I’ve just returned from an appointment with the surgeon who will be operating on our dog, which in addition to having a blown out CCL (like a bad ACL) also has bladder stones. Going through this experience, it struck me that the whole thing is a free market Libertarian’s wet dream.
First, I am totally in control of what procedures my dog is going to have. There’s no government bureaucrat telling me what I have to do, and I can choose from options that range from doing nothing, to having a procedure where monofilament is used to replace ligaments (MRIT), to having a more invasive, supposedly better procedure (TPLO) that results in improved joint flexibility. Totally my choice. I went with door #2, MRIT, because our vet and the surgeon recommended it for a small dog. But, I talked to another surgeon who said TPLO was the way to go. I ignored that vet’s advice by combined operation of my unbounded free will and rational agency. In fact, one vet mentioned that it is possible to inject $4,000 worth of stem cells into that dog’s stifle, if my autonomy so desired. There’s no evidence that it works, but, hey, I had almost unlimited options. The exhilaration I felt just considering the possibilities open to me was intoxicating!
Another facet of this idyllic free market is that pricing is totally transparent. You get an estimate with upper and lower bounds of the cost of the procedure, everything is discussed in advance, and, again, there’s no government standing between the vet and my wallet. If you’re a taker, then your options are limited to the veterinary equivalent of the emergency room: euthanasia. If you’re a maker, then you’re free to buy stem cells and TPLOs for all your pets by exercising your God-given rights as a wealth creator.
My pup is going to have two procedures (bladder surgery and MRIT) in one session. One vet (TPLO dude) wouldn’t do it, because of the risk of infection to the joint. My surgeon (Captain MRIT) is going to do it, because it is cheaper and probably easier on the dog. Again, no pesky medical association or bureaucrat got between me, my will to power, and my self-made standard of care.
By the way, Captain MRIT is a board-certified veterinary surgeon with a good track record who was recommended by my vet. But I could have used a goddam witch doctor if I pleased, because freedom.
As far as veterinary medicine is concerned, I am the king of the world. So say I, so let it be done. The one cloud in this silver lining is that, in order to apply the lessons of this libertarian paradise to the clearly inferior human medical world, we’d have to treat everyone like a fucking dog.
MattF
And, the system only really works if you have an Owner.
pylon
You are your dog’s very own death panel.
Ms. D. Ranged in AZ
And we don’t already?
Gin & Tonic
Plus, if in the exercise of your rational agency (or whatever the cool kids call it) you decide that your dog is suffering more than any medical or surgical treatment will alleviate, you can euthanize him without being arrested for murder. If your father has terminal, inoperable metastatic bone cancer that is causing him unbearable pain, you are allowed to watch as he suffers for weeks or months until he (inevitably) dies. Great country.
Berial
It has come to my attention that some very wealthy people’s pets DO get treated better than some people.
Mike R
Paul Ryan, Rand Paul and the Koch brothers all rejoice at the idea.
chopper, interrupted
@Gin & Tonic:
there’s that also.
maya
Pop-up ads of doggie probate lawyers will soon be soiling balloon juice.
dpm (dread pirate mistermix)
@chopper, interrupted: My dad asked me one question when I was telling him the dog’s troubles: “Don’t they have vets who practice euthanasia out there?”
Knight of Nothing
Unfortunately, I know way too many people who think what you wrote sounds absolutely perfect. It’s depressing.
Elizabelle
Furthermore, your dog (the patient), has absolutely no say in the matter.
ruemara
You’d need to be owned by a fairly well off person to have all those options, tho.
Elizabelle
@pylon:
Funny, but so true.
Sophia
The glib is meta.
Betty Cracker
@Berial: True. Every time I drive through thoroughbred horse country, I envy the critters their well-appointed stables! And Ann Romney’s horse’s tax liability is a pretty good salary in its own right.
Hope the Dread Pirate Doggie is feeling better soon!
Citizen_X
@MattF:
And there you have found the ultimate endpoint of “Libertarianism.”
Gex
The “let them die” crowd at the GOP primaries last year are completely okay with euthanasia being the primary treatment applied to the takers. I think many of them got to skip their doses of male enhancement medications after that debate.
ETA: I’m a little surprised that “male enhancement” didn’t land me in moderation.
Jay C
@ruemara:
See! More arguments in favor of letting the Koch Brothers run everything!
Citizen_X
@Betty Cracker:
Yeah, but you won’t get shot if you break a leg.
Splitting Image
The other difference between dogs and humans is that the dog going into treatment does not have a lot of inheritable wealth, and the person making the decisions for it is not the primary heir.
Just Some Fuckhead, Thought Leader
Did you get a cash discount? Because my glibertarian friends insist we could all get practically free health care if we paid in cash.
I have to take my cat to the groomer one day next week. I italicize “my” because we have a lot of cats but this one is my shadow in that he follows me everywhere, except he isn’t shadow-like, but rather a giant orange and white blob perched on the arm of my chair or the nightstand beside the bed or precariously on top of me as I sleep on my side.
The last time we took him to the groomer, the groomer called and told us to come get him because he was too mean to groom. So I have to go with him this time and hopefully his being so near to me will allow the nice groomer lady to groom him properly.
Roger Moore
@Gin & Tonic:
* Oregonians excepted.
The Red Pen
My wife worked in a vet clinic in north Dallas. While the Mexican family was searching their pockets and the bottoms of purses for loose change to save the family pet, the bleached-blond who pulled up in the Jaguar would be asking if it was “cheaper to just put it down.” Frequently, this lucky pet was suffering from something that could have been prevented with options that were also dismissed for cost.
LibertarianCare would save a lot of money.
Bill in Section 147
@Splitting Image: Schottzie would beg to differ if begging were not beneath it.
Roger Moore
@Gex:
Not at all. Euthanasia involves giving the patient medicine that ends things quickly. The “let them die” crowd sees that as going against the “culture of life”, and prefers that people die slowly, painfully, and expensively of natural causes.
Betty Cracker
@Citizen_X: Good point. That is rather a drawback.
Kirbster
Don’t worry. Pricing for veterinary services will become far less transparent as pet health insurance becomes more popular.
JoyceH
The really astonishing thing about veterinary medicine as opposed to human medicine is how much cheaper it is for the exact same treatment. Compare the cost of an xray for a cat and one for a human. Or blood work. Or just about any procedure. And it’s the same exact product. Veterinarians have school bills, they have rent to pay, they have payroll for trained techs – and yet they can provide the same service at a fraction of the cost. And they’re not going bankrupt, either. So why do human doctors charge so much more? Because they can, because they’ve been getting away with it for decades, because doctors in the US have come to expect that they must get paid as well as a small kingdom’s royalty.
Just Some Fuckhead, Thought Leader
@Roger Moore:
That’s because you never know when Jesus will miracle one of them back to perfect health, like he did Terry Schiavo.
Just Some Fuckhead, Thought Leader
@JoyceH:
A woman brought a very limp parrot into a veterinary hospital. As she lay her pet on the table, the vet pulled out his stethoscope and listened to the bird’s chest. After a moment or two, the Vet shook his head sadly and said, “I’m so sorry, Polly has passed away.”
The distressed owner wailed, “Are you sure? I mean, you haven’t done any testing on him or anything. He might just be in a coma or something.”
The vet rolled his eyes, shrugged, turned and left the room returning a few moments later with beautiful black Labrador. As the bird’s owner looked on in amazement, the dog stood on his hind legs, put his front paws on the examination table and sniffed the dead parrot from top to bottom. He then looked at the vet with sad eyes and shook his head.
The vet led the dog out but returned a few moments later with a cat. The cat jumped up and also sniffed delicately at the ex-bird. The cat sat back, shook its head, meowed and ran out of the room. The vet looked at the woman and said, “I’m sorry; but like I said, your parrot is most definitely, 100% certifiably …dead.”
He then turned to his computer terminal, hit a few keys and produced a bill which he handed to the woman. The parrot’s owner, still in shock, took the bill. “$150!” she cried. “$150 just to tell me my bird is dead?!”
The vet shrugged. “If you’d taken my word for it, the bill would only have been $20, but with the Lab Report and the Cat Scan, what did you expect?”
schrodinger's cat
@Just Some Fuckhead, Thought Leader: Aaww Fuckhead kitteh sounds adorable. Photos plz.
Tissue Thin Pseudonym (JMN)
@Kirbster: Maybe, but probably not. My pet insurance doesn’t work like my health insurance. I do all of the negotiating with the vet, pay the vet myself, and just send the receipts to the insurance company for reimbursement.
JPL
@The Red Pen: One of the better vets that we used was in far north dallas off of Hillcrest. When I moved to the Atlanta area, I still would call for advice once and awhile.
Ash Can
All laffs aside, here’s wishing your doggie all the best of outcomes.
Chyron HR
@Just Some Fuckhead, Thought Leader:
Does the groomer lick your cat herself, or does she have another cat on staff that does it?
Betty Cracker
@Just Some Fuckhead, Thought Leader: Finally, a CLEAN joke on Balloon Juice to share with the kiddies!
Tissue Thin Pseudonym (JMN)
@JoyceH: Most of those procedures aren’t really exactly the same. In general the version for humans is done to a more exacting standard. In the case of the vet, the primary doctor does pretty much everything himself. He takes the x-ray and he does all of the interpreting. With humans, there is an additional person who is specially trained in imaging for that. This makes human medicine more expensive but also more accurate.
Just Some Fuckhead, Thought Leader
Never go to a veterinarian that is situated right beside a filipino restaurant. On the other hand, those are the best filipino restaurants to eat at because everything is so fresh.
workworkwork
On a slightly related, but still a bit OT note:
At my last visit to the vet, he mentioned that his wife would be moving to Medicare soon and that meant that he would be losing his medical coverage. After questioning him, I found out that he and his entire staff get health insurance through their respective spouses. (He has about five or six people on staff.) In addition, he would have a problem getting on Medicare since he was born in Germany to American parents and he doesn’t have a birth certificate or U.S. passport.
I mentioned that as of 10/1 he might be able to shop for a plan on our Colorado exchange (I didn’t use the term ‘Obamacare’ or even ‘ACA’) and he said he’d look into it.
We don’t generally talk politics but my take is that he’s pretty right-wing.
JPL
Doug, I hope the pup is okay. Don’t forget to send in a picture for the calendar.
@Just Some Fuckhead, Thought Leader: ugh
Ash Can
Look out, folks. Fuckhead’s on a roll!
Maike
@dpm (dread pirate mistermix):
My father-in-law’s comment on ANY veterinary procedure was: “Bullet would be cheaper.”
Maike
@dpm (dread pirate mistermix):
My father-in-law’s comment on ANY veterinary procedure was: “Bullet would be cheaper.”
Just Some Fuckhead, Thought Leader
What has two legs and bleeds a lot?
Half a cat!
Belafon
@Elizabelle: Exactly. My healthcare would probably be cheaper if, when one of my kids got too sick, I could just say “please put him to sleep.”
Jamey
Are you going to have him declawed, too?
chopper, interrupted
i can’t wait until someone breaks his leg running in the olympics and the coach comes out and wipes away the tears as he shoots him in the head.
WereBear
Vets and techs loathe those assholes who just opt to have them “put down” when they can clearly afford it, if they cared.
So the moral of the story is that you are better off with the family who truly loves you… as always.
My philosophy is summed up here:
When the perfect is the enemy of the good
Ilya
@Roger Moore: For all I know, you’re a critical care doctor who sees this scenario every day. In my experience in medicine, though, the vast majority of patients in such a situation WANT to live as long as possible, so even if euthanasia was widely available, I don’t know how many people would request it.
Ilya
@Roger Moore: For all I know, you’re a critical care doctor who sees this scenario every day. In my experience in medicine, though, the vast majority of patients in such a situation WANT to live as long as possible, so even if euthanasia was widely available, I don’t know how many people would request it.
Yatsuno
@Roger Moore: Well yeah. What’s the point of proving your superiority if you can’t enjoy the suffering of those beneath you?
PS: Can do that in WA as well. Best way to get this state to do something progressive is have OR do it first. Same with them and gay marriage. Now if I could only get a law to feed Tim Eyman to the orcas…
Ilya
@JoyceH: Joyce, you are free to see a vet when you have appendicitis or cancer if you don’t want my services. Also, I can guarantee you that I don’t make that much more money than a vet does, even though I’ve been through 2x as much schooling (4 years college + 4 years med school + 5 years surgical residency + 2 years fellowship, compared to 4 years college + 4 years vet school).
Roger Moore
@workworkwork:
Probably not as right wing- or at least not as important a right winger- as the vet my family used when I was growing up.
Craig
Treat everyone like my dogs, and it would be an Earthly paradise. Yours too, I imagine. Hope your friend makes a strong recovery.
The cross-contamination concern with multiple procedures is a real thing–not saying you made the wrong call; in fact, I think you made the right call–but it’s not just blowing smoke.
Just Some Fuckhead, Thought Leader
@WereBear:
Yes, but there are also vets that will use you like an ATM machine given half a chance. Years ago, we took in an outdoor cat from someone that was moving away. The cat acquired a large oozing hole in its gut which we gamely tried to treat until it didn’t appear the cat was healing. We took it to the closest vet and he wanted hundreds and hundreds of dollars to do this procedure and that procedure while not being able to guarantee the cat would survive. He also wouldn’t put the cat down, thinking we would pony up the money since we are warm, caring and compassionate human beings. We took the cat to the vet beside the fillipino restaurant and had it put down.
Booger
@Just Some Fuckhead, Thought Leader: If he was any good, he’s have run a pet scan as well.
Bill E Pilgrim
@Just Some Fuckhead, Thought Leader: Good thing he skipped the rhinoplasty.
Citizen_X
@Maike:
Heh. Something to remind him of when he starts racking up the inevitable medical bills. “Well, you know what you always used to say…”
WereBear
Yes, but I find it easy to tell which is which. Nowadays, with the diagnostic Power of the Internet, it should be a skill most people can acquire.
When my darling little foundling, Smokepuff, developed terrible seizures at age 13, we knew going in that little could be done for him. The doc got some points for me by being up front that the best thing was to let him go.
A lot of human doctors don’t have that “luxury of honesty,” either. Some confided in me that there are cases where the best quality of life would come from doing very little. But they don’t get to offer that unless the patient brings it up!
Roger Moore
@Ilya:
To me, the big thing is that patients have the option of a painless death, even if very few of them take it. My impression is that’s the way things have worked out in places that have death with dignity laws. Many patients talk to their doctors about the option of assisted suicide, a fair number get the drugs so they have the option of killing themselves, but very few actually go through with it. Somewhat counter-intuitively, patients are more likely to keep fighting if they know that death is an easy option when things get too bad.
WereBear
I know such people. I don’t think very much of them. I know it’s possible for one human being to see animals as meaningless and interchangeable while regarding humans as precious and unique… I just have yet to encounter one.
WereBear
@Roger Moore: It also seems that such circumstances are less likely to actually make people suffer, as in shortchanging them on pain meds, for instance.
I remember, as a child, being shocked that terminal patients would have their pain drugs rationed out, supposedly from fear they would become addicted.
And yet, I understand such a bizarre attitude persists.
Hunter Gathers
Submitted for your consideration.
Ron Fournier Compares Obamacare Rollout To Bush’s Handling Of The Iraq War
Obamacare is stone cold killing people, Dubya style.
Sincap
@JPL: Try Emory Animal Hospital. They are awesome!
srv
If we can marry animals now, are they covered under ACA?
The TIm Channel
At the end of the day you can get the most excellent cancer care in the vet world for your dog at a fraction of the price it costs for your child. I’d be all for letting vets operate on people if the people are OK with it and I could save a buck. Enjoy.
chopper, interrupted
@The TIm Channel:
if only ‘excellent cancer care for a dog’ was even in the same ballpark as ‘excellent cancer care for a kid’.
Angela
@Yatsuno: this is why I want to retire in WA, OR or VT. I want the option for quality of life instead of quantity of life.
And I want that same option for my dogs.
Bill
I don’t understand how Vets stay in business.
I love my dogs dearly, but the replacement value of a free dog is $0.00. Vet bills above a certain limit cut in to human needs. I advise my pooches to stay relatively healthy.
Roger Moore
@srv:
It’s still illegal to marry a snapping turtle despite the homosexual lobby’s best efforts to destroy traditional marriage. You’d think the conservatives would have recognized just how incompetent all these liberal pressure groups are. Despite years of effort, we still haven’t come close to destroying America, Christmas, traditional marriage, or the free enterprise system.
Riley's Enabler
Ugh. Kitten update, tears ahead. After spending the day at the vet yesterday, being bottlefed and having fluids, I took Caspar home and continued the same. Around 11 he stopped swallowing, and he died quietly in my arms around 4 this morning, his fat and sassy brother nearby.
I love my Vet. They offer alternatives and scale their pricing and are loving and wonderful. The tech who’d held Caspar all day yesterday cried when I called them this morning. About a year ago, I found a cat on a highway that had been hit and was unable to walk, but had been left there alive. I took her to my vet, who examined her and gently suggested euthanasia since her hip and spine were broken badly. He refused to charge me for any of that.
Bah. So teary today. The balance is that Shadow (the other rescue kitten) is fine and eating like a horse and running roughshod over my 40 pound mutt Riley.
furklempt
Given the free (to them) access that my dogs have to good nutrition, clean water, medication, fluffy beds, exercise, naptime, and veterinary specialty care I sort of wish more people were treated like (my) dogs.
My biggest problem with the vet industry is that I’ve found it very difficult to find a vet who doesn’t consider price as paramount. It can be maddening trying to extract a legit medical recommendation from all their discussion of cost effectiveness. What will give my dogs (and cats) the best outcome with the best quality of life. That’s all I want to know, and we can take the discussion from there.
dpm (dread pirate mistermix)
@Craig:
Agreed. I’m informed on the risk going in and took it on based on a review of the factors: MRIT puts less hardware in the joint than TPLO and there’s much less bone affected, so less places for infection to take root. The bladder issue is not accompanied by an infection, and history with our dog is that she’s hell on her stitches (chew/bites them, doesn’t tolerate the cone well, etc). I’m frankly hoping that a double whammy slows her down so she’s more accepting of the close confinement she’ll need for the leg recovery. She’s 9 years old going on 9 months.
I’m sure that if she gets and infection and the leg has to be amputated or whatever, my dog will be perfectly understanding of the trade-off I made.
Another Holocene Human
@workworkwork: In addition, he would have a problem getting on Medicare since he was born in Germany to American parents and he doesn’t have a birth certificate or U.S. passport.
it’s all good, if his favorite party gets their way he won’t be able to vote, either
/nelson muntz
Another Holocene Human
@WereBear: What’s better are the freaks who tell (scream at) vets they should do surgical procedures on their pets for free because they just love pets so much.
Ilya
@chopper, interrupted: ssssshhhhh, don’t tell him ;)
Lee
My wife is a vet and when some wingnut comes up with this model of healthcare, she just asks if she can be the one to decide when to put them down.
FlipYrWhig
@Riley’s Enabler: I don’t remember seeing the original story, but, that’s terrible. We lost two oldsters in 5 months. Peace and strength.
WereBear
@Riley’s Enabler: I’m so sorry. What a little dear.
At least he was not alone, and was able to be comforted… sometimes we have to settle for that.
Mnemosyne
@The TIm Channel:
Well, sort of. As the vet explained it to us when our cat Natasha had cancer, vets don’t feel that it’s ethical to give an animal the same level of chemotherapy or radiation that you would give a human because of the amount of suffering the animal would go through. A human can comprehend that they’re suffering now in the hope of feeling better later, but an animal can’t, so they give a cat or dog a “maintenance” amount of chemo that can slow but not stop the cancer.
Mnemosyne
@Riley’s Enabler:
At least you were able to be with him. G still feels guilty that Natasha died alone even though I’m sure in my heart that it was what she wanted since she said a long goodbye to each of us and waited for us to leave for work before she made that last climb into her beloved cat tower.
Capri
@Ilya:
Actually, a board certified veterinary surgeon has had 4 years college + 4 years vet school + 1 year internship or equivalent + 3 year surgical residency training at a minimum. So they are not identical to human but not all that far off.
There’s also this huge infrastructure/compliance part in human medicine, at least hospitals, that isn’t there in veterinary medicine. At the vet hospital were I work, we hired a manager a few months ago. We had a lot of applicants from the human side, and their answer to every question about managing a hospital was to get buy-in for the published guidelines and SOP’s that exist for every single, teeny tiny aspect of human medicine. There is nothing like that in vet. med.
Mnemosyne
@Capri:
Plus vets have to learn to treat multiple species. Human doctors only have to learn how to treat one. ;-)
RosiesDad
@Berial: Not so very wealthy people’s dogs and cats get treated better than a lot of people, too.
@Capri: As a veterinarian with 20+ years in who is married to an MD who has been practicing for nearly as long I can tell you unequivocally that I would never want to leave my world for hers.
Arclite
@pylon: Death Panels… you beat me to it.
Mr. Mix, this is an epic post.
Trollhattan
From the time we got our first dog (1990) to today, veterinary costs have gone up roughly tenfold. I suspect in the interim, it has been discovered there is no upper bound to what can be charged from the simplest of services to surgery to medications to tests to food. It’s gotten so out of hand I suspect by the time our next dog arrives we’ll be obliged to buy doggie medical insurance.
Sigh.
Sister Rail Gun of Warm Humanitarianism
@Mnemosyne: Most limit themselves to two, maybe three species.
The rest of our animal companions visit the exotic animal vet, where I just picked up antibiotics for the turtle. A month of injections, yay.
Mnemosyne
@Sister Rail Gun of Warm Humanitarianism:
The VCA branch we take our cats to is well-known locally for their rabbit care, so they treat at least three different species. On the other end of the spectrum, there are several local vets who specialize in cats only.
Phoenician in a time of Romans
@ruemara:
You’d need to be owned by a fairly well off person to have all those options, tho.
Yup – the vast majority of domestic animals in America are, of course, treated as necessary to keep them economically viable and then slaughtered when the cost-benefit ratio turns against them.
Now, consider how corporations would treat employee health if they REALLY had no limitations…
Bubba Dave
@Riley’s Enabler:
Deepest sympathy.