I wish this thread would go away. If everyone figures out that vets offer cheaper healthcare (I’ve been going to one for years) - prices will spiral out of control 
In humans, at least in the US, most of the costs of healthcare over one’s lifetime are incurred in the first year, and the last six months of life. This applies much less to animals.
Most pets give birth unattended. And owners don’t usually have the runt of the litter admitted to the veterinary equivalent of an NICU. If a puppy or a kitten dies, that’s too bad, but nobody sues the vet as they very commonly do the obstetrician.
And when a pet gets old and gets cancer, most owners treat until the pet no longer can enjoy life, and then euthanize. Not always, but the fact that most veterinary care is paid for out of pocket means that sentiment runs into the hard wall of reality pretty quickly. Sure, you love your pet, but are you going to spend tens of thousands of dollars on the latest and greatest treatment and thereby extend the animal’s life for a year or two, at best?
You mentioned hysterectomy specifically. Most spays are done on a young, healthy animal for purposes of contraception. Most human hysterectomies are done on women for health-related reasons - fybroids, uterine cancer, etc., and they are much older at the time.
It’s simple economics. Veterinary care is cheaper because demand is lower. For veterinary care, 99% good outcomes is acceptable. For humans, anything less than 100% is not.
That’s because death panels and rationing are the only possible alternative to increasing health care costs. Implementing single payer will not do the trick.
Cite.
Regards,
Shodan
My … uh … WAG … is that this is indeed a very large part of it. The size of the team involved in a human procedure is much larger as the tolerance for risk is much lower.
I suspect also that human hospitalization costs would be cheaper if human patients were content to be placed in a cage and pooping in their bed was considered no big deal instead of typical hospital care. We really cannot treat humans in a human hospital like animals.
Another factor is that pets have owners who will clean up the patient’s feces, make sure they eat and take their meds … not all human patients have such reliable and prepared loved ones around. So humans cannot always get discharged as quickly. For some if only they were treated at home like many of us treat our animals.
Yes the selection bias to the simple low cost cases - both by virtue of doing procedures like ovariohysterectomies on young healthy animals as a routine and often opting out of procedures on a pet with many complicated other medical conditions going on and instead euthanizing. Yes, in comparison human procedures are done in the presence of greater risks and complicated circumstances.
But no question that human OBG surgeons charge more per hour than vets do. Malpractice rates are part of that and length of training to be able to practice. Pet owners are fine with a general vet out of vet school doing a simple spay; human patients are done by those with an additional four years of OBG residency.
Shodan, does that OECD study recommend death panels and rationing?
I cannot support any bill that provides healthcare to squirrels.
There is no outside constraint upon the supply of veterinarians akin to the residency system for doctors, and veterinary organizations have been warning of oversupply for some time. On the other side of the ledger, the fact that insurance is rare means that there is direct price competition visible to consumers.
It recommends things that Americans will think is rationing and death panels, even if Europeans are implementing them already.
Cite.
Should we (the US) do it anyway? IMO, yes, certainly. Will people like it? IMO, certainly not.
Regards,
Shodan
Rationing health care isn’t the same as rational health care. If frequent mammograms don’t produce better health outcomes then you discourage it.
Unfortunately, ISTM that rational health care necessarily involves some form of rationing. Because you are entirely correct - practices that don’t improve outcomes shouldn’t be covered.
But as mentioned, Americans are used to being over-treated, and will react to any reduction as death panels/rationing/etc.
Maybe mammograms for women under 50 catch one case in a million that would otherwise be missed. They would also waste a lot of resources that could be better applied elsewhere, lead to a lot of unnecessary worry, and generally not be worth it.
But you know as well as I do how the argument is going to go -
“My sister got breast cancer, and she was only 43! Mammograms would only cost the taxpayer less than a penny a day! You want my sister to die, just so you can save a penny a day!?!?!!”
To which the rational response is, Yes. We do. We want to save money, and we are willing to accept the tiny, probably statistically insignificant decline in outcomes that are a consequence. Anecdotes notwithstanding.
If you want to say ‘that’s not rationing; it’s just reducing over-treatment’, fine. Quibbling about terms isn’t going to change anything. Both involve saying No, you can’t have that, even if you are used to getting it.
Regards,
Shodan
So we’re talking about two different things then. Actually rationing and percieved rationing? And ignoring, and allowing patients to be ignorant, of the negative consequences of overtesting and false positive tests?
I prefer to think normal people can understand that not changing the oil in your car every week is not “rationing” car maintenance.
That’s possibly true. Americans may decide they’re being under-treated if their health care was reduced even if it was on the basis that the reduced amount hadn’t been needed.
Some people have made this argument against a public healthcare system. They argue that if healthcare was essentially free (at least to the patient) then people would want more healthcare. The demand would increase as the cost to the consumer was lowered. And that is standard economics.
But I think it’s plausible that this wouldn’t be a significant problem. I think there are very few Americans who are undergoing medical examinations or tests for the fun of it. Patients get examinations and tests because health care providers recommend them. If we’re being over-treated, it may be due in large part to being oversold treatments.
This could be a result of our profit-based healthcare system. Our healthcare system is designed to sell healthcare not just provide it. Remove the providers’ financial incentive in selling additional healthcare and you might find that consumers have no inherent interest in consuming that additional healthcare.
So healthcare might be one of the unusual cases where making the product free for the consumer would actually reduce demand for it.
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Rarely do Veterinary patients sue, so Malpractice insurance is way cheaper.
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Altho by no means easy, it is cheaper to get thru Vet school than Medical school.
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Very little insurance industry. It really isnt all that more expensive in the USA, but here is what happened: Most USA patients do have medical insurance. The Insurance industry demands steep discounts. The medical industry more or less doubled (or more) their price, then gave the Insurance companies a 50% discount. But if you’re NOT insured you pay the doubled price. (If you see a small medical practitioner, they will often offer a significant discount for cash customers).
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Us humans demand more unnecessary pills and procedures, being bombarded with ads.
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Not much vet cosmetic surgery, other than say tail docking. (feeds off #4)
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And yes, oftimes when it gets really expensive you opt to have Bowser put down, especially if you know he wont have any real quality of life. Rarely are we willing to do that for humans.
Human procedures cost more because people value their own lives/health more than they do their pets’.
Which is really two ways of saying the same thing.
Hysterectomy is a fairly easy basic surgery. Used to be done with one family doctor and a nurse. Presumably the same is true for most pets. But your pet probably doesn’t require a highly paid staff of 7 just in case something goes wrong. If something goes wrong with your dog’s surgery…
Then your dog is put in a cage to recover. You get put up in a hotel room to recover. And you’ve got the notoriously expensive secondary costs of the American medical system.
When it’s not an emergancy, hysterectomy is also going to involve a lot of preliminary care: non-emergancy surgery rquires a high level of informed consent.
While most of the answer has already been provided - dogs are worth less than people - there are additional factors.
Hip replacement is an outlier. Humans, with their upright pelvises, bipedal locomotion, and higher body weights, demand more or their hips than dogs do. Human hips (particularly the femoral head) invariably have age-related changes which don’t appear in dogs. Or, to be more accurate, healthy humans develop arthritis in their hips. Healthy dogs don’t. Dogs get hip arthritis from trauma, congenital malformations, or outside factors. Dogs have three other legs to walk on.
All this means that human hip replacements are more difficult and expensive than dog hip replacements. Apart from anything else, the prosthesis has to last much longer in a human; a typical human joint replacement will have a lifespan of 15-20 years, which is longer than almost any dog will live.
Any answer to this which justifies the excessive charges for human medical care, without first INVESTIGATING all the details being assumed, is illogical.
I’m very frustrated myself, that in all the millions of hours invested, and all the millions of dollars spent to TALK ABOUT the high cost of medical care in the United States, there has to date been NO WELL FUNDED NON-PARTISAN INVESTIGATION into the reason for all of the pricing practices.
It’s like trying to fix a machine, without talking to the designers, or removing the covers to see how it works, or even asking what it’s supposed to do.
I must not be understanding you. Do you mean that nobody knows why health care costs so much in the US? Or do you just mean that lots of people are wrong about why health care costs so much?
Regards,
Shodan
Also not understanding - what sort of “investigations” do you think should be done that have not been done? The number of non-partisan (and partisan across many dimensions of partisanship) think tanks and panels and academic studies that have looked into the root causes of the costs both of healthcare overall and of specific segments and items, complete nonpartisan institutes created to the study of, is huge. Which does not mean that there is 100% consensus either about the most important root causes nor even among those who agree on the root causes what the best approaches are to address it.
So a pretty big “huh?” here.
Post 33.