New Study: Barriers to Veterinary Care & Proposed Solutions

A new, national study finds that in the last two years, more than one out of every four people who share their homes with an animal — 28% — had difficulty getting needed veterinary care because of its high cost. This not only impacted the quality of life (and in cases where they could not afford emergency care, the actual life) of the animal, it also negatively impacted the emotional health of the people.

It noted specifically that the old saw, “if you can’t afford a pet, you shouldn’t have one,” was not only oversimplified given the broad demographics of the families involved (for example, “there are also middle-class families that live paycheck to paycheck, with limited funds for veterinary care, especially when the need involves high-cost”), it was counterproductive (it does nothing to solve the problem), unfair to people of limited means, and also unfair to animals needing homes. It would, in fact, lead to more death as “29 million dogs and cats live in families that participate in the Supplemental Nutrition Assistance Program, also known as food stamps.”

The paradox we face is that while it may be logical that someone should not have a pet if they cannot provide veterinary care, it is difficult to defend denying companionship with pets. Consequently, pets will continue to live with families with limited means. These families deserve companionship with pets and to enjoy all of the benefits that come through these relationships.

The conclusion: there “is a need for a financial support system for accessing veterinary care that opens the door for more families to receive it.”

The problem is that the study also surveyed attitudes of veterinarians and found that rural veterinarians were less sympathetic to and more suspicious of non-profit veterinary services such as subsidized sterilization, vaccination, and wellness clinics through humane societies. They see these as threats to profits, compared to their urban counterparts. (There is some evidence that this attitude also seemed to be more common among older veterinarians — boomers — vs. more recent — Millennial — graduates.)

There is tension between for-profit and nonprofit veterinary service providers. This may be largely related to the perception that nonprofits’ tax-exempt status provides an unfair competitive advantage: they feel they are losing their client base to low-cost clinics… Those employed in the nonprofit sector argue that few pet owners they serve could seek care from a for-profit practice.

These attitudes will limit the scope of solutions and it shows in the recommendations offered. The study recommended more widespread availability of pet health insurance, partnerships between “for profit” practices and “non-profit” ones that serve the animals of indigent clients, expansion of credit for veterinary expenses, discounts for “good Samaritans,” incremental care (as opposed to doing nothing), education, and encouraging more landlords to rent to people with pets.

While there’s nothing per se objectionable about these recommendations, they hardly break new ground. Indeed, they are conservative, which is not surprising since the study was conducted by veterinarians surveying veterinarians. The second problem is that they call for more research, but don’t offer long-term recommendations to actually solve the problem as doing so would have challenged existing profit models of veterinary care.

What should have the recommendations looked like? In addition to what they did offer, one need only look to the evolving area of human health care for guidance and examples for comprehensive, long-term solutions. These include:

  1. An “emergency care” model where veterinary clinics would not be permitted to turn away clients facing emergency care needs based on inability to pay, as is currently Federal law for human patients;
  2. Establishing veterinary care as a right, regardless of the human family’s ability to pay, through compulsory, affordable, and subsidized insurance or even a single-payer system;
  3. Banning the killing of animals for treatable medical conditions. Indeed, killing a healthy or treatable dog, cat, rabbit, or other animal companion should be illegal, regardless of whether the animal is at a shelter or taken to a veterinarian. Animals should not be killed (or go on suffering), simply because the family they live with is having financial difficulties;
  4. Banning housing discrimination for families that include animal companions. The study identified housing insecurity as a second barrier to good care.

While these recommendations are not without cost, these costs are offset by a series of savings and increased revenues. For example, a University of Denver study found broad impacts on public health and social cohesion, including increases in social contacts and civic engagement and “perceptions of neighborhood friendliness.” In addition to reduced costs associated with killing, as well as an increase in adoption revenues and other user fees, these kinds of policies would lead to increased spending in the community, as well as additional tax revenues from that spending. Such spending could be used to create funds to provide many of the services suggested. (Moreover, a lot of opposition to these kind of comprehensive solutions may be generational, rather than structural. As such, they are more likely to be implemented when the oldest generation of veterinarians retire.)

The study had one, additional (and glaring) limitation. It was based on surveys of veterinarians about their own attitudes. As such, it is subject to wide error as a result of cognitive bias: the respondents are more like to exaggerate their answers based on the good that they claim to do (e.g., offer discounts) and underplay their answers in terms of their attitudes about low-cost/no-cost veterinary clinics. Survey studies can be notoriously unreliable for this reason, thus potentially underreporting veterinary objections to providing affordable services to animals who live with people of limited financial means. A history of the veterinary community’s opposition to these programs seems to suggest as much.

In the 1970s, for example, the American Veterinary Medical Association (AVMA) opposed the endorsement of municipal — or SPCA — administered spay/neuter clinics that provided the poor an alternative to the prohibitively high prices charged by some private practice veterinarians. Despite the fact that low-cost spay/neuter services aimed at lower income people with pets had a well documented rate of success in getting more animals altered and reducing the numbers of animals surrendered to and killed by “shelters” in a community, the AVMA would not agree to any program that threatened the profits of veterinarians, even though poor people were not, and were unlikely to ever be their customers. In 1986, it also asked Congress to impose taxes on not-for-profits for providing spay/neuter surgeries and vaccination of animals at humane society operated clinics. And to this day, it has successfully opposed legislation that would allow families to get damages beyond market value even in cases of wrongful injury and death because of veterinary malpractice.

The study, “Access to Veterinary Care: Barriers, Current Practices, and Public Policy,” is available by clicking here.


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