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Comment by GlenTheMachine | Hacker News Reader

My wife is a vet.

One big issue is that most people don’t have pet insurance. But they do have medical insurance. As a consequence they are completely surprised by the out-of-pocket costs of medical procedures.

Hip surgery (to pick something at random) is hip surgery, even if it’s for a dog. It still costs thousands of dollars. But a significant portion of the population expects to pay what they would pay for insurance-covered human surgery, eg a couple hundred dollars at most. And when they see the bill they accuse the vet of “only being in it for the money” if they won’t significantly discount the price.

Meanwhile, the vet is paying back $150,000 in student loans, same as a human doctor, but only making a third of the pay.

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The cost of preserving life, human or otherwise, has skyrocketed. When I was a kid, it cost $25 for a vet visit and something like $100 for a minor surgical procedure. Adjusted for inflation those are probably about the same today, the difference being there were no major surgical procedures available for pets. Also, the vet did not carry $150k in student loan debt.

A decade ago I had a kitten with heart arrhythmia. The vet suggested we go to a cat cardiologist. To me that seemed insane, it was going to be $1000 just to get inspected. The cat is alive and well today with no cardiologist visit.

What is the value of the kitten’s life when it was a rescue and there are thousands more to pick from if it passed?The reality is that creating life is cheap and plentiful on planet earth. The resources to preserve life are not. If you are privileged you can afford to pay for your pet’s care. That is a sentimental choice for most people, not a practical one. The equation is different for human life, but only by degree. Insurance is only going to do so much, there is a real cost to medical treatment.

> Adjusted for inflation those are probably about the same today, the difference being there were no major surgical procedures available for pets. Also, the vet did not carry $150k in student loan debt.

Yeah, I remember it being "the dog has cancer? That sucks, let's give them some cheap drugs to keep them comfortable as it gets worse, and plan to put them down when that stops working." Not "let's do chemo". Dog-surgery or otherwise expensive human-like care for pets was like a Beverly Hills rich person thing for celebrities with risible relationships with their pets, not something normal people did. You'd maybe get a broken leg or whatever dealt with, but that was about it, and even that kind of thing would be a lot lower-tech than these days.

> But a significant portion of the population expects to pay what they would pay for insurance-covered human surgery, eg a couple hundred dollars at most.

Time travelled from the 1990s, or one of the few who’s never had normal middle-class health insurance in the last decade.

I haven’t had a plan that wouldn’t put us into at least high-four-figures if anyone gets actually-sick, since the ‘00s. Not even the best-available plans to me at any time (which I’ve noticed tend to make little or no economic sense, if you run the numbers) would keep it in the hundreds. Mid-thousands at best (and the higher premium just makes it break-even anyway)

[EDIT] Example: a recent tonsillectomy cost us $2,500 or so. We have middling-leaning-good insurance. It's not some ultra-high-deductible thing. Everything went great, no complications, out of the hospital like an hour after waking from surgery. I don't know how people who make median wages afford kids, with medical & housing costs the way they are. A specialist copay for a 30 minute routine check-up visit (fucking prescription med control rules are a cash-cow for doctors, what a joke) of which ten minutes was with a doctor, was $95 out of pocket the other day, for which we received nothing we actually needed aside from checking a bureaucratic box. Surgery of any kind being in the hundreds is fantasy-land from where I sit. Usually I'm shocked at how cheap veterinarian bills are without insurance. They're usually much cheaper than the same thing on a human with insurance.

For some reason, a certain part of humanity thinks that vets should be doing the work just out of kindness, eg free or nearly free. Minor surgery on your dog still requires anesthesia, x-rays, IV fluids, scalpels, etc etc, and those are usually exactly the same supplies as for human surgery. They cost the same.

Also bear in mind that the nature of veterinary practice is different from eg a surgical practice. If you need surgery, you don’t go to “the local surgeon”. You get referred to a hospital or a specialty surgical practice. Ever seen a Yelp review for a heart surgeon? Neither have I.

But if your dog needs surgery, you go to the little vet practice down the street. The vets in that practice are generally exactly the same people you bring your dog to for their shots. They aren’t protected by a layer of administration and lawyers. They get Yelp reviews all the time — very, very bad ones. Death threats. Because they had the temerity to tell a patient that a cardiac bypass on Benji was going to cost $10,000, and the family couldn’t afford it so Benji died.

Vets are in your community in a way that surgeons aren’t. That exposes them to direct abuse to a far greater degree than surgeons.

My wife knows a vet who was sued because an owner claimed that the rabies vaccine “gave the cat autism”. Really.

Also, not sure how common it is, but an extended friend of mine was a vet tech. She quit due to the emotional toll of seeing animal abuse. Specifically sexual abuse. Apparently they had very limited tools to actually deal with the problem and instead had to give the dogs back to the abusers. That was not an emotional burden that she could continue with.

Not something I would have thought vets would have to deal with.

I used to work with a guy who developed photos in a lab in the 90s. He saw far too much stuff along those lines.

I looked into pet insurance. The best cover I could find would have cost me £250/year, and would only cover up to £7500.

It cost me £7000 for my cat to spend 2 days in "ICU", nothing surgical, though they did do a _cat scan_ and put him on oxygen.

I found the cost of insurance ludicrous given how expensive the vet was and how little the insurance would cover. Granted ICU is expensive, I would still expect there to be an option which would wouldn't cap out at such a low figure.

For such a measly cover, I would prefer to self-insure.

Exactly this! People think they are spending $25/month and getting full coverage in case something happens, but the reality is that if you have a fairly healthy pet, you're just better off self-insuring and putting that money into an interest bearing account instead.

The insurance companies have done all the math and are counting on you making an emotional decision.

I self-insured my previous cat. About a year after she passed of cancer, when I felt I was ready for another pet, I did the math for insurance. I would have paid a lot less with the insurance plan I found. So my new cats have insurance.

The costs for my previous cat were heavily skewed to the end of life period. But if there is ever an an accident or other emergency situation during their youth, the insurance would work out even more favorably. If I never end up having to use it, all the better.

You can't get insurance for an end of life cat. The comparison doesn't work against a young healthy pet. If you never have to use it, you've just wasted a bunch of money.

Don't think you can outsmart rooms full of people who are doing the math against much larger volumes of input data.

My comparison is to a young healthy pet who reaches end of life, as pets tend to do. I did the math, including interest on self-insurance savings and deductibles and co-pays. In my circumstance, insurance would have saved me thousands of dollars. Of course, I might not have needed it. Or it might have saved me $20,000. It's risk management. Pay a medium amount to hedge against the possibly having to pay an exorbitant amount.

No $25/mo insurance is going to pay out $20k, they all have maximum caps.

That's also 800 months of payments and your cat isn't going to live to 66 years old.

My insurance policy does not have any maximums. Your second sentence is nonsensical.

Which insurance is it?

  20000/25=800
  800/12=66

I have mentioned it elsewhere in the thread, so I feel slightly uncomfortable mentioning it repeatedly because I don't want be a walking advertisement, but it's Trupanion.

Definitely not an advertisement. For me with my dog there is no $25/mo plan. The lowest it goes is $60.95/mo, with a $1000 deductible.

Trupanion covers 90% after the deductible. A $3k bill would still require me to pay $1300 ($1700 savings), which I could have just saved myself by stocking some money away. $1700/$61=28 months. I've had my dog for more than 28 months and haven't had any $3k bills.

Of course, if my dog has a $20k bill, it makes more sense, but the chances of that are pretty low given how I know my dog. It becomes an emotional decision, which is my point and what they are counting on.

250/year is not a lot. thats 20/month which is the cost of a netflix subscription these days.

No indeed, but the insurance caps out at £7000, which is not an amount I need to insure myself for.

Insurance must on average cost more than it pays out. When it comes to pets, there is less competition, less transparency on cover and less competition on veterinary costs.

All these factors combined make it unattractive to me, as I have enough income to self-insure beyond the low cover pet insurance provides.

This. Vets probably got into the job hoping to care for animals in the best possible way. But economics prevents that.

I've always been very conservative in treating my animals. Mostly due to costs, but also because modern vets offer a lot of questionable treatment options. I've had dogs with cancer where I was offered tens of thousands in care that would have had marginal success and would have extended suffering for the animal. Same thing with my 20+ year old dog with kidney disease and cataracts. I'm not going to take resources away from my human child to add months to my dogs life, regardless of how much I adore my dog.

What's a good pet insurance carrier/plan, that's not just a straight up scam that just cover's the yearly stuff and some select things? Legit asking because with two super active GSD's I'd sign up in a heart beat if I found one.

In the US, Canada, and Australia, it's Trupanion. It doesn't cover routine wellness costs (exams, shots, teeth cleanings). But it covers virtually everything else at 90% with a $250 deductible. No annual limits or lifetime limits. For my cats it costs $30 per month (each).

That's way better than anything I've seen. I get a 79.50$/mo quote with a $1000 deductible from Trupanion for my 2yr old dog. Which is why we've never picked it up.

The $250 deductible version is a crazy $184.55/mo.

I'm not really familiar with how much dogs cost, but it seems like large dogs just cost a lot. I just did a quote for a small 2 year old dog (Maltipoo), and got $55/month. A 2 year old cat is $38/month. (I enrolled my cats as kittens.) I expect breed in general to be a much bigger factor with dogs than cats. Veterinary costs also vary significantly based on location.

This is true. If you're an experienced cat owner in good financial health, indoor cats are generally not worth insuring.

For dogs, it ranges wildly from "not worth it at all" to "mandatory" depending on the breed, and which breeds you should purchase insurance for is pretty trivial to find information for online. In general, bulldogs and large dogs are generally worth getting insurance for, as long as you get it when they're still puppies.

And the cost of everything of the surgery - IVs, antibiotics, catheters, testing reagents, syringes, needles, are usually the same items used in human medicine. Vets don't get a discount on this.

You just don't see that a bag of saline solution is $100 if you go into surgery because your insurance pays it. Meanwhile, the vet has to pass the $100 to you.

Just paid $30k for a variety of tests and a surgery for my dog.

I have insurance, but the yearly coverage limit is $5500.

Some insurance claims to have no limits, but then turns around and denies many claims.

I’m just glad I could afford the surgery and medications to keep my dog out of pain and help him have a few more happy years.

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