If dealing with the American Private Health Insurance System to get affordable care is a nightmare, then needing the same system to get mental healthcare is even worse. Author Roald Dahl coined the phrase trogglehumper to describe a whole next level of Rube Goldberg of nightmares. As if it is not bad enough, mental healthcare is already at the bottom rung of the healthcare system because it is neither sexy nor profitable. Given that the mental health field has been relegated to the wayward stepchild of medicine, it stands to reason that insurance companies are less likely to provide any benefit at all.
This is kind of the issue I am facing now. As a disabled man, I qualify for Medicare and Medicare provides good mental health coverage but the Medicare Part D Prescription Plan through SilverScript has virtually nothing for these kinds of medications. All of the medicines listed are a minimum of 20 years old and all have generics. What does somebody do when nothing of the established medicines work? Well, this is where the trogglehumper begins. I have to see if I can convince my psychiatrist to drum up a letter of prior authorization for a recently FDA-approved medication. Then this letter needs to sit in some queue for 10-15 days while SilverScript’s army of evaluators geared towards protecting profits make a decision. In most cases, this decision will be denied outrightly since insurance companies are not required to keep these statistics for legal purposes.
Then, I can go through an appeals process which could take 30 or more days. My depression is rather severe right now and I fear that I may not have even that long. The medication that I want isn’t even that new. It’s been used as a tranquilizer and anestheic. Ketamine is most often used for veterinary medicine but it has been found to be effective for people like me that do not respond to traditional antidepressant medications. In some cases the effect has been startlingly profound. Do I not deserve, as a basic human right, the same right to live as clinical depression free as possible. It sucks because if I were somebody like Mike Bloomberg, 650 dollars for a 30 day supply of the medication that could help me might as well be $0.065. That’s six and a half cents. To me that is more than half of my monthly disability income.
I think of my Twitter friends that have lost people to mental illness. I wonder how much longer I can last when I continue to feel really bad despite getting sunshine and physical activity. I am just not getting better. As soon as any kind of activity ceases, my mental state crashes and crashes hard. I can go from relatively tranquil to so sad I can just cry and I am not typically a crier so I know this is all neurochemistry and not situational. But profits must be protected at all costs. I was hopeful that Medicare For All might become a reality but the army dedicated to stopping it just might be mightier than the pen after all.