In mid-summer, I took our old dog Cody to the nearby veterinary hospital for his regular immunizations. He got several shots, a nasal spritz, and a physical exam. The hospital charged us $293. Not for the first time, we reacted with some shock, and decided that that vet simply charged too much. We determined to find another one.
At the end of the summer, I went back to the expensive vet to get an ultrasound exam of Cody’s chest. Doctors had detected a heart murmur for some three years, ever since we had adopted Cody, and the expensive vet recommended the exam to see if he had fluid on his heart, or some other treatable condition. The expensive hospital has a regional emergency room, where specialists like the ultrasound doc come by on a weekly schedule.
It was easy to make the appointment. I just had to show up at 6:30 a.m., and Cody and I would be first in line.
In the event, we got bad news.
“Look here,” the doctor said, sliding his probe over Cody’s chest. “There’s a three-centimeter mass on his aorta.” He quickly charted, marked, and printed the image. “I’m sorry. I really didn’t expect to find this.”
We got some reassurance. Heart tumors, the doctor said, usually grew very slowly. Certainly, Cody’s three-year heart murmur suggested that. The ultrasound cost $190. A week later, I talked to a doctor at the expensive hospital, who basically recommended that so long as Cody behaved normally, we should do nothing. “Just let him lead a happy dog’s life,” she said. And so we did.
But worse came. In the fall, Cody sprouted a big circular black scab on his back. Thinking of all the burrowing bugs in our area, we peeled the scab off, looking for an insect. We found none, and bathed the wound in hydrogen peroxide. A week or two later, Cody got another scab, this one on his right jowl. And then another, near the second.
I took Cody to the new veterinary hospital we had found, a little farther away from our house. The doctor examined him, listened to his history, had the first hospital fax over his records, and prescribed bathing the sores, putting salve on them, and giving Cody antibiotics for a week. This visit, including medications, cost $90.
Meantime, I had called Maryanne Nicodemus, the secretary of the school my son Bud had attended in New Jersey, and the lady from whom we had adopted Cody three years before. She gave me the number of Cody’s old vet. I called that hospital, and a nurse pulled Cody’s records and told me that no, no exam had ever showed a heart murmur. The call cost nothing, either in time, trouble, or paperwork.
A week’s worth of treatment on Cody’s sores did no good. Back we went to the new veterinary hospital, where the doctor recommended surgical removal of his lumps and lab analysis to find out if they were cancerous. She retired to another room and returned in ten minutes with a typed estimate for the surgery. The estimate — “an Eldorado estimate,” as she said, meaning it came in at the high end — totaled $573. This included the surgery, the anesthesia (not general, since Cody’s heart wouldn’t take it), an operating room assistant, staples and stitches, lab analysis of the lumps, blood work (including liver enzymes and blood gases), and followup medications.
I left Cody right there, right then, and picked him up at 5:30 that day, looking a little patchy but not nearly as woozy as I had supposed he might. The actual bill came to $523, and the doctor had found and removed an extra lump.
Within a week came the sorry results. The scabs were vascular cancers, spread from the tumor on Cody’s heart. The doctor warned me what to watch for, signs of a ruptured spleen or heart failure from internal tumors, and I took the poor dog home.
We won’t have Cody too much longer, but the point of the story is not the sadness. What is the difference, in skill, sophistication, technological resources, and training, between a veterinarian and a physician who treats human beings? Not a whole lot. For perhaps 95 percent of what ails man or woman, we could all go happily to a veterinarian.
What accounts for the difference in price? (Just imagine what those procedures would have cost for a human being.) Dogs don’t carry insurance, and dogs don’t sue. Insurance disguises price. Last year, I went to an otolaryngologist to have a papilloma removed from my lip. The doctor’s office could not even tell me what the procedure cost. When you don’t know the price, you pay the price for ignorance. Lawsuits drive up the cost of a medical practice so much that in some states, doctors almost don’t exist — see West Virginia, as chronicled by National Review‘s Jay Nordlinger.
Want more convincing? There’s an intermediate case. Dental insurance, which usually pays half of a bill, is comparatively rare, and so are lawsuits against dentists. Dentistry costs rank somewhere between human medicine and veterinary, a lot closer to the latter than the former.
So how to address the rising cost of medical care? With more insurance programs? Let’s all go to the vet instead, and force the issue.