Clémentine, stop. Oh my gosh, sorry.

She has thoughts.

From the New York Times, I'm Sabrina Tavernisi, and this is The Daily.

Over the past decade, the cost of veterinary care in the US has skyrocketed, as health care for pets has come to more like health care for people. Today, my colleague Katie Thomas on how vet care became a multi-billion-dollar industry and the fraught emotional and financial landscape it has created for pet owners. It's Friday, July 12th.

Katie, welcome to our Friday episode. Yeah, I'm excited.

Katie, you recently wrote about something that I, as a pet owner, and a lot of people on this team, also pet owners, can relate to, and that is that the cost of veterinary care has skyrocketed. Tell me how you came to this story.

Yeah. A couple of years ago, my family and I, we got a new dog. We got a puppy, and his name was Rasco, and he did great. The first year, he was a very healthy little dog. Then when he was about a year and a half old, he got very sick. We learned that he had been born with a very serious liver defect. Our vet referred us to a bigger animal hospital. And that's when I entered this world, that's a new level of veterinary care that I hadn't realized existed. So as I was navigating this, I was wearing two hats. One was just as a pet owner and trying to figure out the right treatment for my dog. And then the other hat I was wearing is as the health care reporter, which is my full-time job. So I kept on noticing a lot of aspects of the veterinary world that, to me, were starting to feel very, very similar to the human health care world that I cover. And as I started looking into this, I started learning just how much money there is now in the veter industry and also how expensive this care has become over the last couple of decades.

I learned that very quickly, these bills can start adding up to 5, 10, even $15,000.

How much have prices actually increased? I mean, it seems to me like a huge amount, but what are the numbers there?

As we know, prices for all kinds of things are going up because we've seen inflation over the last couple of years. But vet care prices have risen much faster than the overall rate of inflation. My colleagues and I actually ran the numbers. In the last decade, the price of services has risen about 30%. In that same period, veterinary care has gone up by more than 60%.

Why is that, Katie? I mean, that's the question here, right? What's going on?

When I started reporting this out, I found that there were a number of factors that were contributing, and they're all intertwined. One is just that the culture of owning a pet has changed. More and more people are owning pets. There's different surveys, but anywhere between 60 to 70% of American households have a pet. As those of us who do have pets know, we see them more and more as members of the family. I mean, one example is like, dogs used to live outside or sleep in a garage or something. And now there's this one survey that I found that almost half of Americans sleep with their pets.

I would never do that, Katie.

No, none of us would. And we just need to walk into any pet store to see how much money people are spending on pets for cute outfits, birthday cookies. When you go away, you don't just I leave them in a kennel, but they're now dog hotels. There's this fancy one near me where they have a view of the Chicago River. You can pay extra for a river view.

Okay, I would never leave my dog in a dog hotel, though I did just send her to a boarding place where she got a bunch of training when I was on vacation. I am feeling a little sheepish here, but it has gone crazy. I mean, we were talking to the team earlier, and I was saying I was overhearing someone on the street just walking, talking to their friend, having a conversation about dropping her off at daycare, and I couldn't tell whether she was talking about a dog or a child.

Right, exactly.

Okay, so we are all pet owners now, or at least a majority of us are. That bigger demand for services presumably causes prices to rise. Is that what's going on here?

Yeah, that's a part of it. But the big driver is also that there's just been these remarkable advances in medicine for animals. It's like what I saw with my own puppy. Historically, Vets would help with really basic things like a cut on a pie or deworming or spaying and neutering. But for anything life-threatening, like cancer or something like that, really the only option that they had available to them was to put the animals to sleep and to give them a humane death. But over the last decade, there's just been huge leaps in what we can do for our pets. There's been big steps in cancer care, very intricate and involved surgery. Dermatology, there's been some really big new drugs for dogs, in particular, to help with skin allergies. There's physical therapy. There's just so many options now available to pet owners to help their animals live longer and better lives. For example, I spoke to this one vet who she's been working since the 1990s, and she told me this story about how her father was a human doctor. Back then, what she would do is she had a lot of doxons, and doxons often have bad backs.

She would sneak them into the human hospital after hours and into the MRI machine so she could check them out. Today, she has an MRI machine, and many animal hospitals have MRI machines for animals.

That's really a measure of how things have changed, even since the 1990s.

Yeah, and it's pretty amazing and great that we have these options available for our pets. But it also costs a lot of money to do all of this new stuff. Which brings me to another big change that I found in my reporting, which is this has become very appealing to big businesses. Because just remember, historically, veterinary offices were small businesses, and they were staffed by animal lovers, not business people. That has made it an enticing target for investors because they see an opportunity there.

Okay, so big business spots an opportunity here.

What happens?

Basically, big companies and private equity firms start buying up small chains and individual clinics. They pretty much go on an acquisition spree. One big example is the conglomerate Mars, which is probably best known for selling candy and also pet food.

Little known fact, Mars is also a big dog food manufacturer, not just a candy bar maker.

Yes, it makes a lot of different dog foods, and it's been in the pet world for a long time. But over the last several years, they've also bought up the big veterinary chain, VCA. They also own Banfield, which is in a lot of the Pet Smarts, which is a big pet store chain. They also own a specialty hospital chain called Blue Pearl. Then in addition to that, a lot of private equity-backed firms have been buying small individual practices. That trend really peaked in 2021, for example. The situation that we have today is that a quarter of all primary care vet clinics are now owned by corporations, and three quarters of specialty hospitals are owned by companies.

Katie, how does this consolidation, in some cases, three quarters of all clinics owned by big companies, how does that affect these high prices we've been talking about?

Well, I spoke to a number of vets who have worked in these corporate-owned clinics. What they told me is that they are under increasing pressure to do things that basically drive up the cost of care for pet owners. Some examples that they gave me is they felt increasingly stressed and pressured to see more animals per day. Others told me, to a certain extent, veterinarians have always had some of their pay tied to how much revenue they bring into the practice. But at these corporate-owned clinics, the pressure is even greater. They were being asked to order more tests. Or one veterinarian that I spoke to said that she was told she needs to get her cost per client higher, or someone else said that someone needed training on getting a pet owner to YES. These are high pressure sales tactics that you really don't expect to see in a vet office. Some of these vets that I spoke to said that they felt pretty uncomfortable with that as well.

Now there's It's this doubt, right? It's like, is my vet recommending this thing because my dog should have this thing, or is my vet recommending this thing because he needs to make a different bottom line than he used to?

When I spoke to vets, they were very clear that they only provide the care that they think is best for that particular animal. But there's no denying that these incentives and pressures are there. They said that there's a lot of factors that pet owners don't always appreciate. One of them is they are very forward, public-facing, almost like a retail store. They get Google reviews, Yelp reviews. They're very worried about not providing the top-level care and perhaps getting inviscerated in reviews. Sometimes that can put pressure on them to make sure that they've done absolutely everything they can for an animal. The last thing is that a lot of veterinarians do still own their own clinics. They told me that they're facing all of the same rising costs and pressures that any other small business owner is facing. That includes paying a living wage for workers in a pretty tight labor market, the rising costs of prescription drugs and lab tests and other equipment. They say that a lot of times pet owners just see the high price tag and they blame the person in front of them, which is the veterinarian.

Okay, so the rise of this corporate consolidation we've been seeing has meant perhaps higher prices and has put more pressure on vets. But are there any upsides in it for us, for consumers? I mean, just one example from my old neighborhood in Washington, DC, there was a new chain that moved in that was 24 hours, and that was a great option for my very accident-prone dog. She suddenly had a couple of different options of places that we could go in the middle of the night if something happened.

For sure. I mean, anytime there's more money available, You can invest in better services, nicer offices, nicer waiting rooms. There's more money for better equipment investing in some of these specialty services that we've been talking about. There are definitely benefits to this. But as I found in my reporting, even as vet care has really caught up in a lot of ways to human health care, there's a lot of important ways that they're different. That can present some really difficult choices and some prickly moral choices for pet owners.

We'll be right back.

Katie, let's dig into the ways that pet care is actually different from human care, setting aside the fact that pets are not people. Talk to me about what these main differences are.

The biggest difference is how the pet care gets paid for. I'm not sure anyone in the US would say that health care is particularly affordable, but the fact of the matter is that most people do have health insurance that covers the bulk of their medical costs. If you are in an emergency situation, hospitals are legally obligated to give you life-saving care and then sort out the bills later. But that's just not how things work in the vet world. Veterinarians don't have the same obligation to treat. It's almost entirely on the pet owner to pay the full amount of the bill, basically up front and at the time of service out of pocket.

That is a big difference, but isn't there pet insurance as well?

There is pet insurance, but a very small minority of pet owners actually have pet insurance. Just It's just about 4%, and it's very different from the health insurance that most of us are familiar with. Some examples are that with very few exceptions, you still have to front the money for the bill, and then you would submit that claim to your pet insurance, which will then decide whether that's a legitimate claim, and then they will reimburse you. Generally, plans don't cover pre-existing conditions. They charge more for pets that are older. It's like the pre-Obamacare version of human health care. Many things that are now not allowed in the human health care world are still very much a feature of how pet insurance works. Even if you have pet insurance, that doesn't always mean that you can keep it. To take one example, Nationwide, which is one of the biggest providers of pet insurance in this country, recently said that the cost of pet care is getting so expensive that it had to discontinue the plans of 100,000 pet owners. That left a lot of these pet owners basically back where they had started with having to cover the cost of the care themselves.

That's, of course, presuming they can pay, right? I mean, I'm sure For a lot of people, their devotion to their animal notwithstanding, it's just not possible to drop a few thousand dollars on these amazing life-saving treatments. Are those people who can't afford that just having to put their pets down? What are those people doing?

This is where this just gets extremely thorny and difficult. I think there's a number of different answers. Yes, I think some people do have to put their animals to sleep or choose less expensive options. But when I talk to pet owners about this, many of them went to pretty extreme lengths in order to cover this care and to find a way to pay for it. I spoke to people who dipped into their retirement funds. I spoke to somebody who donated blood plasma, someone else who took on a second job in order to pay for this. Many people also charge it on a regular credit card like a Visa and then pay it off. But another option that a lot of pet owners end up going for is something called a medical credit card.

What exactly is that?

It's a specialty credit card that's offered at a lot of these veterinary clinics. It's right there on the counter often. The way that these cards generally work is that there is an introductory period, say six months. If you pay that off within that period, you don't have to pay any interest at all. But if you don't pay it off and you still have some debt at the end of that, the interest rate can be pretty serious.

How much?

Well, I spoke to this one pet owner. Her name's Heather Massey, and she shared her bills with me, and she's paying 30%.

Wow, so that's high.

Yes, it is high. But you can also see why it's tempting. You're really struggling to figure out how you can pay off this pretty significant bill. And then this is an available option to you. And many people think that, Hey, I could think I can do that. I could pay off that during that six months or something like that. But Heather is not alone. I spoke to the company that she got her card through, CareCredit, and they told me that 80% of people who take out the card pay it off in time. But put another way, that means one in five people who take it out don't pay it off within the introductory period.

So a lot of people going into debt for their pets?

Yes.

Can I just pause for a moment on that, Katie?

I mean, these are dogs and cats, right?

These are not our children. And yet we're going into debt like this, trying to prolong their pretty short lives. It does seem nuts in a way. But at At the same time, I'm imagining myself in that vet office staring at the bill and staring at a very sick Clementine. I think I would have a really hard time not doing that myself, not taking on that debt. I can easily imagine myself doing it. It's hard.

Yeah, it's really hard. I think we're in a whole new world right now. The vets that I spoke to used to say that really the only option for a very sick animal was euthanasia. Now, they're going into these exam rooms and offering pet owners so many other options to prolong the life of their dogs and cats. But regardless of what options these pet owners choose, what's happening is that they're the ones who end up in the driver's seat. The decision ultimately sits with them, and they're now faced with this whole new set of ethical questions and big financial responsibilities that they really never had before.

When there's always another treatment to try and there's a credit card to put it on, it feels to the pet owner like it's their choice about whether their pet lives or dies.

The question comes up, just because you can, does that mean you should? Is that always in the best interest of the pet? It's actually the question I wrest with with my own puppy. He got very sick. It turned out he had a very serious health problem. In our case, we learned that there was a surgery that He would fix it. Pretty expensive surgery, but we decided to go for it because he was young and had potentially a long dog's life ahead of him. Unfortunately, he experienced complications patients from the surgery, and he didn't actually make it.

Oh.

But I don't regret having done it, and he got really great care. My experience just really echoed what I heard from so many pet owners and veterinarians that there's really no easy answers to these very new questions that we're all facing. You have to sort out the risks and rewards of pet ownership. In my case, I decided it was worth it to me and I recently got a new dog. So, here we go again.

Katie, thank you.

Thanks for having me.

We'll be right back. Here's what else you should know today. On Thursday night, amid growing doubts about his age and mental fitness, President Biden wrapped up a summit of NATO leaders in Washington.

And now I want to hand it over to the President of Ukraine, who has as much courage as he has determination. Ladies and gentlemen, President Putin.

By mistakenly introducing the President of Ukraine as the President of Russia.

President Putin. He's going to be President Putin. President Zelenskyy.

Later.

With that, I'll take your questions. I've been given a list of people to call on here.

Biden held news conference that was widely seen as a crucial test of his stamina and coherence. In his first answer, he once again stumbled when referring to his own vice president.

Look, I wouldn't have picked Vice President Trump to Vice President, though I think she was not qualified to be President. So let's start there.

But over the next hour, Biden spoke with fluency and command about the war in Gaza, America's policy toward China, and his relationship relationship with Russian President Vladimir Putin. And when pressed on his age and ability to serve a second term, Biden said he had no reservations.

Every single day, I'm surrounded by good docs. If they think there's a problem, I promise you, or even if they don't think it's a problem, they think I should have a neurological exam again, I'll do it. No one's suggesting that to me now.

Still, when the news conference was over, three more House Democrats called on Biden to step aside as nominee. As of Thursday night, 18 Congressional Democrats have asked Biden to end his campaign. A quick reminder to catch a new episode of The Interview right here tomorrow. This week, Lulu García-Navarro talks with Robert Putnam, the author of Bowling Alone. For decades, decades, he's been warning about the decline of American community and what that means for our democracy.

We're not going to fix all these problems in America, polarization, inequality, social isolation, until we start feeling we have an obligation to care for other people. And that's not easy.

Today's episode was produced by Olivia Nat, Claire Tennis-Sketter, and Ricky Nowetzky, with help from Shannon Lynn. It was edited by Lexie Diao and Devon Taylor, with research help from Susan Lee. Contains original music by Dan Powell and Ron Nemistow, and was engineered by Alyssa Moxley. Our theme music is by Jim Brunberg and Ben Lansberg of WNDY. Special thanks to Zuzu, Piper, Tiger, Chichi, Zady, Tobi, Jerold, Cosmo, and Clementine. That's The Daily. I'm Serena Tavernisi. See you on Monday.