every time they go to the G.P.

Anonymous said...

the Irish health system was bad enough in the good days - just found out that the local hosps are no longer doing the chromosomal etc tests that were available after 3 miscarriages, have to travel to Dublin, and by the sounds of it, pay a few hundred quid.
Actually thought I was preg yest, positive preg test, thought I had passed the length of time that the pregyl hormones stay in my system but it seems I am one of those 5% of women who retain it longer - almost feels like I miscarried, periods arrived 2 hours after positive test!
best of luck with your drugs next month.

Martin said... - Yep, its sure is!

@A Free Man - I have family in the states and my stomach turns when I hear what they have to pay for the most basic of health care.

@Lorna - Lorna that is just desperate, those tests are traumatic enough without having to trapse to Dublin for them.
We had a false positive a few months back, absolutely gut wrenching. Mind yourself.

IrishNYC said...

That's fantastic news! Especially the IVF if you need to go there. I can see why Ireland doesn't have coverage like that... good old throwback to the Catholic days.

Martin said...

@IrishNYC - I personally believe the church's stance is the major block on IVF treatments availability on the public health service. The government won't cross that line.