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eftychia at 12:40pm on 2003-09-10I've been eating Tums as though they were candy since I'm out of Protonix -- I've got two pills left that I'm holding in reserve for either Really Bad Days or times when I cannot afford to be distracted by the acid reflux. But over the weekend, facing a reeeeeally looooong Saturday, I did take the single remaining Prilosec capsule that I found in my bedroom when I was packing. It was left over from before Kaiser decided that everybody taking Prilosec would be switched over to Protonix ... allegedly for effectiveness or safety reasons, but my (uninformed) guess is that it had more to do with getting a more profitable deal on Protonix. So it was well past its expiration date, but I wasn't worried about that (especially after reading that web page about old drugs).
My old prescription was for 20mg/day, and this was only a 10mg capsule, but Prilosec always worked better for me than Protonix anyhow. I did chew some Tums on Saturday, but not many, and things never actually got to the point of pain. (Yes, most days it hurts.)
The good news: now I've started seeing television ads for "Prilosec OTC". The not-quite-as-good news: the ads say, "coming soon", so I can't run out and pick some up yet. The dunno-how-good news: the ads don't make it clear whether this is the same thing as I took before, just available over the counter now, or a slightly different version for OTC use; also, I have no idea whatsoever how much it's going to cost. So it might wind up being something I can't afford, which means I need to get insured again and stick with prescription stuff, or it might wind up being a major problem-solver for me, something to help me until I get insurance and a way to stay under the benefit-cap for drugs once I do get insured. So I'm holding my breath, crossing my fingers, knocking on wood, and waiting for more details.
In a related thought ... who among you has health insurance you pay for out-of-pocket (instead of through your employer), and which companies/plans are folks happy with? I need to go into Heavy Research Mode, which I'm not looking forward to, and being able to narrow the field a little -- or at least have some starting places -- will be useful. Not sure when I'll be able to afford insurance, but I ought to figure out whether it makes more sense to try to get caught up and reinstated with Kaiser or find something better.
I've been rather pleased with one of Kaiser's doctors (a PA actually) and not-displeased with another, but I've never been happy -- or even comfortable -- with the organization as a whole. And I do feel that the HMO (probably most HMOs, but I've got a small sample size) is set up to impede my getting decent care. I also haven't liked the way that each of the last couple of years, my benefits have been cut and my premiums have gone up, at the same time. (Shouldn't it be one or the other? Doing both is like rubbing salt in the wound!)
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The FDA press release (http://www.fda.gov/bbs/topics/news/2003/NEW00916.html) also says "Prilosec OTC is a delayed-release 20mg tablet that must be taken before eating once a day, every day for 14 days. Prilosec OTC may take one to four days for full effect, although some consumers may get complete relief of symptoms within 24 hours."
I don't know if that's comparable to, or different from, the version you got by prescription.
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Medications and insurance
I have been fortunate enough only to pay for insurance out-of-pocket once, and the company I dealt with was pure unadulterated evil. (I can't remember the name offhand, and they've probably been bought by someone else by now anyway.) I was on COBRA after the company I was working for went under. They were supposed to offer a continuation of the health coverage we'd had, and instead they offered a plan that covered only emergency room and hospitalization. Apparently they were gambling that most people wouldn't read it carefully before signing. When confronted about this with the help of a state insurance commissioner, they offered an alternative plan based on the principle that the law said they can't exclude you for pre-existing conditions (and that had only been enacted a year or so before then), it didn't say they couldn't quote you outrageous rates to try to keep you out. I'll look up the name so you can avoid them.
If you're not comfortable with Kaiser, stay well away from any other HMO. Kaiser is not-for-profit; the for-profit HMOs are much more driven to keep costs down above all else. Kaiser was at least founded on the principle that easy access to checkups and preventive care can save money by reducing the need for more expensive procedures; the arbitrary cost-based restrictions that are the staple of HMOs in general came later.
<brief gratuitous political rant>
From some stuff I've read, HMOs aren't really managing to contain costs compared to traditional insurance any more. The courts have outlawed many of the more egregious denial schemes they used (which doesn't mean they don't still try them, of course), and they don't really have any other advantages. So politicians who advocate saving Medicare costs by "encouraging" more people to join HMOs are either:
a) Woefully behind the times and ill-informed about this plan's potential for success (I'm willing to give some of them the benefit of the doubt on this; I've lived in the DC area my whole life and the federal government is always several years behind the curve on most things.)
b) Free-market ideologues who know that private enterprise is always more efficient than government, and will pretend any evidence to the contrary doesn't exist.
c) Anti-government ideologues, who don't believe government should be doing things to help people, and want to see Medicare and other health programs effectively dismantled, but don't want to take the political heat of openly proposing that and learning what "regular people" really think. (Guess I should amend that to "cowardly and dishonest anti-government ideologues"...)
(Or, I suppose, d) all of the above, since they're not mutually exclusive.)
</brief gratuitous political rant>
Okay, maybe that wasn't so brief...
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However, when I tried to find anyone who'd used them, I couldn't--requests for info online brought back pathetic cries of "Do *you* know anything about them?"