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Old Dog Resources
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"Putting a Leash on Pricey Health Care"
Dog World, March 2001
Winner, 2001 Eukanuba Canine Health Award
Susan McCullough
When Chip Rerig and Caren Braby bought a house two years ago, they planned
their purchase carefully. A key element of their financial strategy was to set
aside a cash reserve of several thousand dollars to pay for future home
improvements.
But just as they were getting ready to tap that reserve in May 2000, a careless
truck driver struck the Monterey, California, couple's mixed English Pointer,
Jacaranda. The accident severely injured the 4-year-old dog and wreaked havoc
with the couple's painstaking financial plans.
The dog, nicknamed "Jack," was staying with a friend in nearby Moss Beach for
the day. While sunning herself near a boat yard driveway, a fisherman backed his
truck too close to the car Jack was tied to. The truck pushed along the pavement
before traveling over her hind end.
Not surprisingly, the dog's injuries were extensive and acute: shock, a crushed
pelvis, dislocated rear legs, two dislocated vertebrae and damaged sciatic
nerves. Treating Jack would require not only performing complex surgery but also
negotiating a lengthy recovery period — and, for Rerig and Braby, coming up with
about $8,000 to pay for it all.
The couple didn't hesitate; Jack's recovery became their top priority. "We never
thought twice about the money," Rerig says. "But the dough we were planning on
using to fix the house — plus some credit cards — were used instead to fix
Jack."
Dogs Versus Dollars?
When people welcome a new dog into their lives, they usually don't expect
the animal to force them to max out their credit cards or drain their savings
accounts. But as Rerig and Braby discovered, life with a dog can serve up the
unexpected — and dealing with the unexpected can become very expensive.
Sometimes the unwelcome surprise takes the form of an unexpected emergency, like
Jacaranda's accident. Other times, though, a dog's chronic condition can wreak
havoc with a person's finances, as Shannon Wilkinson of Portland, Oregon,
discovered when her Great Dane, Booker, was diagnosed with Addison's disease
(AD).
Treating AD is an expensive proposition that becomes even more financially
daunting when the patient weighs 170 pounds. "He's like a car payment," sighs
Wilkinson. "Right now we have his medications at about $200 per month." However,
the initial treatment costs were much higher. Booker's injections of Percoten-V
cost about $300 per month. Additional outlays were needed to pay for Booker's
hospitalizations, diagnostic tests and daily doses of Prednisone.
Not so long ago, people facing the expenses that confronted Rerig, Braby, and
Wilkinson might have opted to euthanize their dogs rather than part with so much
money. In recent years, however, dogs and other pets have become far more
important to many people, often attaining the same status as the human members
of a household. As Rerig explains, "Caren and I do not have human children, and
Jack is a large part of our world." And even with those families that do include
have children no longer hesitate to fork over four-figure sums to deal with
their canine companions' medical problems.
That shift in attitude, together with advances in veterinary medicine, make
people much less willing to sacrifice their dogs on the altar of financial
security. In fact, a recent survey by the American Animal Hospital Association
revealed that 74 percent of the people who share their lives with dogs and other
companion animals say they would go into debt in order to provide for their
pet's well-being.
However, those same individuals undoubtedly would welcome ways to prevent their
bank accounts from losing the tug of war between dogs and dollars. In effect,
they're looking for ways to maintain or restore the health of their canine
companions without sacrificing their financial security in the process.
Dogs at a Premium
Insurance has long been a health care staple for the human members of millions
of American families, helping to buffer a household's finances against high
health care costs. But over the past two decades or so, similar help has emerged
for dogs and other non-human family members: pet health insurance.
Many pet health insurance plans work the same way traditional fee-for-service
human health insurance plans do. A policyholder pays the insurance company a
monthly or annual premium that's calculated according to the dog's age, breed
and geographic area.
The premiums vary not only among insurers but also within the plans. For
example, a five-year-old Shetland sheepdog living in Virginia draws a $132.00
annual premium under Premier Pet Insurance Company's Basic Plan, and $398.20
under the company's Ultimate Plan. Veterinary Pet Insurance charges $281.00 per
year for the same dog under its basic plan; adding coverage for routine care and
for cancer boosts that insurer's annual premium to $425.00.
Once she's enrolled her dog in the plan and paid the premium, a policyholder
takes her dog to any veterinarian she chooses, pays for that vet's services and
submits a claim to the insurance company. Most fee-for-service pet insurers
companies reimburse the policyholder for about 80 percent of the costs cited in
each claim, minus an initial deductible. Some insurers charge an annual
deductible of about $100.00; others charge a per-incident deductible of about
$40.00.
For many dogs and their people, these plans can save significant sums of money —
particularly if the dog develops a life-threatening illness or is seriously
injured after a policy takes effect. But just like their human counterparts, pet
fee-for-service health insurance plans carry some noteworthy limitations. They
include the following:
Exclusions. Most fee-for-service pet health insurers exclude a fairly
long list of conditions from any coverage at all. For example, pre-existing
conditions are often excluded. In Jacaranda's case, that would mean that her
veterinary bills would not have been covered unless Rerig and Braby had insured
the dog before the accident occurred.
Most plans also do not cover treatment for congenital defects and behavioral
problems. Other common exclusions are alternative or holistic veterinary care —
which Rerig and Braby sought for Jack — as well as dental care and certain
elective procedures.
Pay-out limitations. Many fee-for-service plans limit the amount of
coverage offered per incident and per year. For example, Premier Pet Insurance's
basic plan offers coverage of up to $1,500 per incident and up to $7,500 per
year. With Jack's expenses from her accident already exceeding $8,000, Rerig and
Braby wouldn't have had nearly enough coverage to significantly offset their
veterinary outlays.
Lack of access. Fee-for-service plans are not universally available. For
example, a Virginia resident can't purchase either Petshealth Insurance or
Premier Pet Insurance, because neither company is licensed to operate in that
state.
Of course, these same limitations have bedeviled people who were denied
fee-for-service health insurance coverage — and for many, the answer has been to
join a health maintenance organization, or HMO. A similar option has been
developed for animals: Pet Assure, a health care savings plan for pets. After
paying an annual fee of $99 per dog, a Pet Assure member receives a 25 percent
discount on all veterinary services. The plan covers pre-existing and congenital
conditions, routine care, and holistic care.
The downside to Pet Assure is identical to that of an HMO for people: one can
choose only from among those veterinarians who belong to Pet Assure's network.
That could result in a person having to change veterinarians. For dog owners who
have developed long-term relationships with practitioners whom
they trust, making such a switch might be difficult or even unacceptable.
Deciding among health insurance options — or whether to purchase insurance at
all — can be a complicated proposition. The best decision varies from dog to dog
and owner to owner, depending on the dog's health, age, and breed, as well as
the owner's area of residence, veterinary care philosophy and numerous other
considerations. Following are some suggestions to help owners decide whether pet
health insurance can help defray their veterinary costs — and, if
so, to choose the best possible plan.
Shop around. Pet health insurers' World Wide Web sites (see the
"Comparing Pet Health Insurance Costs" sidebar) make comparison shopping fairly
easy to do. Many of the companies' websites allow a prospective policyholder to
enter information that results in an online premium quote. Armed with such
information and online descriptions of each plan's benefits, an owner can make
an informed choice.
Balance costs and benefits. Carefully calculate whether a
particular plan truly results in significant savings. Some higher-option plans
that charge higher premiums may not offer much more coverage than the lower-cost
option offered by the same company. And if a dog has a hereditary or
pre-existing condition that accounts for most of an owner's veterinary expenses,
pet health insurance may actually save relatively little money.
Set priorities. If an owner's health care philosophy prompts her to seek
certain kinds of treatment for her dog, she needs to make sure that any plan
she's considering covers the costs of those treatments. For example, an owner
who believes that holistic veterinary medicine benefits her dog more than
conventional medicine does needs to search for a plan that covers holistic care.
Look in unexpected places. Owners who work for large and/or
forward-thinking companies may find that their employers offer pet health
insurance as an employee benefit. For example, Pet Assure claims that AT&T,
Tenet Healthcare and Dupont Pharmaceutical each offer the Pet Assure plan to
their workers.
At least one conventional insurance company is also expanding its service to
include pet health care. Monumental General Casualty of Baltimore, Maryland, has
begun to offer a special "Companion Care" program for pets. Companion Care
charges $286 per year for a five-year-old dog. Deductibles are $50 per incident.
The company pays 80 percent of the costs cited in each claim after payment of
the deductible.
Dealing with Drugs
Health insurance can hold down a dog's health care costs, but only if the
owner has obtained the insurance before those costs are incurred. If an
uninsured animal becomes ill or injured, insurance after the fact won't defray
the costs of veterinary care or medicines needed to help the dog recover.
And often — particularly when a dog suffers from a serious, chronic condition —
medicines cost as much or more than a veterinarian's services do. In part,
that's because the owner must pay for those medicines over the dog's entire
lifetime. And, as Shannon Wilkinson found out when Booker was diagnosed with AD,
those costs add up rapidly.
But even far less catastrophic conditions can inflict some unwelcome nicks in an
owner's budget. For example, certain canine eye conditions are treated with
Gonak, a highly concentrated form of artificial tears. This medicine is sold in
very small bottles that provide, at most, a month's supply. Veterinary
ophthalmologists charge as much as $25 for a bottle of Gonak, forcing the owner
to part with $300 annually.
What many owners may not realize, though, is that veterinarians may impose
significant markups on the prices of the prescription medicines they sell. For
example, the same bottle of Gonak that costs the dog owner for $25 is sold to
the veterinarian for $8.95. In another example, Wilkinson was appalled to
discover that the Percoten-V for which she was paying $300 per month was being
sold to the dog's veterinary specialist for about 40 percent less.
Mike Davis, a retired Air Force colonel who lived in Alexandria,Virginia, was
equally dismayed at the high costs for drugs needed to medicate his Springer
Spaniel. Unlike other dog owners, however, Davis was in a position to do
something about his situation.
Davis had established an Internet pharmacy, DrugPlace.com, that was doing a
brisk business dispensing prescription medications at discount prices to human
patients. At the same time, he was receiving requests for help from pet owners
who were looking for discounts on drugs for their animal companions. In
response, Davis established a pet division, PetDrugPlace.com, which today
accounts for about 15 percent of the parent company's revenues.
A pet owner can log onto PetDrugPlace.com or other online pharmaceutical
discounter and either request a drug listed at the site, or ask the online
pharmacist whether an unlisted drug is available. And, most of the time, the
answer will be in the affirmative. "There are very few medicines that you can't
get from us," Davis says.
The same bottle of Gonak that might cost a dog owner $25 when purchased from a
veterinary ophthalmologist costs $8.95 — the distributor's price to the
veterinarian — when purchased from PetDrugPlace.com. Other drugs are discounted
similarly. For example, the anti-fungal drug Sporonax can cost $11 per pill when
purchased from a veterinarian. The same drug is available from PetDrugPlace.com
for $5.89 per pill.
Taking advantage of these discounts is relatively easy, according to Davis and
his chief pharmacist, Mark Erblat, R. Ph. A veterinarian simply needs to phone,
fax or email the prescription to PetDrugPlace.com. From there, the site's
pharmacist can prepare the medication and ship it directly to the dog owner.
Another kind of pharmacy may offer a second option to the cost-conscious dog
owner: the compounding pharmacy. These pharmacies prepared customized
medications for their patients — human or canine.
Several factors give compounded medications a cost advantage over those
dispensed by a veterinarian. For one thing, "the costs are usually cheaper
because there's a whole realm of drugs [available to the compounder] that vets
don't have," says Alton Kanak, R. Ph., a compound pharmacist in Katy, Texas, and
pharmaceutical consultant to Peerlesshealth.com, an online compound pharmacy.
Another reason that compounded medications may cost less is that customizing a
prescription to the specific needs of an individual animal provides more
medicine for the owner's money. That's because many drugs prescribed for dogs
are produced for human consumption and are not dispensed to account for the
physical and metabolic differences between dogs and people. Consequently, an
owner who is giving her dog prescription medication manufactured for human
beings often must try to divide that medicine in ways the manufacturer didn't
intend, and waste often results. Because compounded medicines are customized to
meet the needs of the individual patient, the dosage can be tailored to that
patient's individual needs. There's no need to do any painstaking divisions and
waste is eliminated.
Sharon Ford of Alamogordo, New Mexico, found that buying Florinef from a
compounding pharmacy saved her considerable money in managing her Standard
Poodle's AD. After the dog, Stormy, was diagnosed, Ford paid her local pharmacy
nearly $80 for a 30-day supply of the drug. A compound pharmacy made up the
equivalent dosage for $54.50, including shipping, netting a 32-percent saving
for Ford. The savings resulted from the fact that the a compound pharmacy "can
make up the dosage you need and you can give fewer pills/capsules," Ford
explains.
Another way for cash-strapped owners to cut their dogs' prescription drug costs
is to appeal directly to their veterinarians for help, or even to change
veterinarians. Wilkinson says that she made such a switch after she found a vet
who was willing to sell her Booker's medications at cost, rather than with a
markup.
To reduce a dog's prescription drug costs, pharmaceutical experts and savvy dog
owners suggest the following:
Talk with your vet. A veterinarian — especially if the owner is a
long-time client — may be willing to work out a manageable drug payment plan.
"Some vets are willing to make pricing adjustments or accommodations (such as
letting you pay a large bill over time), depending on your circumstances,"
Wilkinson says.
Do some research. A couple of phone calls to local pharmacies and/or the
distributor of a prescription drug can provide cost information that an owner
can share with her veterinarian. Similarly, a little time spent online can
result in leads on discount and compounding pharmacies that can help reduce a
dog's drug costs.
Be careful with overseas drugs. Sometimes, overseas suppliers offer
significant savings to the cost-conscious dog owner. But obtaining prescription
medications from overseas should be undertaken very carefully, warns
PetDrugPlace.com's Mike Davis. He and chief pharmacist Mark Erblat, R. Ph.,
recommend that consumers double-check to make sure the dosages on medicines
obtained from overseas are correct and to try to guard against counterfeit
medicines. "If you get a drug from abroad and it's in a manufacturers' sealed
bottle, chances are better that it's the drug you want," Davis says.
A Future Option?
In the future, the legal system could help to reduce dogs' health costs.
Rerig has been exploring that possibility in his effort to pay for Jacaranda's
veterinary care. Rerig's quest began when the insurance company of the truck
driver who struck Jack refused to pay the dog's veterinary bills. Instead, the
company offered to pay 75 percent of the estimated cost of a new dog, or about
$300.
To his surprise, Rerig found that the insurance company was within its rights to
offer so little money. "Right now, pets and livestock are considered 'personal
property' — like a car or fencepost — in California," Rerig explains. "The law
says that when personal property is 'totaled,' insurance pays the lesser of
repair or replacement" costs.
Rerig wants to change that law by creating a separate insurance category for
companion animals and has appealed to a member of the California legislature for
help. And he isn't alone in his quest. Other pet owners and jurisdictions are
also trying to change the legal status of dogs and other pets — in the past
year, some gains have been made.
Last year, the state of Tennessee became the first in the nation to allow people
to recover damages for the loss of a cherished animal's "love, society and
companionship. And in Oregon, former professional football player Stan Brock has
filed a civil suit against the man accused of killing Brock's two Labrador
retrievers, Rookie and Jake.
Meanwhile, back in California, a botched veterinary procedure left Lonnie, a
Rottweiler who lives with Helen Evers of Costa Mesa, with broken teeth and
mangled nails. The dog was left in agonizing pain. Evers took the dog's
veterinarian to court early last year, and won over $20,000 in damages not only
to cover Lonnie's medical cost, but also to compensate Evers for her
emotional distress.
Changing the legal status of dogs and other companion animals does not draw
universal applause, however. For example, veterinary groups have warned that
cases such as Evers' and Lonnie's could result in veterinarians having to raise
their fees to cover additional malpractice insurance costs.
Jacaranda's Happy Ending
In any event, the saga of Rerig, Braby and Jacaranda has moved toward a happy
ending, due in part to a lot of help from their friends.
To help defray some of the costs of Jack's treatment — which included not only
surgery and hospitalization, but also acupuncture therapy — friends of Rerig and
Braby started a fundraising effort. Jack's story was written up in a local
newspaper, The Carmel Pine Cone, and townspeople began contributing to the fund.
Contributors were given pins labeled "Official Member of the Jacaranda Fan
Club." And because Jack was unable to walk, friends of Braby and Rerig also gave
the dog a red Radio Flyer wagon. That enabled Jack to resume her visits to the
beach and other favorite haunts.
On October 4, almost exactly five months after Jack's accident, the couple's
friends held a fundraiser for the dog at a local art gallery. "A Night for
Jacaranda" included a private $100 per couple champagne reception with the
canine guest of honor, followed by a "Friends of Jacaranda" reception at $15 per
person. The event also included a silent auction and "people" treats. In
addition, organizers circulated a petition asking a local legislator to
introduce a bill that would confer the same legal status to California companion
animals that Tennessee's new law gives to pets in that state.
"The event was fantastic," Rerig reports. "Over 100 people and approximately 20
dogs showed up and didn't leave till the end. Six cases of wines and champagne
as well as tons of food (and dog treats) were consumed. We were very overwhelmed
by the outpouring of emotional and financial support." Rerig estimates that the
evening's total take was well over $6,000.
Meanwhile, Jacaranda is doing well, too. "Jack is walking unaided and seems to
be relatively pain-free," Rerig exults. "In all, everything is going great!"
Thank you
Susan McCullough
for permission to reprint
Susan McCullough's books and articles about companion animal care
bring a unique mixture of warmth, humor, pragmatism and expertise to
animal-loving readers. Her work has appeared in numerous media outlets,
including Family Circle, The Washington Post, Dog Fancy, ASPCA Animal Watch,
Dogs USA, AKC Gazette, AKC Family Dog, Dog World, Animal Fair, The Bark
and the Popular Dogs series. |
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