Reason.tv: Treat Me Like a Dog—What human health care can learn from pet care

When it comes to health care, who gets treated better—man or man's best friend? Of course, it's hard to make an apples-to-apples comparison when you're comparing four-legged patients to people, and there are many ways in which human care tops pet care. But pet owners told Reason.tv there are some ways where it would be a step up to be treated like a dog.

Pet owners like the convenience of animal care; they also like the client-focused atmosphere. "I think one of the things that human health care can learn from veterinary medicine is the client service side of things, the relationship side of things," says Dr. Peter Weinstein, executive director of the Southern California Veterinary Medical Association. Various reasons explain why people often find animal care so pleasant, says Weinstein. One reason—animal care workers love what they do. Another reason—competition.

Weinstein notes that vets work hard to differentiate themselves from their competitors because "there are a large number of vet hospitals, many located very closely to one another." And vets know even more competitors could emerge because less red tape makes it easier to open an animal hospital. Weinstein recalls opening his clinic, which offered everything from X-rays to operations: "I believe it was 12 weeks from the time I signed the lease to the time I saw my first client. Try doing that with human health care."

It would take at least 20 times as long to open a comparable human hospital in California. It can take even longer in the 34 states with "certificate of need" (CON) laws, where state agencies—not consumers—decide how many hospitals there should be. These laws even allow existing hospitals to hold up plans for new hospitals. "The existing hospitals go in front of these government agencies and say, 'we don't need any competitors; we're taking fine care of the people,'" explains Reason magazine's Ronald Bailey. Recently, certificate of need—often called CON law—provoked a showdown in Tennessee where frustrated residents resorted to protests and petition drives to pressure the state to green-light a new hospital.

Weinstein is happy veterinarians don't have to deal with anti-competitive CON laws, "In veterinary medicine we could have two practices right next to each other and then it's the consumer deciding to whom they want to go." Consumer choice and competition—maybe we could use more of that in human health care.

"Treat Me Like a Dog" is written and produced by Ted Balaker, who also hosts. The director of photography is Alex Manning, the field producer is Paul Detrick and the animations were done by Hawk Jensen.

Approximately six minutes.

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Comments

[robc]

Can anyone explain CoN laws to me? I mean, I know the REAL reason they exist, but what is the supposed reason? I cant even think how they are even arguably defensible.

[prolefeed]

Liberals think competition makes things worse by creating an oversupply of competitors, driving up prices because all those wasted extra doctors and equipment cost money.

Yes, this is their actual logic.

They are dead wrong on the economics, but because liberals are also so smart, as proven by Scientific Studies TM, they don't have to listen to dissenting, dumber libertarians and conservatives.

CON laws are arguably the most wasteful government programs EVAH (well, maybe the WoD runs neck and neck) -- paying government employees to actively make things much worse.

[robc]

Okay, watched the piece, pretty good, couple of comments:

1. Nixon thought less hosptitals would lower costs? WTF?

2. The argument about restaurants doesnt hold up - hasnt the author of this piece watched the reasonTV pieces on taco trucks?

[ed]

When I was a kid, pet care entailed one last trip to the camp and a shotgun.

[Xeones]

I don't know about this. I mean, i took my cat to the vet, and they cut his nuts off.

[Crass misogonist parody]

Xeones, I have heard of people who like to dress like their pets but your nuts!!!!

[Fluffy]

The problem with the analogy to pet care is that the pet is not in charge of making the decision about its care.

If dogs themselves had any voice in deciding what care to obtain, pet health care would have much higher costs.

A lid is kept on pet health care costs by the simple fact that if the bill for the pet's care sounds like it will be too high, people just put their pets to sleep for $50 instead.

I bow to no man in my advocacy of a free market in health care, but the "pet care is cheap and effective and has high customer satisfaction" argument is weak and deeply flawed for the simple reason that no one is polling euthanized dogs to ask them if they too are satisfied customers.

Every time you make any analogy to pet health care, even when just talking about CoN laws as in this case, non-libertarians see that and say to themselves, "Libertarians want to give old people lethal injections if their health care is too expensive." Which is ludicrous, but you're creating the opening for it.

[charge too much]

Fluffy you are exactly right and the vet knows you will walk away.

[John]

You beat me to it. I just said the same thing below. You are exactly right.

[Crudycrud]

fluffy
You are way off. If it were between the doctor and patient alone, prices would go down. Instead, HMOs and Government Bureaucracies control Human Health Care. Look at Lasik Eye Surgery. Not cover by most insurance and the price keep going down.

[Fluffy]

Oh, I agree.

I'm just saying that trying to convince people of this by comparing human health care to animal care is a bad idea.

[charge too much]

I agreed with Fluffy and John agreed with me. I think this me one of the signs they talk about in bible study.

[robc]

The problem with the analogy to pet care is that the pet is not in charge of making the decision about its care.

And thats different from employer puchased health care in what way?

[Geoff]

My employer purchases my health care. I can choose four different insurance plans, and have well over 1000 personal care physicians to choose from. And four competing hospital systems. So far I'm not worried about the euthanasia part, however....

[robc]

"Libertarians want to give old people lethal injections if their health care is too expensive." Which is ludicrous, but you're creating the opening for it.

You've confused libertarians with the British.

[creech]

Don't vets spend as much as MDs to get through school? So how do vets, with similar education costs but much lower revenues manage to survive while Mds can't?

[robc]

There are only 28 vet schools in the US, however 25 of them are public, so that keeps the costs down (if you are a resident of that state).

Avg tuition is 16k resident, 29k non-resident, I assume that is per year for a 4 year program.

Dont know costs of medical school.

[robc]

The big difference seems to be the lack of residency programs after school in veterinary medicine. So vets are "working" (you know what I mean) 3-7? (I really dont know all the details of vet and/or medical training, surely someone here does) years earlier than docs.

[DBN]

You can do a residency in veterinary medicine. I know a veterinary radiologist and another veterinary orthopod.

[prolefeed]

Both vets and MDs survive. There are doctors practicing medicine.

The MDs tend to be better paid, but the vets go into their profession knowing that, and obviously preferring their profession in part for non-monetary rewards.

[Johnny Longtorso]

A lid is kept on pet health care costs by the simple fact that if the bill for the pet's care sounds like it will be too high, people just put their pets to sleep for $50 instead.

You don't know many pet fanatics.

[ed]

A vet's dream is an ugly single woman with a cat. Ka-ching!

[or]

A vet's dream is an ugly single man with a cat. Ka-ching!

[DBN]

You don't know many pet fanatics.

My SO is a vet. People choose to euthanize their animals all the time. The most common course of treatment for severe veterinary illnesses is palliative care leading into euthenasia. The person willing to go into bankruptcy to buy their pet an extra six weeks of life with chemo is rare enough to be mythical.

[T]

Yup. We kept our dog alive for 2 extra years by doing subcutaneous fluid injections every day. But once she had 3 strokes in a week, she was done. A person would have most likely been stuck in a hospital bed and watched as they vegetated and died since there's not much you can do at that point. We took her in and had her euthanized.

[Cosmo Kramer]

I'll take a vet over an MD anyday. They have to be able to cure a lizard, a chicken, a pig, a frog - all in the same day.

[R C Dean]

My introduction to public policy and health care came when I helped get the hospital CON program in Wisconsin killed. Good times.

Of course, the tax on hospital to fund this program, gone for over 20 years now, is still on the books.

Nixon thought less hosptitals would lower costs? WTF?

This is classic utility-based thinking. Way back in the day, hospitals had their rates set by state agencies as well (like a utility), so with no price competition possible, the state had to take on regulating the supply via CON. That's the theory, anyway.

[Joe Dokes]

Here's a question on a related topic that I have tried to answer but can't find the data.

Health care spending has been outstripping inflation by a wide margin for at least forty years. This is clearly due to a number of factors. But how does the inflation rate of veterinarian spending compare to that of health care spending over the same period of time.

If the rates of inflation are roughly equal, then that tells us that as the US has become richer, we have collectively chosen to spend a greater percentage of that wealth on health care, both for fluffy, fido, and grandpa. Thus, the debate of runaway inflation in health care is a non-sequitur, since we are just spending are scarce resources the way we wish.

If however there is a wide disparity, ie veterinarian spending is equal to the rate of overall inflation or at least significantly less than the rate of increase in health care spending, than that tells us something. I would argue that it tells us that we are not allowing the markets to work properly as outlined in this video.

Regards,

Joe Dokes

[DBN]

If however there is a wide disparity, ie veterinarian spending is equal to the rate of overall inflation or at least significantly less than the rate of increase in health care spending, than that tells us something. I would argue that it tells us that we are not allowing the markets to work properly as outlined in this video.

You know, it could be telling us that we're more willing to spend money on Grandpa than Fluffy.

[Johnny Longtorso]

A Dog in the Healthcare Fight
...The chart below shows spending on veterinary care, which I pulled from the Consumer Expenditure Survey, and national health expenditures (for people) from the National Income and Product Accounts. Two things are interesting here: first, the rate of growth of spending from 1984 to 2006 wasn't all that different?and in both cases, spending grew faster than the rate of economic growth. As new technologies are developed for humans, we adopt them for Bowser and Fifi?because we can afford to and we think it's worth it....

[robc]

I think the proper methodology is to track some technology - say MRIs - in both the vet and med worlds and see what the costs of theme over 20 years has been.

[robc]

The reason I say this is that cell phone spending has gone up over last 20 years, but a constant technology cell phone has gone WAY down in price.

[T]

Yeah, if widespread adoption drives down cost, you would expect overall spending on the category to go up, but on a per procedure basis it should go down.

I can get stem cell joint therapy for my dog here in town, but not for me. How messed up is that?

[Rick]

My rant on vet care:

I've had a few incidents with pets where I have had to take them to the vet clinic. It caused me to do an informal survey of friends and family with pets.

What I found was that almost any serious issue (barring the extraordinary) costs almost exactly the same $800-$1200.

How can it be that such a wide variety of services bears close to the same costs? My conclusion/theory: prices are set based upon what Vet clinics believe people value their pets at, not what a service really costs.

I found it amazing that the price was always right in that "sweet spot" where my wife could convince me to spend it, but any higher and I would say no.

Anyone else have similar experiences?

[robc]

My conclusion/theory: prices are set based upon what Vet clinics believe people value their pets at, not what a service really costs.

Um, yeah, that would be the proper point to price it in the free market. Demand curve is the major driver of price in that situation.

Which suggests that veterinary service hasnt been commoditized*.

*firefox doesnt recognize that word.

[T]

Hard to commodotize services when there is a discernable difference between service providers.

[John]

Here is the big difference between human care and pet care. If my dog ever came up with cancer, I would put her down. I wouldn't put my dog through chemo. There is a limit to how much pain and suffering and expense that most people will go through to save an animal. That limit is a lot higher when you are talking about people. If my wife came up with cancer, I wouldn't have her put to sleep. So, all of the catastrophic care expenses, which is a large portion of human health care costs, are for the most part not present in the animal world (yes there are exceptions; million dollar racehorses and people with lots of money and an unhealthy attachment to their pets, bu those are exceptions not the rule). I love the market as much as anyone else. But the reason why veterinary care so much cheaper than human care has more to do with the differences in the services than it does with the market. Yeah, if we started putting sick and chronically ill people to death, our health care would be a lot cheaper.

[robc]

However, if we segregated catastrophic care from regular health care, the regular stuff would come down in price. Hmmm....how would something like that take place...

Oh, yeah, high deductible insurance policies. Insurance for catastrophic care only. HSA or just out of pocket for run of the mill stuff.

[John]

Very true.

[TrickyVic]

Would the combination of a catastrophic care plan and regular health plan be cheaper than a current plan today? How high of a deductable are you talking about?

One of the biggest problems with health care costs is giving it to people who are too poor to pay. Unless that changes, and I doubt it will, there will always be a big amount of loss. That loss will always be factored in. Provider fees, or insurance fees. What insurance scheme would fix that?

[SpongePaul]

But, we should as people have the right to say F the chemo, i will go on a vacation and when i get back you can put me down. i have seen people suffer otherwordly pain in the name of care, when IMHO they would have wanted to end it. its the judeo-christian belief systems that keep us from really being able to make our own health descions. Personally if i were 70-80 and got a serious cancer, i would live out till i was in pain then OD on something, a choice i think a lot of people would make if they had that option. It SHOULD NOT be mandatory, if you are willing to go on with treatment then by all means continue to do so, but if you want to drift off into the good night, that should also be your choice, and a medical euthanasia is better than doing it yourself IMHO

[John]

It is not mandatory. And people do turn down treatment. From my experience of having my mother die of cancer, I would say that the pressure to get treatment comes from the family more than anyone else. I didn't have to go through the hell that is chemo. I just wanted my mother around for a few more months. For that reason I was more inclined to want her to stay in there and fight than she probably was. It is easy to say that you understand that sometimes the suffering is greater than the benefit. But when you are talking about losing someone close to you, it is equally easy to lose your perspective on that. The thing that nearly everyone forgets to do when someone is dying of a terminal illness is to tell them it is okay for them to die. They are suffering and eventually come to terms with their own death and view it as a relief. But they still feel guilty about leaving everyone behind. They feel like they have failed and let everyone down by not making it. And everyone else is so upset about losing them and grasping at whatever straws of hope they can find, that they forget to tell them it is okay if they can't do it anymore.

[TrickyVic]

"""It is not mandatory. And people do turn down treatment."""

Unless it's a child, then the state can usurp the parent. But that's a different story.

[TrickyVic]

"""That limit is a lot higher when you are talking about people."""

No kidding. It includes republicans passing an unconstitutional law just to keep one lady on life support.

[Citizen Nothing]

If my wife came up with cancer, I wouldn't have her put to sleep.
Whew. John's finally on the record with that.
(Cancel my subscription.)

[John]

It wasn't easy policy. There were good arguments made both ways. But, in the end I decided narrowly to choose life. But, with the caveat that the decision can be revisited at a later date.

[R C Dean]

If my wife came up with cancer, I wouldn't have her put to sleep.

I wouldn't be so sure. Not that you'd pull the plug on her right away, of course, but I know from too much experience working in hospitals that damn near everybody eventually gets to the point where they say "Enough is enough. Let her go."

[John]

True. But that point is after a hell of a lot more expense and effort than there would by with my dog. Pretty much the day they tell me my dog needs chemo or she will be dead in a month, is the day my dog crosses the rainbow bridge.

[robc]

Your dog is a norse warrior?

[John]

There is apparently some children's book about animals dying and going over such a bridge to heaven. My wife uses the term.

[robc]

Here is a bunch of english, maybe this will post now.

Bifr?st

[robc]

So, Mr Squirrel, since when was the umlaut not part of the english language? 🙂

[John]

Didn't the Norse believe that evil will win the final battle and Valhalla and everyone in it will be destroyed?

[robc]

The Giants beat the Gods in the end, but IIRC, the giants are destroyed too. Evil/Good is sometimes unclear in norse mythology.

I believe two humans (one male, one female) and hide in Yggdrasil and repopulate the world after Ragnarok.

[robc]

Looking at a book on Norse mythology I have, the sons of Odin and Thor (and a few other next gen gods) also survive and so the whole cycle begins again with a new set of gods.

[John]

Ah. Thanks.

[Kinda Late]

Dude , I laughed out loud!

[TrickyVic]

I doubt a vet pays out a million dollars per decade for malpractice insurance.

[SpongePaul]

ding ding ding we have a winner! Tort reform is nneded post haste in this country. lawsuits are what is driving the price up so much right now, when a hosptial gets sued for umteen millions 100 times a year, the yloose some and the rest cost 100,000's to defend. money that could be spent on healthcare is wasted to the lawyers, and everyones prices go up to cover the loss

[TrickyVic]

I'm just stating it as a difference between the two. If a doctor fucks you up due to negligence, you should be able to sue his butt big time.

I am for some tort reform, but it's about less insurance and a greater ability to take everything the doctor owns.

[charge too much]

Buzzzzzzzzz we have a loser. Tort reform has made no price difference in Texas.

[creech]

Then the Dems should have no problem throwing this bone to the Repubs as it has little to no affect. And they won't because why?

[RCTL]

I guess for the same reason the Repubs didn't throw that bone to the Dems.

[Old Mexican]

It would take at least 20 times as long to open a comparable human hospital in California. It can take even longer in the 34 states with "certificate of need" (CON) laws, where state agencies?not consumers?decide how many hospitals there should be.

This is the same kind of regulatory bullshit that plagues schools as well, making it almost impossible for a bunch of teachers to open a smal school that can compete with the Pharaonic structures that the State requires just to house students, as I tried to explain in another post to MNG yesterday. No surprise, he flew off a tangent on that one . . .

[charge too much]

Do you mean a fit?

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I GIVE HEAD

[?????]

thank u