As a part time contrarian, I couldn’t help but be struck by how Mr. Longo’s article and the following commentary could be extrapolated to be a 2009 version of Jonathan Swift’s 1729 satire, “A Modest Proposal: For Preventing the Children of Poor People in Ireland from Being a Burden to Their Parents or Country, and for Making Them Beneficial to the Public.

This Readers Write note is well written, amusing, and tugs at personal experience; but if we were to be granted this wish of ‘being treated like a dog’ we would be breaking one of the cardinal rules of any good analysis, which is to “follow the money”.

There is a simple reason the veterinary experience is so commercially wonderful and successful. They don’t treat the really sick patients. They kill them.

It the pet world, 6M-8M animals are euthanized every year, which is roughly 10% of the household pet population. These poor creatures are a combination of unwanted pets (i.e. indigent care) and pets too old/expensive to treat (i.e. chronic care). In the human world, AHRQ data says that “Half of the population spends little or nothing on health care, while 5 percent of the population spends almost half of the total amount. Also:
• Five percent of the population accounts for almost half (49 percent) of total health care expenses.
• The 15 most expensive health conditions account for 44 percent of total health care expenses.
• Patients with multiple chronic conditions cost up to seven times as much as patients with only one chronic condition.“

I’m sure Mr Longo’s article did not intend to suggest this, but in order to achieve his state of healthcare & EHR bliss, all we have to do is eliminate those 5% of people who take up 50% of our healthcare costs. If we were to set public policy to follow the pet healthcare delivery model and simply euthanize the all human patients who could not be treated with a $55 doctors visit; we could quite easily fix every economic and IT problem that has ever reared its ugly head in our current 16% GDP healthcare delivery model. We could put an Epic system in every MD’s pot and pay friendly greeters to welcome the surviving patients at every door.

It goes to show you how simple and customer friendly the medical system could be if it weren’t for insurance, including that biggest and most bureaucratic insurer of all, the federal government.

Great story with a sad truth! Vets are using the latest in technology, have the most efficient processes, and are still able to charge a mere fraction of the price charged for the treatment of humans. Perhaps this indicates their willingness to look at technology as a means of improving their business’ capabilities, whereas other medical professions view it as an inconvenience because it requires CHANGE. And “We The People” always suffer from fear of change, our own and others’.