Veterinarian Suggestion For Health Care Reform: Treat Humans Like My Patients

As time passes, the arguments on both sides of the health care debate are becoming increasingly cloudy and dramatic. And here’s yet another sign that America is getting a little too groggy to think coherently on this: a Newsweek story suggesting that the American health care system should more closely resemble the veterinary business. (Headline: “Treat People Like Dogs.”)

Karen Oberthaler, a vet herself, writes this week’s Newsweek “My Turn” column, and has proposed that reforms to the current way the medical industry works redesign the system in the image of pet care, where animal owners make the ultimate decisions on treatment based on out-of-pocket payments and the relative probability it will extend the pet’s life. Sure, Oberthaler admits that pet care is a bit different, especially since most patients come in for geriatric care, so the kind of pressure that would befall a young person suddenly getting sick is much rarer in the animal world. Yet she insists the strategy is a good one:

“While pet insurance exists, only roughly 3 percent of owners carry it; even then, clients pay a substantial portion of costs themselves. That means they usually want to know the rationale behind each test… My clients then choose what they want done, with an understanding of the relative importance, risk, and cost of each option. This step-by-step approach may seem time-consuming, but it dramatically reduces the number of expensive, unnecessary tests. And the process is more gratifying.”

It is true that people squander health care much less frequently when they are directly accountable for paying for it as opposed to going through an insurance company, but eliminating the entire concept of health insurance is a radical and not quite thought-out idea. There’s a reason it works so well in the pet world and not for the common human: the costs. For example, chemotherapy for a cancer-stricken dog can cost between $5,000-6,000. The human equivalent can cost between $20,000-80,000. The price of human medical care can quickly become unmanageable for something suddenly inflicted with a serious condition.

Oberthaler continues her argument by adding some conditions that she agrees make the adaptation of pet health practices onto humans difficult, including the fact that malpractice lawsuits are rarely filed (and even more rarely won), but then brings up one of the most common vet practices rarely seen in the human world: putting a pet down. Knowing that their pet is close to death, she argues, “No family wants to subject its already sick pet to uncomfortable tests or dump thousands of dollars into dead-end diagnostics. So why do we do that to our grandparents?”

Noting that she understands the difference between a human patient and an animal one doesn’t quite erase the meaning of the sentence preceding her clarification: by putting an animal down, we are more humane to them than to the family members we keep alive through treatment. In other words, time to bring in the death panels?

The initial point of her piece is a valid one– people who are held directly accountable for their medical care are more informed and cautious about it– but that issue gets lost somewhere under calls for the eradication of insurance companies altogether and the dog/grandparent analogy indirectly supporting euthanasia. As much as Oberthaler would like to emphasize she can see the differences between her trade and the one the Obama administration is so keen on reforming, nearly all of her arguments contradict that. Sure, in an ideal world all Americans would live the lives of upper-middle class dogs, but the transformation of the health care system based on veterinary care is simply untenable.

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