The Healthcare Headache Continues …

I thought I had the answer: I would take a 3-credit course, in part out of interest and in part because it would make me eligible for my school’s “voluntary” part-time student insurance. But today I learned that there are no longer any part-time student plans available – whether that’s because my school dropped them, or the insurance company stopped offering them, I don’t know. I just know that I was very confused and frustrated when one part of the site still said I could opt-in to the voluntary insurance, but when I clicked the link it said no plans were available.

I’ve reluctantly accepted that they’re not offering insurance to part-time students, based on the mail-in forms having last year’s dates. They just didn’t bother to update the whole website. Lazy bums. (Acceptance doesn’t make me any less angry. It just saves me the trouble of trying the same thing over and over again just to be repeatedly disappointed by the results.)

I’m disinclined to trust the $400/month short-term insurance plan offered by an affiliate of my school’s insurance company. The very nice representative I’d talked to called back, reminding me to apply in time for coverage to start on the date I’d requested. She also re-sent the information she’d initially sent me. I’m tempted to call her back and thank her for her help. But the attached PDF clearly stated that prescriptions weren’t covered; when I tried to see if other plans were available, the one she’d recommended disappeared, so there were no plans available at all! I know I can call her back and ask questions, but I don’t want to risk wasting money (that I don’t really have) if the information she gives me turns out to be wrong.

In light of all this, paying nearly $2,000 to take a class purely out of interest became a lot less appealing – especially since a similar one might be offered for free on Coursera. I started listening to the lectures for one of my Coursera courses last night and found them to be positively fascinating. It felt so good to just soak in the information. No deciding what to wear, traveling, finding parking, potentially being late, awkward social situations, and consequences for not doing assignments required. So, I’ve decided to drop the 3-credit course I’d registered for at my school, and go the continuous matriculation route. A relatively small fee means I’m still a graduate student, really!

That still leaves the matter of health insurance.

I’ve decided against going to see a psychiatrist for the time being. The SAM-e (along with other factors) seems to be helping quite a bit, especially on days when I remember to take 2 doses of it (400 mg 2x/day, total 800 mg per day). It’s not perfect, but it’s at least as good as the antidepressants I’ve tried so far, with less adverse side effects (maybe because it doesn’t contain weird, unnatural chemicals?). It’s not exactly cheap, but I think I’m saving money over seeing a psychiatrist and paying for medication, especially if I need brand-name instead of generic. I can buy the SAM-e in 3 clicks and have it shipped to my front door – no phone tag, traveling, disclosing personal information to a stranger, and waiting at the pharmacy required. It might not be the best, but it works better for me right now. I can’t help wishing I’d found out about it years ago.

Health insurance suddenly seems a lot less important if it’s not the only way I can afford to treat my depression. Wakana doesn’t take insurance; I’ve been paying her at a discounted rate out-of-pocket. Insurance wouldn’t cover the SAM-e anyway. Hospitals are required to give life-saving care regardless of whether you have insurance. The only thing left is preventative care, which I’m hoping I can find a clinic for nearby. To my knowledge my state isn’t among the insane ones trying to shut down Planned Parenthood, so I intend to begin my search there.

(In case it’s not blatantly obvious, I hate going to see doctors. So, for most things, I wouldn’t bother seeing a doctor. If I’m miserable with a cold or something, I’d rather be miserable at home where I have access to things that help – like tea and soup – instead of at the doctor’s office.)

And in October I should be able to shop for an insurance plan on Healthcare.gov, so hopefully I’ll only lack health insurance until January. Hopefully.

Let’s be honest, I hate making these decisions. But this is the hand I’ve been dealt, and I need to do (or choose not to do) whatever it takes to protect my mental health. I’ve been burned by conventional medicine and the insurance required to make it remotely affordable, so I’m finding alternative ways to take care of myself.

Ingredients

I looked up the inactive ingredients in the generic “equivalents” I had been taking and compared them to the brand name drugs I was prescribed. In the table below, I organized the inactive ingredients list to clearly show which ingredients are shared by the different medications (Zoloft, the generic sertraline HCl I was taking, BuSpar, and the generic buspirone HCl I was taking).

I suspect that ingredients in italics are essentially the same chemical, but with slightly different names. There may be differences between them, but I’m inclined to think that any differences in their biological effects are relatively insignificant.

The ingredient in bold is only present in one medication; interestingly, the medication in question is the generic buspirone HCl. The only explanation I can come up with for why they’d randomly add sodium lauryl sulfate is because they need it in order to get the anhydrous (condensed) lactose to behave similarly to non-modified lactose during production. I find the presence of sodium lauryl sulfate in my medication disturbing, but haven’t found any information to suggest that it might’ve been interfering with the effectiveness of the medication or having noticeable adverse effects.

Ergo it seems likely that if inactive ingredients were limiting the effectiveness of my medications, switching from generic to brand wouldn’t help me much … unless differences in amounts or proportions are significant. I have no idea whether the amounts of the ingredients are the same across the included medications, but each medication had them listed in a different order.

Wakana sat me down at her computer, worked with me step-by-step to find a psychiatrist within reasonable driving distance who takes my insurance, and insisted that I call to make an appointment. I had to leave a message – to which I have yet to receive a reply – but at least I did something. I felt like a huge weight was lifted from my shoulders. And maybe finding out information about other organizations / programs that could help me will be similarly painless … especially if I can do a lot of it online.

One thing I’ll definitely be looking for as I conduct my search for a new psychiatrist will be strong knowledge of how inactive ingredients affect one’s response to a drug, particularly when that may cause significant differences between brand and generic. I need a psychiatrist who will take this concern seriously and be willing to fight to gain me access to the brand drug ze’s prescribing (instead of a generic “equivalent”) if necessary.

UPDATE: I’ve color-coded the inactive ingredients list to indicate possible concerns raised by Disorderly Chickadee in Generic Versus Brand: What’s In That Pill? Part Two. Many thanks once again to DeeDee for compiling the information. Trying to do so myself has been very difficult and frustrating.

Coding scheme:

  • allergen
  • carcinogen
  • toxin, irritant, or other health risk
  • animal product
  • restricted by some religions

Zoloft (50mg)

Sertraline HCl (50mg) Camber Pharm.

BuSpar (15mg)

Buspirone HCl (15mg) Mylan Pharm.

Dibasic calcium phosphate dihydrate Dibasic calcium phosphate dihydrate
FD&C Blue #2 aluminum lake FD&C Blue #2 / Indigo Carmine aluminum lake
Hydroxypropyl cellulose Hydroxypropyl cellulose
Hydroxylpropyl methylcellulose Hypromellose 3cP & Hypromellose 6cP
Magnesium stearate Magnesium stearate Magnesium stearate Magnesium stearate
Microcrystalline cellulose Microcrystalline cellulose Microcrystalline cellulose Microcrystalline cellulose
Polyethylene glycol Macrogol / Peg 400
Polysorbate 80 Polysorbate 80
Sodium starch glycolate Sodium starch glycolate Sodium starch glycolate Sodium starch glycolate
Titanium dioxide Titanium dioxide
  Colloidal silicon dioxide Silicon dioxide
  Lactose Anhydrous lactose
    Sodium lauryl sulfate