MYTH: Pet insurance will create a managed-care nightmare.
TRUTH: That's a longshot and you have all the control.
Comparing pet insurance to human healthcare is like comparing apples to oranges. The pet insurance model isn't similar to
managed care and it would take major changes in the profession to steer it that direction.
A big part of what has made human healthcare a mess is the contracts between three parties: the insurance company, the physician,
and the patient. The insurance company has influence on the doctor's decisions. It can even exert pressure on the physician
to practice medicine a certain way, whether offering certain prescriptions or treatments.
It's hard for the pet insurance companies to put pressure on veterinarians because the companies don't have a contractual
relationship with them. "No one wants the veterinary profession to suffer the nightmares that human doctors are going through
with insurance," says Dr. Felsted. "It's not likely to happen because the insurance products are different and the relationship
is between the insurance company and the pet owner—instead of with the veterinarian. Plus, she says, only a small percentage
of pets are covered or expected to be covered in the future.
So instead of comparing apples to oranges, let's look again at the car insurance model. You hope you don't get into a car
accident, but if you do, the insurance company pays you an amount based on the value of your vehicle. The goal is to never
Pet insurance follows the same model. Despite this, there is a fear in the veterinary community that pet insurance will turn
into a nightmare like human health insurance. "For us to say that it will never go in that direction wouldn't be true," says
Dr. Merle. "But it won't dominate because of the independent attitude that veterinarians have. Remember 15 years ago, when
everyone was scared that corporate practices would take over? That hasn't happened."
Here's why a change in the current model isn't likely: Human healthcare is very specialized. To get the go-ahead to see a
specialist, patients must go to a primary care doctor first. This minimizes costs because patients don't make appointments
with specialists when all they really need is a primary care doctor.
In contrast, veterinary medicine predominantly consists of general practitioners—far more general practitioners than specialists.
And even though you refer to specialists, it's not a requirement for a specialist to conduct the treatments like it is in
human medicine. Also, there are no cost savings in the veterinary world if you minimize the number of people going to see
If managed care were to work in veterinary medicine, there would need to be a very large group of practitioners willing to
participate. Practitioners would have to choose to be involved—it wouldn't be forced upon anyone. The industry has a great
deal of control over not letting pet insurance turn into managed care—you hold the cards.
If you don't want to take the next steps and form networks, just say no. "We're already in a profession that doesn't charge
what it's worth," Dr. Downing says. "So why on earth would we sign up for managed care? I hope that's a huge motivator for
the profession not to go down that path."