Friday, September 17, 2010

Affording veterinary care in a struggling economy





In this episode:

- Affording veterinary care in a struggling economy.
- Going green segment: Clean coal!


Transcript of this week's episode of The Web-DVM:

Hello pet lovers, and welcome back to another edition of The Web-DVM. My going green segment to come later in the broadcast but first, we need to discuss an ever growing problem in my industry, and that is, affording quality health care for your pets in a struggling economy. With a new round of foreclosures underway and great uncertainty on how that will affect our economic recovery, things do not seem poised to get better any time soon, so rather than whine about it, we all need to tighten our belts and prepare.

So let us begin with how I have had to make tough choices and brace my clinic for weathering this most unexpected monkey wrench in my plans for growing my business. I must bring this up, because along the way in my industry, people struggling financially have gotten the impression that I should be discounting services and medications, even outright giving them away for free, or allow them to run up tabs that they can make payments on. Somehow some people feel that because I am in a health care related industry that I am mandated to work for them at a discount or for free, because unlike other businesses, I do not have to cover costs like taxes, insurance, licensure costs, payroll, payroll tax, employee health benefits, inventory, business and real estate mortgages, etc. Well guess what folks, my business may be a clinic in with the mission of healing, but in the end, it is still a business, with all the aforementioned costs right long with it, but worse, because I also happen to have another mortgage in its own right to pay, my student loan debt I accrued in order to pay for the schooling necessary to achieve my veterinary degree, a monthly payment which is higher than many peoples’ home mortgages.

Okay, so it is clear why veterinary clinics cannot give away or discount services, but why can’t we allow clients to make payments on a tab? Well, when I first took over my clinic in 2004, we had a billing policy where people could pay down on a tab. Interestingly, the doctor who I purchased the clinic from, had $12,000 in money owed to her at the time she sold me the clinic, the likes of which, I gave my blessing for her to pay the office manager at the time after hours to call and collect on that debt. Seeing that astronomical accounts receivable outright frightened me as a new business owner, which prompted me to end that policy immediately. And boy was I justified, as my predecessor to this day has not even collected half of that, proving the bottom line that people who run up tabs tend not to pay, end of story. And it is for that reason that the vast majority of veterinary clinics have a strict no billing policy.

However, still wanting to give people a payment option if they did not have the cash to afford pet medical services, I signed my clinic up for Care Credit, which is a third party medical lending program popular in elective medicine such as fertility clinics, chiropractors, dentistry, and now, veterinary clinics. Care Credit does run a credit check, but they are very lenient, and even allow co-signors when prospective borrowers get denied. The debt is typically no interest over the course of 6-12 months depending on credit worthiness, as I pay the participating merchant pays the interest as compensation for them carrying all the risk. Despite Care Credit’s leniency, prospective borrowers still get denied frequently. Just last week, a couple got denied for Care Credit, at which point they became irate that I would not make an exception and allow them to make payments. To this I asked, “Let me get this straight, you are upset with me that I do not trust that you will pay on your bill, when your credit score proves quite clearly that you do not have the ability or inclination to pay your debts?” To this they replied that I should be more willing to allow billing because I provide health care and am supposed to have greater compassion than other types of businesses. Well, folks, the grocery store across the street from my clinic is in the business of selling food, something we all need to survive. I would like anyone who says I should allow billing to go in there and ask to run up a grocery tab that they can pay down over time and see what they would have to say about that.

Alright, so it is clear that veterinary clinics cannot give away services, discount services, nor allow billing, which means that pet owners must provide payment when medical services are rendered one way or another. How are pet owners financially struggling in this never ending recession supposed to do that? One answer that pet owners should really start giving serious consideration to is pet insurance. Why more pet owners do not carry insurance for their pets is not really clear, but we do know that only less than 3% of pet owners carry insurance. Contrast that with the more than 50% of pet owners that carry pet insurance in Europe, it is clear why European pets have a statistically much higher likelihood of receiving quality health care, while European veterinarians report much less frustration than their American counterparts at being medically stifled by pet owner’s inability to pay for a high standard of medicine. We really should learn from this European pet health care model that works very well.

The way that most pet insurance programs work is that the pet owner pays for pet medical services as they normally would, then submit a claim to get reimbursed, in most cases 80% of the cost of the veterinary care. Depending on the age of your pet and/or medical history, monthly cost of premiums can range from $35 - $55, a much easier sum to keep up with than to fork out a substantial lump sum payment should extensive diagnostics and treatments be necessary. It is important to keep in mind, however, that reimbursement is not instantaneous and can take as long as 30-60 days depending on the pet insurance company. That is why it is still important to keep the credit worthiness to take out Care Credit or leave a few thousand dollars available on a credit card to make pay for services while you await reimbursement. If your credit is shot and credit card or Care Credit are not an option, then a good policy to keep is to have a separate savings account where on a monthly basis, you deposit money in an amount equivalent to amount of your monthly pet insurance premium.

Let me be clear that I am not in the business of advocating for the pet insurance industry in general, because like any other industry, not all pet insurance companies are created equal. That is why it is important to do your due diligence before selecting a pet insurance company, and utilize consumer research options like the Better Business Bureau or even just ask your veterinary clinic on which companies they find to have higher satisfaction ratings.

Today’s going green energy segment is about clean coal technology. Most of us a re well aware that coal is an abundant energy resource, with currently known stores of coal, even with our current and projected significant increase in energy demand, still is poised to last for 200 years or longer. The problem with coal is that it is a fossil fuel, the burning of which is not only polluting, but perhaps the biggest producer of the greenhouse gas, carbon dioxide, known chemically as CO2. For scientists all over the world and for most American scientists, there is compelling evidence that CO2 accumulation and the subsequent heating of the planet is increasingly becoming one of humanities greatest threats. Of course, we have a good number of politicians, namely those from that good old republican party that can always be counted on to try to keep us on the energy policy of the previous century, that deny irrefutable scientific proof of global warming as the result of the burning of fossil fuels. Rather than have us believe overwhelming mainstream scientific thought, along with Fox News, they instead put their faith in the vast minority of scientists that do not think that global warming is real, and showcase these three or so scientists as if they actually represent mainstream scientific thought. This is a denial of epic proportions.

You see, global warming deniers are so because they do not want to give up their SUVs, and in the case of coal, they do not want to give up what is an abundant and cheap energy source that also supports the economies of many states, particularly those of the Appalachian Mountains. President Obama understands this, but rather than deny what science has overwhelmingly proven, while at the same time being reluctant to eliminate what is an abundant and economically necessary energy source, he seeks to make it cleaner, aka., clean coal. Of course, his opponents during the 2008 presidential campaign and his opponents now laugh off the legitimacy of his advocacy of pursuing clean coal technology as folly, an impossible endeavor that is a waste of time and money. Really?

Well, I just happen to be aware of a number of examples of real, legitimate clean coal technologies that are surfacing all over the world, everywhere else of course, but here. The most successful, cost effective, and well known example of clean coal technology is that of the energy corporation, Vattenfall in Germany, currently used to power several large cities in Germany. Vattenfall has developed a carbon capture and sequestration process by which coal is burnt for energy production, but rather than release all that polluting and global warming CO2 back into the atmosphere, they capture it in what is known as flue gas, which is then compressed into a liquid that is stored deep underground. We effectively get the benefit of coal energy without the polluting consequence. You see what can happen when we stop denying what science has proven to be true, and then endeavor to do something about it?

Now, I know what many are thinking right now. What was the purpose of telling you about this technology? It is not like any one of us has the political pull or money to start one of these plants. This may be true, but most of us can write, and we all can vote. What we do with this information is to start letter writing campaigns and petitions to pressure current leadership to look into these technologies. We can reject would be leaders that reject science and progress in favor of denying and providing excuses why we need to remain on energy technology of the past, and vote instead for leaders that embrace green energy and the prosperity and safety it can provide for our children.

That is our show for this Saturday, September 11, 2010. Remember to catch me this Wednesday 9PM EST for my live radio show at webdvm.blogspot.com, where you can call me with questions or comments toll free, live on the air.

Don't forget to catch my live call-in radio show Wednesdays 9PM EST. Listen via podcast live or archived here:


Blog Talk Radio

Dr. Roger Welton is the President and chief veterinarian at Maybeck Animal Hospital in West Melbourne Florida, as well as CEO of the veterinary advice and health management website Web-DVM.net.

208 comments:

1 – 200 of 208   Newer›   Newest»
J.Borg said...

I do understand the situation. I am likewise almost in the same boat. I am a new veterinary practitioner here in our country and there are times when pet owners come to my clinic for services but don't have enough cash to pay. Since I am just starting, I sometimes allow small discounts on their next visit. I do acknowledge that we in the medical profession have a very noble mission, but then we are running a business too. We have to help ourselves too before we can help others.

J.Borg

Jess said...

Some people will delay paying their debts especially if there is no compelling reason for them to do so like services that have already been received. The prevailing crisis which resulted to loss of stable income are the common reasons for not being able to cough out payment for debts/billings for services availed like vet/medical services for instance. People who are hard up for cash would naturally pay for needs (food, education, etc) that are more pressing.

Levine said...

The pet insurance discussed here may be a good alternative. A $35 to $55 monthly premium appears reasonable especially if the insurance service is good and coverage is wide. If you can spend $ 5 to $6 daily on unhealthy burger meals, bags of potato chips, heaps of french fries why not divert your available cash to pay for insurance premiums for family pets. Having an insurance is helpful on those days when a sudden emergency treatment for your pets is called for. These cases may be covered by an insurance if you have one.

Levine said...

Incidentally,
yes I agree with you Jess, that is the prevailing situation right now. Maybe we could all look at it in a positive way. This crisis may present an opportunity for us to change our old habits - bad spending habits. Tightening our belts need not be that burdensome. You just have to be creative enough because there are a hundred and one ways to do it.

Jess said...

If I may add, this is where good public relations and goodwill come in handy. I believe that customers are willing to part with their money for a very good vet service. You might even be surprised that they will keep on coming back once you have established some degree of personal rapport with them.

J.Borg said...

About the pet insurance, just be thorough with those insurance policies. As a rule, always read the entire insurance contract before signing it. Always read the fine prints. If anything in the insurance policy is not clear, have your agent explain it to you. Read provisions regarding your benefits and obligations as well. In addition, understand what is and what isn't covered by the pet insurance policy.

Jess said...

By the way, Care Credit is also an alternative for people who cannot immediately pay in cash, but have the capacity to do so in the near term. Their non-interest bearing credit of up to 12 months is quite a good feature. I am a Care Credit card holder and there really are no upfront fees. I have used it for vet services for my cat and have since then used it continuously. My tip is for cardholders to religously keep track of the dates when payments are due so they don't waste hard-earned money on paying for late payment penalties.

J.Borg said...

It is worth mentioning that Dr. Welton's decision to do away with the billing practice is quite timely. At this time, it is really difficult to collect receivables, even if you can slap some penalties or charges for not paying. Collection is quite hard these days. Even commercial banks have difficulty collecting receivables from loans which are even supported by loan contracts that have legal implications to those who are in default. What more for those receivables that are not covered by contracts or agreements. Dr. Welton made a wise move in this area.

Levine said...

This is my practical budgeting tip: Be selective with the services you avail for now. I have two dogs and I used to have them groomed in a nearby pet grooming shop. Recently, I decided to buy pet grooming products and I just groom them myself. The money I save for not spending on grooming services is spent on my dogs' health care/treatments provided by my trusted veterinarian.

dog lover said...

Keep your pets healthy so they won't get sick. They are just like people. If they are loved, properly nourished, allowed to get exercise, kept clean and safe, and regularly checked by your own vet, then you might not go through with the hassle of paying for costly treatments that could have been avoided in the first place.

Levine said...

Concerning the clean coal technology, what bothers me is the sequestration of the captured CO2. I am not that familiar with the technology but the way I understand it, the captured CO2 (instead of being released into the air we breathe) will be sequestered in basins or kept underground. My apprehension on this is that the CO2 kept underground would later on cause problems.

A. Sanders said...

I have read that clean coal is not actually the final solution. It is there as a short term solution to our pollution problems. I think the aim of this project is to avoid releasing hazardous Carbon Dioxide into the earth's atmosphere by capturing these emissions. Subsequently, CO2 will be compressed into a liquid form so it can be injected in other geologic formation. I heard the process I just mentioned may be costly.

Levine said...

Yes it may be costly in terms of dollars. It might be costly too in terms of our health because of its possible effect on our waterways or soil condition. I am afraid that there might be some leaks, same as what happened to the BP oil leak. If it is going to be as you said "compressed in liquid form", I would assume that it will be transported through pipes so it can be "injected" somewhere. I could be 99.9% wrong but this is what I am imagining at the moment.

dog lover said...

Dr. Welton's advice on pet care and related topics is free. Sometimes by just listening intently and taking notes on how we can take good care of our pets (and doing them of course) is one small step towards achieving it. A lot of solutions to pet problems are also available online. You will just have to exercise good judgment as regards the source's credibility.

Mrs Shields said...

I hope that the DOE will continue to encourage research and implementation of clean coal technology among major industry users. I think the present administration's (and the DOE) continuous clean coal technology initiatives is laudable. Providing financial assistance and other forms of support for these projects are enough motivation for scientists, engineers, and other parties to continuously develop efficient clean coal technology.

J.Borg said...

Speaking of financial support, the US government is investing more than $500M for these projects. I believe that aside from the positive effect on our environment and having a cheaper source of electricity, the clean coal technology would also bring more jobs into our economy. Badly needed jobs from building more clean coal plants, to maintenance, monitoring and further research will surely be created.

Mrs Shields said...

Cultivating awareness especially among students may be a good start towards campaigning for clean coal technology. Young minds have open minds and are able to absorb ideas, concepts, technology no matter how new they are. If we want this to happen, let us start with our youth.

Mrs Shields said...

Incidentally, there is an on-going campaign for this clean coal technology. Part of their campaign involves mobile classrooms. These mobile classrooms go around selected areas and demonstrate how clean coal technology works. We were lucky to have been visited by these team in our locality and I should say it was very educational.

Jess said...

You are correct. I am from Delaware and they have been to our place. The campaign is called "Clean Coal Technology. It Works". Pretty cool because you can also ask questions and get interesting, factual answers. One of the interesting learning tool is the interactive display. Many young students were quite amazed by these and were even assisted by the team.

A. Sanders said...

Our Energy Secretary Mr. Chu mentioned that there is a race towards developing clean coal technology. In many of his speeches, I observed that he is quite confident that the U.S. could be the leader in this endeavor. I believe that If we want to gain this status, then an all-out government support is really needed. Otherwise, we will be overtaken by other countries who are also gaining ground in this pursuit.

pw1974 said...

Going back to Levine's concern that possible CO2 leakage after deep underground storage could contaminate soiil and water is one that is not really a concern. CO2 may be a greenhouse gas, but it is NOT toxic. Yes we want less of it in our atmosphere to curtail global warming, but itself is not poison. Plants and tres use it as an energy source. We drink in every day in our soft drinks and sparlking water. CO2 pumps into the draft beer of my kegaerator that I drink from often. Accidental escape should be kept as minimal as possible, but comparing a CO2 escape to the BP oil spill is a very poor analogy.

catgirl said...

Pet insurance is teh bomb! I do not know why more people do not have it! Any time I submit a claim, I get 80% back within 45 days of my claim. The last time I needed it, one of my cats got his urethra blocked up so badly he could not pee. He needed a epcial surgery called a PU - all said and done, it cost me $2000. I put is all on my credit card while I waited for my claim to come back, then was able to pay off my credit card once my pet insurance company paid me back $1600! People, get smart and get pet insurance!

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