Wednesday, October 10, 2007

Ramblings regarding mental health parity, prescription drugs, health insurance, and more!

I've been reflecting on how our lives might have been different right now, if my "good" health insurance had truly been required to provide the care that my DH needed the first time he was hospitalized. DH was in the hospital for three weeks, which is, in itself, remarkable. But he was still suicidal when he left the hospital. His psychiatrist in the hospital had begged the insurance company to allow him another few days' stay, just to see if the meds kicked in, and to make sure that my DH was truly going to be safe. He (my DH) was not only required to leave the hospital before anyone involved in his case (except the insurance company, of course) thought he was "better", but also, two of the drugs that had been prescribed for him while he was in the hospital, were not covered by the insurance at all. (As an aside, Minnesota, the state where I live, does have a mental health parity law, but it can only be applied to insurance companies that operate out of Minnesota. Other insurance companies, like mine, that are based in other states aren't affected by the law.)

I was doing some reading tonite and I read this story about a senator's son, called "What you Don't Know Can Hurt you" and I was convinced that since issues like these mostly tend to affect us working-class people, and you typically don't think that a senator would take notice of something like this, the fact that a senator was affected and decided to try to do something about it, signifies to me that there are probably a lot of unsophisticated people out here who are just being raked over the coals by their "good" health insurance, especially for mental health coverage and issues.

There is such a shortage of prescribing psychiatrists and psychiatric nurse practitioners in our area, that if my DH has a bad reaction to his meds, or if they don't work, he has to go to the hospital to get them changed, or else he can wait 6-8 weeks for an appointment. His regular physician is comfortable ordering refills of mental health drugs, but not prescribing new ones. All of this "hurry up and wait" is really hard on the patients and their families.

To me, what all of this says, is that the fact that mental health patients are not being treated in the same way as patients with arthritis, diabetes, and heart problems (parity), is probably doing a huge favor to all those people writing about how the mental health system is overwhelmed, because if people got the treatment and medications they really need before a crisis hits, then maybe it would end up being tantamount to going to the doctor, finding out your blood pressure is high, and getting a prescription for that before you have a stroke. It all seems so common sense, and yet so full of red tape.

Some of you might remember that I briefly touched on the fact that our new prescription drug plan (through my job) is potentially going to kill us next year (See Whew! post, October 6).

I cringe every single time DH takes his pills, which, even with the copays that we won't have at all next year, cost us about $160/month, which, for this newly one-income, not-rich-by-any-standard family, is quite a hefty sum, but if he stays on the same drugs that he is on right now, we will be shelling out over $900/month for prescriptions. So. We basically will probably need to start over with the meds, trying to find cheap ones that work well, because for me to pay for those prescriptions, well, it would be either DH's sanity, or the mortgage. It's a tough call, for sure. But I know I'm not the only one struggling with these issues. I know I'm lucky that I still have insurance of any kind. Like I said, I haven't mentioned any of this to DH yet, I don't need him to be stressing out about this, that's my job for now!