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Health care and them annie-mules, update
Anyway, when you look at the increase in spending per capita, health care spending per person rises by 350 percent, vet spending per dog rises by 335 percent, and vet spending per cat rises by 340 percent.. So on this one, I think the conservatives have the better argument, despite the flaws in the original evidence.
That is Scott Winship, here is more. Little did the blogosphere guess that this topic would turn so popular. I also liked the comment from the guy who wondered about the aging of America's pet population and whether illegal pet immigration might remedy the associated fiscal problems.
Posted by Tyler Cowen on July 15, 2009 at 12:28 AM in Medicine | Permalink
Comments
I was curious about the number of vets dealing with "product" animals, ie., animals that produce something like milk, meat, wool, but I couldn't find any numbers for them, or the drug costs for such animals. I think that means few vets deal with productive animals (some "pets" are guide dogs, and other working dogs, but I don't think cats "work").
So, if we look at the amount spent on human health on people who are productive, and with the primary objective to keep them productive as long as possible, more human health care is directed to boosting the economy. Steve Jobs treatment has been called by some a material event that requires disclosure under SEC rules. A million dollars of treatment on Jobs will yield perhaps billions in economic value. The preventable death of a man with wife and two young children with cost the Social Security tens of thousands a years for 15+ years, and cost the family much more in lost income. Yes, there are the odd cases of a stud horse getting experimental surgery to save its life, and failing, but far less often than for humans.
Spending on children is mostly highly positive return individually, and as a group a great return for society from their life time of earning to come in the fifty years to come.
So, spending lots of money on humans based on their producive value makes human health care more rational than pet health care.
Posted by: mulp at Jul 15, 2009 1:04:57 AM
"So, spending lots of money on humans based on their producive value makes human health care more rational than pet health care."
Who gets to pick value of the humans? In the free market, it would be whoever pays them, in a socialized market all value is political so it would be whoever handles the political considerations.
Posted by: Doc Merlin at Jul 15, 2009 1:29:51 AM
"and whether illegal pet immigration might remedy the associated fiscal problems."
Gerbils and ferrets are illegal in California. Since many in California illegally own these anyway, legalizing their sale would allow California to pick up some sales tax revenue.
Posted by: Richard A. at Jul 15, 2009 1:58:28 AM
But why spend any money on unproductive pets?
And how can you determine the future value of a child; to a degree it is like investing in the germ of an idea - you don't know if it will grow into anything useful, but if you don't invest in it, you'll never know, but you expect the investment to seldom pay big rewards. You seem to be arguing that preventing lead poisoning, actively vaccinating kids, nutrition for good health are not useful investments for society, as if badly behaved, mentally retarted, and sickly citizens are not a cost to society, so society shouldn't act.
Posted by: mulp at Jul 15, 2009 2:06:45 AM
"You seem to be arguing that preventing lead poisoning, actively vaccinating kids, nutrition for good health are not useful investments for society, as if badly behaved, mentally retarted, and sickly citizens are not a cost to society, so society shouldn't act"
Not at all, thats a strawman. Everyone wants people to be healthy. One group thinks free market is the best way, another other group thinks monopoly power is the best way, and another group thinks forced redistribution is the best way.
We really aren't arguing about outcomes but about methods here.
Posted by: Doc Merlin at Jul 15, 2009 2:36:42 AM
Why are we certain these are related?
Posted by: josh at Jul 15, 2009 6:36:22 AM
Its funny how some people seem to think spending on pets serves as an efficient proxy. When the cost is too high, we let them die. Would conservatives care to put forward that argument in favour of the free market.....I thought so
Posted by: Tony Cohen at Jul 15, 2009 6:46:34 AM
Woof. Woof, woof, woof, woof.
Posted by: dearieme at Jul 15, 2009 7:31:50 AM
Now all we need is for veterinary malpractice suits to rise to the same level as in human medicine.
This would introduce a tremendous moral hazard, since you can take an unwanted pet from a shelter whose market value is less than zero and by fiat instantly turn it into something much more valuable. And if something, er, unfortunate should subsequently happen to that cherished family member, and you collect even a mere few thousand dollars in a quick out-of-court settlement from an insurance company (because that's less than the cost of mounting a legal defense), then the inevitable truly vicious arbitrage schemes will probably drive malpractice insurance rates for veterinarians to the same levels "enjoyed" by obstetricians. Consider this a prediction, of sorts.
Posted by: anonymous at Jul 15, 2009 9:09:16 AM
The numbers check out. However, the increased expenditures can also be explained to a significant degree by the pets simply receiving more care. In 1983 the average dog had 1.8 vet visits per year. By 2006 it was at 2.6. For cats it goes from 1 to 1.7.
More notable is the percentages of households obtaining vet care. In 1983 for dogs it was 74%. In 2006 it was 82.7%. For cats the increase is from 47% to 63.7%.
For me the more interesting figure would be to look at expenditures per pet receiving care, rather than simply per pet, many of which don't receive any care.
Posted by: Colin at Jul 15, 2009 9:20:12 AM
colin: "the more interesting figure would be to look at expenditures per pet receiving care, rather than simply per pet"
I guess some will find that interesting, though I cannot understand the economic relevance of such a statistic. Pets do not make decisions to consume veterinary care. Humans make those decisions. Statistics about veterinary spending per human will give us insights about the economic motivation of humans who have decided to consume more veterinary care.
An important debate about human health care is whether third party payment motivates humans to consume more health care. The data about veterinary spending shows that humans are deciding to consume more veterinary care even though few possess pet health insurance. So, at least for human decisions about pet health care, third party payment was not the cause for increased consumption. That fact alone should make us reconsider the extent to which third party payment is responsible for increased human health care.
Posted by: John Dewey at Jul 15, 2009 9:53:26 AM
But just what is driving the increase in vet expenditures? More importantly, what role do the New England Patriots play? A Tufts University study has a partial answer:
http://www.patriots.com/news/index.cfm?ac=generalnewsdetail&pid=37873&pcid=41&rss=1
Posted by: Rick at Jul 15, 2009 10:09:18 AM
I guess some will find that interesting, though I cannot understand the economic relevance of such a statistic.
The relevance is that it would give us a better sense of cost inflation in the vet care sector. Higher costs dispersed among a greater number of animals receiving care means something different than higher costs dispersed over the same number of animals.
For humans we can simply divide total health care expenditures by the number of people because we assume that everyone gets at least some health care. However, for pets there is a significant part of the population that does in fact receive zero care, with the owners simply allowing them to expire or live in pain.
Posted by: Colin at Jul 15, 2009 10:26:08 AM
Over the past 20 years we have spent many thousands on vet care for our dogs, including diagnosis and treatment for exotic ailments like diabetes incipidus, lipid storage myopathy, spindle cell carcinoma, heart murmur and heartworm in addition to all the periodic maintenance considered normal in Houston.
My mother tells me the family dog from the '30s never went to a vet in his life. Humanoid members of the family, on the other hand, did go to the doc on occasion.
This suggests that over the longer term the growth in medical care per dog has greatly exceeded the growth in medical care per person.
Where's the outrage?
Posted by: Kent Guida at Jul 15, 2009 10:42:39 AM
The illegal immigration arguments apply in reverse among pets. Keeping many North American native species as pets is illegal. So we keep introduced species (from dogs and cats to gerbils and pythons) instead. Maybe native species would require less vet care?
However, the quality of care question remains: Are veterinary errors killing as high a proportion of patients as medical errors do? The answer will tell us about how far the extraordinary past success of cats in moving in on humans as a symbiote is likely to be endangered by humnas addiction to unhealthy quantities of 'health' treatment.
Since the main driver in the fall of levels of human mortality and morbidity appears to be additional education received by the 'patients', we can assume that additional veterinary treatment recieved is of little benefit to species exempted from lengthy education.
Posted by: Diversity at Jul 15, 2009 11:13:16 AM
As with the majority of people in the world if not the U.S., I am for single payer universal health care.
What do other countries do for their pets?
Posted by: Scott Burger at Jul 15, 2009 11:31:58 AM
While related, the 3rd party payment argument relates to cost containment not growth of expenditures. That the rate increases fall on each other seems fortuitous. However, there is a 100x fold difference in absolute numbers. There is no information on quality. I would think a better comparison is higher ed where there is no education insurance, though there are 3rd party payers. Lottery scholarships seem a perfect internal experiment. Is vets versus docs really an internal apples-to-apples experiment?
Vet schools are (I hear) more selective than med schools. Evolution is the prevailing paradigm, right? So, it's plausible the some of the same procedures driving cost increases in human healthcare are being translated to animals. Are potential vets going into med school? The assumption seems to be that these are two related fields are the same, except where they aren't the same.
Posted by: Andrew at Jul 15, 2009 12:03:13 PM
Colin: "The relevance is that it would give us a better sense of cost inflation in the vet care sector."
Spending per pet treated can tell us something about price inflation? I don't think so, Colin.
Your assertion about relevance would only be true if the type and mix of services performed on the pets remained the same over time. Of course, we know that's not the case. Just as human medical care providers have expanded greatly the treatments they've provided for humans, so too have veterinarians expanded greatly the treatments provided for the pets of those humans. At the same time, the mix of treatments demanded by owners of pets have drastically changed.
The only way we could know about price inflation is to investigate the real prices of exactly the same treatments over time. That data is hidden in the aggregate data about total veterinary spending. Any statistics based on that aggregate data are worthless in analyzing price inflation.
Posted by: John Dewey at Jul 15, 2009 12:25:38 PM
Your assertion about relevance would only be true if the type and mix of services performed on the pets remained the same over time..
Well, yes, but since we don't have this data I think that the spending per pet that received care would be a second best solution.
Posted by: Colin at Jul 15, 2009 1:05:34 PM
pets do make choices about vet care; anyone who has ever tried to get a mewling cat into a cat carrier can see that the animal's choice is "hell no I won't go." It's just that we, the owners, do not honor these choices.
Some of the driver may be the fact that a lot of human medical advances can now be applied to pets. I just spent $1700 on getting my cat's thyroid radioactively zapped in order to avoid giving the animal a pill a day for the rest of its life. My understanding is that the treatment is relatively new and certainly wasn't available for either human or animal thyroid glands some twenty years ago.
Posted by: Diana at Jul 15, 2009 1:43:15 PM
Since vet malpractice suits haven't been rising, can we conclude that this isn't an issue for humans either?
Honest question.
If yes, there's no sense in medical malpractice reform.
If no, then it goes to show that the animal-human health spending comparison really tells us nothing at all.
Posted by: brian at Jul 15, 2009 1:43:53 PM
brian: "Since vet malpractice suits haven't been rising"
I believe vet malpractice suits have been rising. But not nearly as fast as malpractice suits for human medical care, and without the huge awards frequently awarded to humans.
brian: "can we conclude that this isn't an issue for humans either?"
Sorry, but I do not follow your thinking. Are you arguing that medical malpractice suits is the major driver for the increase in health care? Are you arguing that if all drivers of animal health care spending are not consistent with all drivers of human health care spending, then comparisons between the two tyoes of spending are meaningless?
Posted by: John Dewey at Jul 15, 2009 2:44:57 PM
colin: "since we don't have this data I think that the spending per pet that received care would be a second best solution."
I can't see how comparisons of aggregate data - data composed of significantly different mixes of services - can tell us anything at all about price inflation of those services. All such comparisons will do is fool the careless into seeing trends which do not exist.
Here's what the popular Pet Lovers Companion has to say about changes in veterinary medicine:
"Like all other health professions, veterinary medicine has experienced dramatic advances in knowledge and expertise over the past 20 years. Veterinarians are now able to provide their patients access to the same health services physicians provide human patients."
What is significant is not that veterinarians can provide medical treatment to pets equivalent to what humans receive. Rather, the significance is that there is widespread demand for such treatment. As Americans have become much wealthier the past 30 years, they have elected to consume much more medical care for both themselves and their pets.
Posted by: John Dewey at Jul 15, 2009 3:09:16 PM
I'm confused. Why are the conservatives trying to prove that veterinary care, where there's a free market and no third-party payment, is experiencing the same cost inflation as human health care? Doesn't that prove that making the health care market more "free" won't help to contain costs? Is that what conservatives want to prove?
I would note that the veterinary care market does share some characteristics of the health care market that contribute to cost inflation: lack of information available to consumers about comparative effectiveness, pharmaceutical drug pushers, fee-for-service as opposed to fee-for-health, etc.
Posted by: dbeach at Jul 15, 2009 7:04:32 PM
Is this a surprise to anyone? A vet could always treat people if it wasn't the case after all. All this demonstrates is the increase in doctors incomes (and testing and treatment costs). It does rather strongly indicate many of the presumed hobgoblins like malpractice insurance, legal fees, and the rest are just bunk.
Posted by: Lord at Jul 16, 2009 12:08:48 AM
