Pet Economics 101 “Man Vs. Mutt” on the healthcare front

Last week’s “Man Vs. Mutt” article in the Wall Street Journal’s weekend section traded on a concept that’s been dominating the news and––albeit obliquely––Dolittler’s headlines, too. Yes, we’re talking healthcare reform again. At the risk of bashing this concept into submission, I’ll admit that “I’m on a roll”––or is it merely a barely opaque display of my obsessive tendencies?

Either way, it’s clear this topic is on the minds of many Americans as we struggle with the idea of taking our healthcare system to the next level. What, we wonder, is it going to take to make our medical care more accessible to the masses, to keep our public hospitals in the black, to support the solvency of a system teetering on the brink of collapse under the weight of staggering and still-rising costs?

We can pick on big pharma, condemn the insurance industry and badmouth the lawyers but are their profiteering ways truly what ail us? Or are their methods a mere symptom of a larger ill?

I don’t have the answers. But “Man Vs. Mutt” claims UK veterinarians might. The British veterinary system’s way with pets is undeniably more alluring than the UK’s human health version, author Theodore Darymple argues in his pithy WSJ piece:

"The conditions in which you receive your treatment are much more pleasant than British humans have to endure. For one thing, there is no bureaucracy to be negotiated with the skill of a white-water canoeist; above all, the atmosphere is different. There is no tension, no feeling that one more patient will bring the whole system to the point of collapse, and all the staff go off with nervous breakdowns. In the waiting rooms, a perfect calm reigns; the patients’ relatives are not on the verge of hysteria, and do not suspect that the system is cheating their loved one, for economic reasons, of the treatment which he needs. The relatives are united by their concern for the welfare of each other’s loved one. They are not terrified that someone is getting more out of the system than they."

Short wait times, pay as you go, happy vets, a healthy pet insurance industry a competitive system of distribution. And if you’re very poor or really don’t want to pay for the good stuff you can always go for the bottom-of-the-barrel, bare-bones kind of care offered by the UK’s version of the ASPCA––for free.

The way it goes in the UK sounds great for pets. I won’t deny it. But compared to what the bulk of the US citizenry gets, for themselves or their pets, the UK’s human health approach doesn’t seem half bad, either. Yet Darymple bashes the UK’s needs-based system of human healthcare delivery with the blunt side of their veterinary version. As if animals have it soooo much better. Which they don’t.

Poor pets in the UK have no access to any kind of advanced care. Bones may be set but you can forget about care for major trauma or chemo for cancer. It’s a haves and have nots dilemma with far greater disparities than the human system faces. Its saving grace? We can euthanize pets to control costs. And we can use it for glib comparison whenever we want to call attention to how crappy the humans have it.

Darymple does make some fine points, though––or perhaps that’s what I’d like to read into what he’s set forth: Veterinarians know how to run a good competitive system. We’re well-educated. We control costs well. We know how to treat a client. And we care.

Thanks for the pat on the back, Mr. Darymple. But don’t tell me we’ve got it all sussed out. Because I don’t know my way out of this morass any more than I know what to do with the six stray kittens sitting in my hospital. And I doubt it's that much better in the grand UK.

August 13th, 2009

Add Comment17 Comments

Isn't this ALL a bit of a generalization? Not that I want to get into this with you Stefani--I know where you happen to be coming from. But sometimes––not always, mind you––it's disheartening to see that you don't miss an opportunity to bash the bad apples, leaving the rest of us hanging in the wind to suffer your spatters.

Dr. Patty Khuly August 13th, 2009 12:54:44 PM

As far as people involved in care delivery to humans not being able to get away with harming other humans, that's just ludicrious. The woman who died in the emergency room (sorry, I don't have the actual link or remember what city she was in, but I'm sure most if not all of you heard about it) last year - no one was disciplined because no blame could be apportioned out. I am quite sure that there are a large number of people whose relatives receive(d) substandard care in hospitals and nursing homes, and even when there's 'proof' little is done to prevent it from continuing, on either the same or a different patient. Just because one person stands up and says "Dr. So-n-So didsomething wrong and I saw it happen" doesn't guarantee thatDr. So-n-So will be the one who loses his/her job - although the whistleblower might.

And while they aren't medical care people, in numerous tasering and beatinginstances by police, who should 1) not inflict the harm they often do, and get away with claiming it was 'necessary to subdue' someone, and 2)provide immediate transport to medical care after they do it, and their idea of immediate transport is hours later, they almost always get away without punishment because theyand their cities have immunity from prosecution.

As far as the care that people (whether in the US or the UK) get as opposed to the care that pets get - what a specious argument for anything! I have never heard of, and never will, a pet being kept alive in a vegetatitve state for years, at government expense. Nor have I heard, or ever will, of medical care being flown in to far off places, at government expense, for a pet. And while there are often vaccination clinics, and sometimes s/n clinics that are assisted with government dollars, they are always done to avoid bigger problems that could affect people and their tax dollars more than because animals have an intrisic value. Yeah, if you get splattered in an accident, the medical care comes before anyone talks with your 'responsible party' to make sure the care will be covered. Sure, the care provider (and its collection agencies) will try anything and everything to get that care paid for, but it will be after the fact of you receiving it. And that happens in both countries, so Theodore Darymple can bite me in trying to make it seem that animals are better cared for than people. They are, only if their owners have the money - and people who have the money often pay for medical care for themselves out of their own pocket too. It always has been, and always will be, that those that have, get and those who don't, don't, whether they are human or otherwise.

KateH August 13th, 2009 02:16:21 PM

Sounds to me like the UK vets have drawn a firm line based on resource availability and are sticking to it. I find that better in many ways than pricing and availability that's all over the map. I know that sounds harsh but we should take care of the broad needs and work up by adding additional care levels as it's economically and resource-available. The truly wealthy are always going to have more access just as the truly poor will have none but the systems need to address the great majority in the middle for starters and decrease the wide discrepancies that have developed. I have a peculiar auto immune problem and my Shiba has allergies. We won't be any where near the front of the line in a system like this but I firmly believe it's needed for long term success of medical care systems (and our overall economy).

As for professional CEs. Well, they're almost all kind of a joke if you ask me. Those who care will keep up with or without CEs and those who don't check in at the CE and head down the hall to network.

And now off to the vet with the small female black "Lab" that I found on the way home last night... Yep, I'm back in the country now.

PJBoosinger August 13th, 2009 03:31:32 PM

Darn it! About a month ago, I had read up on the curriculum(s) in the 6-7 or so Veterinary Colleges in the UK and the veterinary "nurse" programs. I found it fascinating reading. But cannot quote any statistics.

Now, why is it that it is thought that advanced care is unavailable for pets in the UK? I did not have that impression as many are board certified in various specialties---just like here. But I suspect, that the British public may have different, if not, more realistic philosophy about pet care. I'll have to post to my lists, just don't recall the topics coming up often from the Europeans.

I know several UK Sealyham owners that had the exact same IVDD surgery, but would also have to follow up for price comparison---my "guess" is that it was less expensive. My guess is also that the UK clients and veterinarians share their philosophies and guilt/pressure stays out of the picture.

Don't misunderstand, they have veterinary complaints & board review too, probably with the same poor statistics we have!

I share Stefani's concern of both human & animal tort reform and obviously the AVMA is concerned also, which begs the question : Why?

http://www.abanet.org/genpractice/magazine/2009/jul_aug/petlawsuits.html

GPSOLO July/August 2009Back to GPSOLO July/August 2009 Issue

Non–Economic Damages In Pet LawsuitsBy James O. Cook and Adrian Hochstadt

"Another argument frequently made in support for expanding damages is that they are needed to deter veterinary negligence. This ignores the fact that all state legislatures in the United States have created veterinary medical boards to discipline veterinarians where there is evidence of misconduct or incompetence. Given the sacrifices of time and money required to become a veterinarian, the risk of losing a license or having it suspended or restricted is a serious deterrent indeed."

Well the above statement is certainly misleading: since statistics speak for itself: 90-97% of veterinary complaints are sealed from the public & dismissed in full!

A real eyeopener article by Alice Villabos re: deception common in both human & veterinary medicine, although I beg to differ that it is a frequent problem in human med as she cites:

http://www.veterinarypracticenews.com/vet-practice-news-columns/bond-beyond/why-is-deception-so-common.aspx

Barbara A. Albright/NH August 13th, 2009 04:10:12 PM

OT but gotta do it :) Took "Baby" to the vet's and was assigned to the newbie vet, licensed less than 3 months! WooHoo, she hasn't been disillusioned too much yet! And suddenly I remember why I can afford to take in strays when I'm in the country where the vet doesn't have huge overhead either. $150 for prelim exam, shots, tests and they discounted it to $100 (good Samaritan) and I didn't even ask. Worms, worms, worms... Came home with dewormer and HeartGuard and will be scheduling the Hearworm treatment soon. $650 for radiographs, blood work, and treatment. I can live with that to get her adoptable (well, that and whatever the spay costs :). First of all I've got to get about 10 pounds on her though. (I get to channel my ancestral women without guilt for a while.) Sorry for the OT posting but, after my recent vet experiences, this was quite a nice experience!

PJBoosinger August 13th, 2009 06:41:51 PM

OT reply, PJB: Maybe not smoke in the house while you are rehabbing her ;)

Barb A./NH August 13th, 2009 07:22:15 PM

LOL, she can't come in the house until we kill off those heartworms. (Besides, we all pretty much live on the covered porch and outside. I have no doubt I'll be sleeping on a pallet on the porch next to the kennel for the 2 30 day stints of confinement she'll have to endure.) Frankly, I'm not sure she's ever been inside a house. Poor thing. But, no, there will be no smoking any where near her until she's in much better shape.

PJBoosinger August 13th, 2009 08:01:09 PM

To continue OT (sorry) to PJB: Why can't she come in until you've killed the heartworms? Just askin.'

Dr. Patty Khuly August 14th, 2009 06:36:28 AM

Want another perspective on this theme? Written before this post, here's the version I wrote for USA Today. It went up last night. Just don't lambast me for my inconsistency. A girl's got a right to let her opinions wander. ;-)

btw, I'll be writing a weekly column for USA Today online over the next eight weeks. Let me know what you think of it.

Dr. Patty Khuly August 14th, 2009 07:16:43 AM

Actually, not so much the heartworms. Vet suggested 2 weeks isolation from other pets for starters and then there's those 2 long confinements. Then there's the fact that, with all her parasites, she's HUNGRY and eyeing my cats when it gets close to the next meal time although we're doing 4 of those/day for now but I think we're feeding the hookworms more than her at the moment. Then there's the introductions with the big Lab (who is being really nice so far but might not be once she realizes...); she's the one who always wanted to eat other dogs at the condos. The house is currently a construction zone so we're all living more outdoors than in for now. My Lab and Shiba are nearly 9 and pretty sedate inside the house. This girl is rambunctious in the extreme. She can contain herself to walk on a leash but, other than that, she doesn't appear to have any training. Climbs on the tables on the porch, doesn't respond to verbal or hand commands as far as I can tell so far.

More likely, once she's got minimal manners and can be trusted not to eat a cat, she'll probably have the same privileges as the other 2 to come in and out as she pleases (although they do have to come get me to get out to their big kennel since it doesn't have a top so is off limits to the cats). And, of course, if the weather gets bad, she'll be coming in and I'll find a way to make it work. I may sound like a harda** but my dogs know I'm a total pushover. (The house is going to take time to fix up because the yard, fencing, kennels, etc. get priority :)

PJBoosinger August 14th, 2009 02:55:32 PM

Like the USA Today article! Looks more to me like evolution of thought than inconsistency. While at the vet yesterday, when I asked about ballpark cost for the Heartworm treatment, I saw the cloud come over the vet's face. "Well, I'd recommend radiographs and blood work but I know most of our clients can't afford it..." And, after the last few days of moving, then bringing home a sickly dog, I'm quite sure I looked like one of those clients. She wasn't quite sure what to do when I asked for the total, including those recommended items; found that an acceptable cost and moved on to the next topic. She waited until after these preliminaries to do the hands on exam and I realized they were really expecting a death sentence, at best, after giving me the worm test results. So then she finds a lump in the girl's side (maybe a B-B, maybe not). Hm, says I, can we look into that when she's being spayed? Why, yes we can says she.

I'm not one who'll always go to extremes in the care of my pets but I'll go pretty far when I can afford it. But, wow, that disillusionment for vets must start even before getting into practice. Turns out my new vet has a very pleasant smile when it's real; unlike the guarded, fake one she was wearing when she entered the room.

I have to give really big credit to Dr. K and the others here at Dolittler for how well my appointment with the vet went yesterday. Having a better understanding of both sides and perspectives was truly, truly helpful and I didn't walk into the office feeling guarded and defensive. I'll be paying much closer attention and asking lots of questions but having the curtain pulled back has made me much less suspicious of every tiny little word or act.

PJBoosinger August 14th, 2009 03:31:10 PM

PJB: Sometimes having a young, freshly minted veterinarian helps, too. This is exactly what she was trained to do and it's an incredible joy to be granted the oportunity to treat heartworms. It's soooo rewarding. Thank you for your contribution to our collective mental health!

Dr. Patty Khuly August 14th, 2009 04:31:00 PM

PJB & Dr. K: I completely agree and in my book , the best part is that the veterinarian did not attempt any guilt or bullying type attitude to insist on treatment.

And was honest to reveal her newly achieved license. If given a chance, Joe Q. is receptive to the newbie, it is all about honesty & trust. After all, everyone can relate to being a newbie or student at some job in their life.

The problem arises when blind & obedient acceptance to commit unethical & immoral acts or be party to them because of fear , ambivalence , or adulation of the person(s) in the authoritative position. I think this goes on far too often to the client/patients' detriment.

I can give a non-medical example: My niece was required to do a short internship as part of her curriculum. She was sent to a licensed person to perform duties & learn . This professional added non-related personal duties that were expected in past internships, and then additionally, added licensed legal duties to perform in his absence.

I am proud that my niece "stood up", at her young age & precarious position and student and said "No, I will NOT do those assignments, it is unethical & illegal for me to do". She shared this with her parents & the college advisor or program director. It turns out they had received similar complaints, yet---, continued to retain this firm for internships!

I'm very proud of my niece, but how many other students felt too intimidated??

Similar thread OT: BBarbara'sBlog

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khay November 15th, 2009 02:35:59 PM

This is a cute way to take care of our pets: giving them their health care insurance. At least, humans tend to extend his benefit to animals. But sad to say, there are countries that still don't extend health care to their citizens. hampers

alice November 19th, 2009 06:18:27 PM

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