In 2014, I got a whole bunch of people fired up by writing a piece called “No Obamacare for Dogs” that spoke to the issues people face when they arrive at the vet ER without enough funds to pay for a pet’s needed care.
And here we are now, three years later, same old same old. Somewhere, in the United States, a pet has arrived at an ER and the owner was unable to afford the estimate. Chaos ensues. Nothing new, really, and here we are again waiting for someone else (read, the veterinary emergency clinics) to solve the problem.
Now I get that this is an emotional topic, and understandably so. I think there is room for compassion both on behalf of a pet owner in a bad situation and a veterinary professional who is being asked to do the impossible. But in order to move forward- to really try and make a difference- we need to lay out some simple truths here.
1. You Can’t Compare ER Costs to Your Regular Vet
A 24 hour ER is expensive to maintain. It’s not considered an essential public service like human hospitals and no one will bail them out if they run out of cash, so the owners have to run it like a business or else they shut down. Overnight staff make more money because they earn it. It makes it hard to have a normal life, it affects your family and often your health, and if they weren’t being compensated well no one in their right minds would do it.
As emergency services they have to maintain a lot of high-end, high-cost equipment and medications. Overhead is huge. If they have a criticalist on staff, surgeons on call, 24 hour RVTs on staff, all of those premiums add up too. Many times- at least in my area- they also need to pay for extra security. People show up with guns, grudges, and bad opiate addictions. Everyone’s stressed, no one in the lobby wants to be there, you don’t get even the lift of a new puppy visit to break up the sad stuff. Do you know why I don’t do ER any more? You couldn’t pay me enough. It’s backbreaking, heartbreaking work and I am so grateful to my colleagues who take that task on. They’re the reason your regular vet shows up at work smiling at 8 am, because they got a full night’s sleep and decent coffee.
2. Your Vet Can’t Afford Not to Charge You
I hear a lot of people talk about the good old days when their vet would ‘give them a break’, knock some money off the bill. You understand where that money came from, right? From them. From their own take home, because the electric bills didn’t give them a break, payroll didn’t give them a break, the grocery store didn’t give them a break. No one expects anyone to give them a break anymore, except for veterinarians, because as a profession we’ve let it go on way past the point of viability.
Here’s the difference between now and then: today’s vet is carrying an average debt load well over six figures. The debt to income ratio is higher than it’s ever been. Despite what you may think, most vets are terrible businesspeople who give away way more than they should; maybe if we ran things better more of us would be the wealthy Scrooge McDucks so many people think we are. We just can’t afford to gift out discretionary income in the form of “breaks” any more, because we don’t have discretionary income to give. I know some vets who still give too much away: out of a sense of obligation, usually, this idea that “this is just what vets do”. They are generally unhappy. That life is unsustainable.
3. I Can Care and Still Want to Earn a Paycheck
Unless you, personally, donate 100% of your paycheck to animal angel funds you aren’t allowed to use the “if you cared you’d do this for free” line. It’s mean, and untrue. Ever try that on a plumber? They’d laugh, and leave you standing ankle deep in sewage.
4. This is What We Asked For
If you believe pets are family members, and deserve to be treated as such with high end food and Paul Mitchell shampoo and highly trained oncologists, you also have to be ok with the fact that these things cost a lot. It’s either worth it to you, or not.
Back in the good old days, the James Herriot days that everyone with a steep bill in their hand starts to wax poetic about, they barely had antibiotics. Seriously- penicillin, not widely in use till the 1940s. Of course vet care was cheaper back then: it was morphine, alcohol, and lead. It really wasn’t a great time to be a pet, to be honest.
5. So Whose Fault Is This?
No one’s. It’s not a fault thing, it’s a reality thing. People want something that is expensive to not be so expensive.
When I say I am sympathetic to the problem of unaffordable care, I mean it. In ER I spent at least 30% of any given day trying to help people come up with a realistic solution: calling angel funds, working up plans B and C, crying with them when it sucked. I guarantee you, turning someone away or doing economic euthanasia for something like a dystocia or a badly broken limb or septic abdomen hurts like hell. No one wants that and we usually do everything in our power to avoid that, but we aren’t Superman. Our powers are finite, and people’s antagonism is the Kryptonite that sends so many of us off the proverbial and sadly sometimes literal cliff.
Bottom line: People want their pets to get better without going bankrupt. ER vets want to help people’s pets get better without going bankrupt. Really, we’re all on the same page here.
6. How Do We Fix This?
I know I sound like a broken record, but nothing has changed. It has to be a team effort, because affordable care is too big an issue for one person or one clinic to solve. The costs aren’t going away, so we need to figure out how to ease the burden of a sudden huge bill. Here’s how it works:
Our role as veterinarians is to provide care and offer you options, without being the ones to personally subsidize them. I think as a profession there’s still lots we can do, from encouraging more people to utilize pet insurance to working with outside financing companies to offer payment plans without taking on the burden ourselves. There are some great options out there and we should continue to explore how they can help.
Your role as an owner is to be as prepared as you can and understand that there is no safety net for pets. You are the safety net. Get insurance, set aside a savings account, get a Care Credit card. Donate to angel funds when you can. Know your limits; we’ll do our best to give you options, but you have to meet us halfway.
We’re in the middle of three major, major disasters in this country right now and I’ve seen nothing but grace and kindness from the animal lovers and veterinary community risking their lives to save helpless pets. Everyone’s come together. I know it’s possible for us to be there for each other. We can do this.