Letter to Vetted: Pet insurance worries me

October 31, 2018

This veterinarian learned to hate vision insurance when she worked as a human optometrist, and shes afraid what more insurance control of veterinary medicine could mean.

Editor's note: Are you worried about pet health insurance, or excited about its ability to help pet owners afford care? Do you think pet insurance will penetrate veterinary medicine the way it has in human medicine, or do you think they're two different business models with very different realities? Email us your thoughts at dvm360@ubm.com.

I was an optometrist first and practiced for several years before going back to vet school. I still own two optometry practices and practice part-time, but mainly do veterinary medicine now, which is really where my heart is at. Because of my background I have a strong understanding of the similarities and differences in human vs. veterinary medicine, and, unfortunately, I see veterinary medicine taking a similar path to the one human vision/medical insurance went down 20 years ago.

Back then, vision insurance was in the same place as veterinary medicine, with many insurers allowing payment for 100 percent of the doctor's charges. Today, most charges are discounted by anywhere from 50 to 70 percent, and doctors aren't allowed to bill the patient the remaining balance. For example, if I charge $100 for an eye exam, but I accept a certain vision insurance I only get paid $35 total and am not allowed to collect the remaining $65 from the patient.

This same vision insurance was started with seemingly good intentions-just like today's veterinary insurance. However, the negative impact comes when a majority of clinics sign provider contracts. Then the insurance companies change the fee schedule and reimbursements. By that time, patients are already used to Dr. X taking their insurance and even if Dr. X stops being a provider, another doctor down the street is a provider and the patient will just switch practices.

To compensate for the reduced income, doctors raise their rates to offset the discounts by collecting more from patients with no insurance, and it becomes a vicious cycle. This same bait-and-switch cycle has happened with nearly every vision insurance company, and by the time optometrists knew what was happening, they could no longer drop the insurance or they would lose too many patients. They also couldn't discuss it with colleagues due to federal consumer trade laws, so the cycle continues.

I don't see a 50 to 70 percent discount as something feasible in veterinary medicine from any of the articles I've read about tight margins, struggling income-to-debt ratio of new grads, etc.

- Jessica Czerny, OD, DVM

Spearfish, South Dakota