Two questions about the economics of veterinarian bills

My dog- 8 year old rat terrier- has had to have major surgery; just got news that he came through all right though of course he’s out of it. The surgery, which is about halfway to a gender reassignment, required major plumbing changes (a urethral reroute to be precise) and while I haven’t gotten the final total yet the estimate was… rather high. It at least made for a memorable facebook post yesterday:

But the important thing is he’s doing okay. He’ll be recovering for a while. And I got to see a world class dog fight while there (a Golden Retriever attacked a big mut in the lobby of the vet clinic and damn- literally every employee- about 6- and the dogs’ owners took minutes to pull them apart. The Retriever more or less won but the vet said the mut wasn’t badly hurt at all, but all agreed it was the worst fight they’d seen in years; I was so thankful I was holding my rat terrier instead of the Jack Russell mix because that one- even if he’d been bandaged and catheterized like the Rat- would have screamed something you wouldn’t have to be Dr. Doolittle to translate as “TODAY IS A GLORIOUS DAY TO DIE!” and would have leapt into the fray, and would at least have come in second. (With humans he’s the sweetest dog ever, with other dogs he’s hell on wheels- though currently he’s depressed over his ‘brother’ being gone- really is, he’s barely eating and looking for him constantly even though they rarely get along {they rarely fight, but they growl and fuss at each other constantly}).

Anyway, apologies for the digression. The questions and comments (and this may not be the right forum but I’ll let the Mods decide):
1- Luckily for me and for my dog I was able to afford the $1800- I don’t mind telling you that it stung like a bitch, but at least I can afford it. There have been many times, such as most of my life, when I couldn’t. This is the only vet in town who performs this particular surgery and their payment plan is “Half down/half now” basically; they give you an estimate and you have to pay half up front and leave a credit card (or other proof) that you’re good for the rest, and obviously when you build a Urethra Bypass it’s a very necessary operation. (He couldn’t pee without a catheter and this is the rather drastic cure.)

So this may be a naive and stupid question: what happens when a pet needs an operation and his owner/s can’t afford it? (The vet recommended a particular petcare credit card, but that assumes you have good credit.) I completely understand that a vet has to pay their staff and their bills and their mortgage and all and is highly qualified and is not working a charity, but this has to be a frequent decision: is it common for animals who are unhealthy but can be helped to be put to sleep?
Or are there any agencies or charities that will help with this?
While my dog is incredibly important to me- moreso arguably than he should be- I don’t pretend that their well being outweighs that of a human in terms of government aid, but I would argue til the cows come home that a human beings quality of life is definitely affected by the health of their pets, and being unable to provide emergency care would cause enormous pain and depression and yet there are tens of millions in this situation. If the bill had been $18,000 instead of $1,800 I’d have been. For this reason I’d love to donate (once I’ve paid this off) to an agency that provides this type of emergency assistance. Does anybody know of one?

  1. Completely unrelated but something I’ve wondered before and even though it seems like a very stupid question I’ll ask: this again was major surgery- requires anesthesia, qualified surgeon, post-op care, etc., and it was $1,800. If it had been done to me (God forbid) in a human hospital, it would have been closer to $180,000. Some of the same drugs are used in the IV and painkillers that would be used with me.

What is the biggest difference in price variation twixt veterinary procedures and human procedures? Is it the fees of the surgeon, the hospital, or what exactly?

Your vet’s office would be a good place to ask about this. I don’t know of any national organizations, but there is a local one here I know of, and I am sure there are others:

Ashley’s Angel Fund

There are vet’s offices here who keep donation canisters on their counters for AAF.

Also, Ohio State University does a certain amount of free/low cost stuff specifically for greyhounds through their Greyhound Health and Wellness Program. I know someone who got free chemo for her dog through them (it’s one of things that donations pay for), and I’ve gotten a no-cost consult from them.

Our local greyhound group will also donate funds to members who are having expensive medical treatment for their hounds if they know the person is having financial difficulties. I wouldn’t be surprised if other breed-specific groups do the same thing for their members or people their members know.

I’m not in the biz or anything, but I’d bet there is a significant difference in the cost of malpractice insurance, for one thing. And since there has been a trend of late in the court system of viewing pets more as family members and companions as opposed to property, I wonder if/how/when that may change.

Also, salaries and overhead are higher in human medicine, often by quite a lot.

Oh, and as far as folks putting pets to sleep because they can’t afford treatment? I don’t know how often it happens, but I sure know it does, and I’d bet it’s not uncommon.

Sampiro - When I was at the vet’s office three weeks ago, having my dog Grace euthanized (end of life with congestive heart failure), another owner was there and made the decision to euthanized because he didn’t want to pay for surgery. He signed the euthanasia release papers and left, then the vet told the receptionist he’d do the surgery on his own dime and rehome the dog. Obviously vets can’t afford to tell everyone that they’ll do surgeries for free, but in the case of my vet, he’s told me straight out the the needs of the animals come before the wants of the owners if he’s treating them. He also accepts payments if you can’t pay for everything up front. I have known plenty of people who have made the decision to euthanize if the cost of treatment was prohibitively high. Every person needs to make the decision as to how far they’ll go - do you pay hundreds for chemo that will only prolong life for another 6 months? Do you max out your credit cards when you’re unemployed?

I’m lucky that although I’v had to make the call to euthanize my pets, money has never been the reason. I don’t know how I’d stand that.

StG

Here in the UK there are charities that offer financial assistance to pet owners, or provide free treatment at charity run clinics. This is usually only available to pet owners who are on means tested government benefits, and there may be limits on the treatment offered. There are also charities that contribute towards neutering costs.

As for animals being put to sleep because of the cost of treatment? Happens a lot, in my experience. Either because of long term expensive medication, or a sudden unexpected cost. Money may not be the only factor, but it often affects treatment decisions, even for pet owners who appear to be well off

I guess Americans have a slightly different attitude towards vet bills, in that you have an idea of the cost of your own healthcare. The attitude here is more “But why does it cost anything? I’m doing a good deed by looking after an animal!” We keep our prices as low as we can, but people still complain.

This is how I got my pup. When he was four months old his previous owner stepped on his front leg and broke it. He was only about five pounds (pomeranian) so it was a very delicate surgery involving a metal plate. They couldn’t afford the surgery to fix it so they signed the release to euthanize. The vet then did the surgery for free and adopted him out to me. All of his follow-up visits and everything were covered by the vet. All he got out of it was the adoption fee ($250 I think). He was also fostered out during his recovery before I got him. Unlucky for the owners, but lucky for me. He’s a great little dog.

Wow, St Germain; I love your vet. I know that my vet often does things like that, but just Wow that your vet did that. I have three rescue horses that get free care from my vet, because she’s happy that the horses have a good home. We all do the best we can, no?

If the vet is going to do a surgery anyways, why not do it for free for the person who couldn’t afford it? Many owners can afford the day-to-day cost of pets, but can’t drop $1000+ in one go on something… So many vets don’t have payment plans available, and a sudden unexpected surgery can really screw with someone’s finances. It seems rather judgmental and unfair to tell someone their pet will be euthanized, and then treat the pet and give it away. Not being able to pay doesn’t make them bad owners, it just makes them people with less disposable income. Yes, part of getting a pet is taking responsibility for it, and that means being willing to take care of the animal when it’s sick, but where’s the limit? $1000? $5000? $10 000?

Sorry, but in my mind, this pretty much amounts to theft. The owner paid for a service (euthanasia) and even though he doesn’t expect anything tangible in return, he expected that the pet would be put down, but the fact is that service isn’t being done and someone else is receiving a healthier animal for it. I’m happy the pets were rehomed into good homes, but if the vet is willing to do free work, then he or she should be willing to do it for the owners of the pet. It just sits wrong with me.

Sampiro, PM me with your info. I’ll gladly pay for your pet’s care.

mnemosyne - In reality, if it became known that vets were giving away care to those who couldn’t afford it, people would all claim they were broke. This particular case was a prolapsed uterus. I doubt the surgery would’ve been much more than a normal spay. As I said, my vet makes payment plans for those who can’t afford the cost upfront. This person chose not to treat their dog because they didn’t want to incur the expense. Why should they get medical treatment for free?

Although the case could be made that the vet “stole” the dog, I have no doubt the euthanasia release allows the vet to take custody of the animal.

StG

This has been my experience - when the animal is surrendered it is because the owner has refused a relatively simple, inexpensive treatment.

My friend who is a vet got her dog this way. The owner had run over the dog’s tail and it needed ampuation. Owner didn’t want to bother, between the surgery and the at home aftercare (changing bandages, etc). Dog was young, healthy and friendly.

I’m glad your dog got a good home, but IMO, this was a pretty dickish and dishonest thing for your vet to do. If the owners chose to euthanize because they honestly couldn’t afford the surgery, your vet should have either euthanized the dog, done the surgery for free and returned it to them, or told them he was going to do the surgery and give the dog to someone else.

If my pet was injured and I was unable to pay for her treatment, I would be devastated if my only option was to euthanize her. Thankfully, I’m in a financial position that I don’t have to worry about that, but a lot of people aren’t so fortunate. This doesn’t mean they don’t love their pets. I would be beyond livid if I was told my pet was dead when it had really been given to someone else.

When I was 16 my mum died and since my father was already dead, I was in no position to keep the dog and cat alive. I had to put them both to sleep, which was a bit hard since they were still healthy but no one would take them. (The cat was 10 and the dog 15 so the shelters wouldn’t take them and the pound said they’d just wind up euthanized anyway since no one wants old pets)

But I knew of a girl who worked for a vet and she said, that if you put your pets to sleep you should stay with them so the vet doesn’t use them for anything, like she said the vet she worked for would use them for drawing blood out, before euthanizing them.

So I stayed with both pets while they were being put to sleep to know that what the vet said he was going to do, he actually did.

I appreciate that more than you can possibly know, but it’s not necessary. Since he had the good sense to be my mother’s dog before mine (and is thus a holy relic) my sister is willing to help out if needed, but major major thanks.:wink:

Besides which pets can live for many years. Your financial position when you get the pet may not be the same as it is five or ten years down the road, and nobody really wants to give the pet away because they had a lay-off or something else that ate their finances. I agree- it’s best for the pet and the owner that if you’re going to do the surgery anyway then return it to the owner and work out a payment plan that they would probably gladly consent to pay.

I’m glad your dog’s equipment rerouting went A OK. Surgery is always hard since they don’t understand what it’s all for and what is going on. :frowning:

One I’ve donated to when I am flush is http://www.imom.org/

I’m not a vet but I wonder about this too. Most vets have to have their own facilities/hospitals and pay for all their equipment themselves. Plus, unlike human doctors, they have to be prepared for and know how to deal with more than one species! They probably have to price themselves as not to cut everyone off. I know if I had to pay $11,000 to get my dog’s leg fixed, I’d probably not be able to do it and I don’t know how many would. probably the lack of insurance coverage plays into it, too. I know there is pet insurance available, but IME once your pet hits a certain age, they don’t cover at all, so I’ve never gotten it.

The legal position (here, at least, may be different elsewhere) is that if someone signs a consent form for euthanasia and pays for the procedure, then THAT’S what should happen. I know of at least one case where the original owner discovered that his dog had been rehomed by the vet without his consent, and took legal action.

In the clinic where I work, our policy is that if the animal can be rehomed, we will try to do so, but only with the owner’s consent. Nobody ever says no. We usually then do the treatment for free, as long as it’s a one-off.

Give free treatment and return the animal to the original owner? Then nobody would ever pay us for anything. And the animal would be in exactly the same position if it got sick or injured again; back with an owner that couldn’t afford treatment.

I don’t get the problem with not euthanizing pets and ‘giving’ them to someone else. Like others have said, if it would be known that vets pay for procedures, this might breed freeriders who would try to get procedures done for free. I actually think this is quite closely related to the thread (which is active at the moment) about doctors not being allowed to donate organs to patients.

In both cases there is a possibility of doctors bieng put on the spot (either to donate an organ or a vet to pay for a procedure) where they need to make a decision no one should be forced to make.

If somebody won’t or can’t (sadly it is impossible to distinuish between the two) pay for a procedure for a pet, and the vet (from his own goodness of heart) decides to save the pet anyway, then all the better. And I wouldn’t think it was a bad thing if the pet ended up somewhere else.

I agree that it is dishonest and probably illegal for the vet to lie to the owner like that (and most places charge for euthanasia, so they are stealing both an animal and the euthanasia fee).

There are a lot of things that go into the lower fees for animal surgeries, etc. As mentioned above, malpractice is one. Average vets earn a lot less than their people-doctor counterparts in the US, vet assistants/techs get paid a lot less than RN’s, there’s no dietary consultant/social worker/occupational therapist in house, space required is much less (you can fit a dozen animal cages into the space required for one person’s hospital bed).

As for why people in the veterinary industry are paid so much less, it’s because the pet-owning population as a whole doesn’t value them as much as in the human health industry and are therefore willing to pay less. As others have mentioned, some people don’t even want to pay a few hundred dollars for a simple procedure. Pet insurance exists, but many people (including those who spend a pretty penny on their own health insurance, car payment, etc.) don’t consider the expense to be worth the benefit of peace of mind/saving their pet if need be. Hell, people don’t want to put more money into the food animal industry so that there are more vets to protect the food supply (there is a shortage of food animal vets yet they are paid less than dog and cat vets, indicating a lack of demand), but that’s a whole 'nother story.

Yes, animals do die when their owners can’t or won’t pay. I’ve seen owners wearing expensive clothing and driving a brand-new Lexus SUV who refused to have their puppy admitted so that its diarrhea could be treated with IV fluids. Other people are well-intentioned but just plain do not have the money. Vets generally become vets because they love animals and want to help them, but you can not save them all and you can not run a viable business, pay your bills, pay off your loans, and survive by giving away care all of the time. Most vets will try to work something out with you or give you a break on parts of the bill, but they have to make decisions about whom to help.

Somewhat OT, but as much as it pains me (as a future-I-hope vet) to have to euthanize an animal you could have saved, I do not think it is morally wrong to give them a peaceful death. I DO think it is wrong to refuse treatment and let them suffer.

Other cost considerations:

Most vet bills have to be paid up front, or you can sign up with a credit-type system there. Thus they’d have far fewer unpaid bills than many hospitals.

Few to no insurance companies to work through contracts and frequent renewals with, reducing overhead there.

Many human hospitals are non-profit, which requires them to give a certain amount of free or highly reduced health care to the poor.

Downside: People generally don’t abandon a sick family member at the hospital - or at least, the patient can be sought after for payment in the case of humans. This can happen at vet offices if the bill is too high. I was at my vets’ office one day (specializing in “exotic” pets - i.e., not dogs and cats) and listened to the tech diplomatically explain to a family new to that practice that they had a policy that if sick animals were brought in by new clients, the people couldn’t leave the office without the animal, even just to “get a cup of coffee” as they’d had problems like that before. Fortunately the family understood.

A cousin who worked for a vet that dealt mostly with reptiles (mainly pythons and iguanas) said they had a major problem with stoner kids (whether 18 or 40) who would buy these animals because they thought they were cool and alternative, then panic the first time it either had a health problem (which for snakes and lizards is rarely cheap) or the first time it went snake or lizard and abandon it at the vet if they could. If they couldn’t they’d abandon it at the animal shelter (which didn’t take snakes or exotic pets) or just abandon it. This was on the Gulf Coast, and they still have a major problem with pythons and iguaners gone wild in some regions.