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June 13, 2021

Comments

KC

That's an intriguing idea for the immunosuppressed (although, uh, probably not a full-on IV drip; that'd be a lot of vaccine). But I wish they could send the spare supply to Canada or Mexico...

Have you gotten your antibodies checked post-vaccine?

TheQueen

KC - I have no idea how to get antibodies tested.

KC

Your doctor should be able to order a blood test? We still don't know exactly the metrics for how many antibodies are "enough" antibodies, *but* they drew approximate lines for people donating post-COVID plasma (a line like "yep, your plasma is still violently angry against COVID" vs. "eh, we are not sure your plasma will fight it enough in our ICU patients") so that might be somewhere to start?

That said, if you can't get blood drawn without potentially exposing yourself to the disease itself, then... eh.

TheQueen

KC - I don’t think they can order unnecessary tests - and this wouldn’t be necessary, because they pretty much know i couldn’t get a full response — therefore it’s unnecessary. Even if they could and even if I did have a full response, would I go out? I don’t even know anymore. I’d be the prisoner blinking in the light outside the cave.

KC

I do think it'd be informative rather than unnecessary, because if you did get a decent response, then your risk status is different.

But yes, your risk status is not, for instance, stopping you from going into the doctor's office or getting your mammogram, so it's medically less vital.

But if they did let you get a dose of J&J on top of your current vaccination to see if it raises the antibody levels, if your antibody levels aren't already at an okay level, then that would *definitely* be relevant. But odds seem good that they would not be up for that. So. Harrumph.

TheQueen

KC - it seems there are home tests for $125 that require no doctors or insurance. I suppose there’s a scenario in which I am just swarming with antibodies and I can go out, but I don’t anticipate that.

KC

That would be lovely, but yes, improbable. (But lovely!)

Odds are good that if you called your doc and said "hey, I'd like to know what my antibodies are at this point, can you call a test in to [local bloodwork place]" the doctor would say "sure!" and go for it. (and honestly I would trust that more than a mail-in fingertip-prick test)

TheQueen

KC - I do not have the kind of relationship with my doctor where I can summon tests.

KC

*blinks* That is fascinating. I thought that, while some doctors *wouldn't* do things a patient requested, either out of a "it wasn't my idea, therefore it is bad" or a "that is actually a dumb idea," the most common course of conduct was to agree to order tests or medications that are within the reasonable course of treatment/investigation? But so it goes, I guess. Doctors are sometimes odd ducks.

(if your immune doc won't, will your GP?)

TheQueen

KC - that is my GP - I would be even less inclined to ask my neurologist. Are you familiar with the full body MRI scan? I know two people who had recovered from cancer who have used those to quell their fears after cancer treatment (both found cancers). Insurance did not pay, and I don’t think they had a prescription. That’s the type of thing I could see asking for. I did glare at a neurologist once until he signed me up for an MRI. (They found active lesions.) But this would just be to calm my curiosity. Even if I had 95% protection I’ve got old people. I’m not going out socializing.

KC

See, full body MRI scans are expensive and rarely "medically indicated" whereas blood tests are usually cheaper and more often ordered on a hunch and thus more reasonable to be ordered because the patient asked.

Also AUGH. But I am glad you glared at the neurologist enough.

(also I would like to note that I HATE insurance companies segregating doctors by "they often order more expensive tests/medications" vs. "they rarely order things that are expensive" and making one set of doctors cheaper for the patient to see than the other set, because 1. it messes with doctors being willing to order things based on the patient's needs - if their practice is still getting off the ground, they *need* to stay in the cheap category to keep getting enough additional patients from this insurance company's collection of patients and 2. it means that people who need to see doctors who specialize in weird things instead of just covering the absolute basics end up needing to pay more per co-pay, while also needing to pay more for medications and tests for their weirdo condition.)

(but basically I really hate insurance companies in general, so there is that.)

TheQueen

KC - I had no idea insurance companies did that!

KC

Yep! Ours is also now experimenting with carrot-and-stick financial rewards/punishments for which place you go for testing, and I'm like: while it's nice to get tests done at a less-expensive, non-hospital testing center, *AGAIN* this is disproportionately penalizing the people who, say, have had reactions to contrast dyes or whatever and thus it is a good idea for them to get them done in the hospital rather than at a freestanding, no-medical-care-available testing place. (or otherwise just need The Version The Hospital Does instead of the freestanding testing center default, or get the tests done in a more-emergency situation, etc.)

Oh! And they also have "preferred medications" vs. non-preferred ones, which changes the co-pay by a lot and your physician is supposed to help you with finding "preferred" medications, but it's not "here are two equivalently effective medications for the same illness" but is instead just a list of medications, and some illnesses have no medications on that list, and I'm like "oh, okay, so for Alzheimer's you should really go for the preferred medication list and maybe pick... oh, how about an erectile dysfunction medication! Or maybe you should take a blood pressure medication instead. For your Alzheimer's. Because there is no preferred medication for Alzheimer's."

(I also wish that people could get exemptions to the big price jumps for name-brand vs. generic in the cases where the format of the medication matters - for people who are allergic to specific dyes, or who are cutting the pill in half and thus need a pill that *is* cuttable instead of not, etc. But nope. Which I sort of understand because more people than *need* the name brand would opt for the name brand, but still.)

I guess: most insurance companies are attempting to maximize their profits. Some of these ways are more reasonable and ethical than others, and when their optimization efforts are at odds with good patient health outcomes, then that is BAD in my opinion. (Spouse thinks that insurance companies should instead be nonprofits; I do not disagree with him; the group health cooperative that I grew up with - it was the main medical system and main insurance system in my home city - was a nonprofit thing and it was *good* both at minimizing costs in reasonable ways and not minimizing costs in unreasonable ways. I don't think all nonprofits are equally competent, though, so there is that.)

TheQueen

KC - name brands - that’s a real thing. For some reason my husband requires the name brand. I don’t know why. If I hadn’t seen it for myself I would have thought he was just being suggestible.

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