Economic Euthanasia

[sumstorm]

The only difference is that the owner has more time to pay off the charge.

And, at least where I worked, there was some off the top of the cost that went to Care Credit

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[168135]

Care Credit is sort of like a credit card that the owners can apply for. It's available in many different areas of human medicine too such as at dentists. You have a certain amount of time to pay off your bill without interest. The amount of time you have to pay it depends on how much the bill is (more money spent, more time to pay it off). However if you go over your allotted "grace period" the interest rates are pretty high. Unfortunately in my experience the owners that need it the most are the same owners that don't have a high enough credit score to get the card. The vet office gets paid in full by Care Credit (just like if it was a Visa/Amex/Mastercard). The only difference is that the owner has more time to pay off the charge.

We have free health care. That's probably why it doesn't exist.

No matter what your economic situation is, an emergency fund isn't a hard thing to start. I mentioned to my mom that she should be sticking $5 away every week just in case an emergency crops up with Susie. She rolled her eyes and said "Sticking away money... for the cat?" Then she got a little upset when her final vet bill was in the $300 range. I'm a student... but whenever my wallet is bulging with change, I put most of it in a container, roll it, and set it aside in case I need to make a vet visit. I don't have that much saved to far, but it does help... and it keeps me from spending it on things that I don't need, like the low fat cranberry muffins at the school cafe.

 

[Bill59]

And, at least where I worked, there was some off the top of the cost that went to Care Credit

It's 5% I think for the 6-month plan. More if you offer the longer plans. Most credit cards are 2-3% so it's not much different.

It's nice to be able to offer when clients don't have a credit card. And if they don't get approved for care credit it's not youthat's refusing.

Finally, if they get turned down by care credit you pretty much know you would get screwed if you offered to let the client make payments.

 

[spicykimchi]

We have free health care. That's probably why it doesn't exist.

No matter what your economic situation is, an emergency fund isn't a hard thing to start. I mentioned to my mom that she should be sticking $5 away every week just in case an emergency crops up with Susie. She rolled her eyes and said "Sticking away money... for the cat?" Then she got a little upset when her final vet bill was in the $300 range. I'm a student... but whenever my wallet is bulging with change, I put most of it in a container, roll it, and set it aside in case I need to make a vet visit. I don't have that much saved to far, but it does help... and it keeps me from spending it on things that I don't need, like the low fat cranberry muffins at the school cafe.

I second this. My mom WILL NOT put aside money for a veterinary fund and she FREAKS OUT every time one of her animals rack up a vet bill that she's not sure how she's going to pay. So guess up who ends up helping her pay the bill? Yours truly. Ugh!

 

[DVMDream]

Finally, if they get turned down by care credit you pretty much know you would get screwed if you offered to let the client make payments.

That is making a big generalization. Just because someone does not have enough credit to qualify for care credit does not mean they will screw you over. We offer payment plans to clients who don't qualify for care credit and yes we will occasionally get the one who screws us over, but the majority of them actually do pay. The clinic I work at extends out a lot of payment plans and very few actually have to be sent to collections (around 3%). Bad credit does not equal non-paying people. Sometimes people mess up or bad things happen in life and their credit takes a hit, unfortunately some of these people could have had their credit nose-dive 10+ years ago, once it drops it is nearly impossible to bring back up.

 

[sumstorm]

Sometimes people mess up or bad things happen in life and their credit takes a hit, unfortunately some of these people could have had their credit nose-dive 10+ years ago, once it drops it is nearly impossible to bring back up.

This is not accurate. you can request a roll-off of even complete non payment on everything but government loans (ie student loans) after 7 years. You can take a low (300-400 score) and raise it to over 600 in 3 years if you actually negotiate debt, start pay down, maintian revolving credit, and pay essentials ahead of schedule (ie electricity, water, mortgage. I use to volunteer at a community center where we helped individuals repair their credit, so I helped a lot of folks with this process, and it was pretty amazing how focused effort did so much. If folks are claiming screw ups from a decade ago, then they have not made any moves to repair those screw ups...and consequently, I'm not sure I'd trust them to make moves to repay their bill.

Now, if you have no credit, that can be harder. and that is what a lot of young adults are dealing with; they either have no credit or blew their credit out of the water because very few people seem to teach kids how to manage credit. if you have no credit, it can take a couple months up to a year to establish credit.

I have to agree with Bill on this one. There may be the occasional long term client I would work with, but for the client off the street, or who is always stretched for bills, I am not a personal bank. If their family, friends, creditors, banks, and pawn shops aren't willing to provide funds, I'm not sure why I should.

Are you saying 3% of all payment plans are sent to collections, or 3% total of all bills? And what percentages of clients are getting payment plans and what is the average payment plan bill vs. bill paid in full at time of services. If 3% sent to credit are also your highest bills for the month (which are generally the ones that can't be paid up front), that can be risky to business. Also, there are legalities surrounding the extension of credit that many of us aren't aware of, and if you have to send it to collections, you are also losing off the total bill if it is ever repaid.

 

[NStarz]

This is not accurate. you can request a roll-off of even complete non payment on everything but government loans (ie student loans) after 7 years. You can take a low (300-400 score) and raise it to over 600 in 3 years if you actually negotiate debt, start pay down, maintian revolving credit, and pay essentials ahead of schedule (ie electricity, water, mortgage. I use to volunteer at a community center where we helped individuals repair their credit, so I helped a lot of folks with this process, and it was pretty amazing how focused effort did so much. If folks are claiming screw ups from a decade ago, then they have not made any moves to repair those screw ups...and consequently, I'm not sure I'd trust them to make moves to repay their bill.

Now, if you have no credit, that can be harder. and that is what a lot of young adults are dealing with; they either have no credit or blew their credit out of the water because very few people seem to teach kids how to manage credit. if you have no credit, it can take a couple months up to a year to establish credit.

I have to agree with Bill on this one. There may be the occasional long term client I would work with, but for the client off the street, or who is always stretched for bills, I am not a personal bank. If their family, friends, creditors, banks, and pawn shops aren't willing to provide funds, I'm not sure why I should.

Are you saying 3% of all payment plans are sent to collections, or 3% total of all bills? And what percentages of clients are getting payment plans and what is the average payment plan bill vs. bill paid in full at time of services. If 3% sent to credit are also your highest bills for the month (which are generally the ones that can't be paid up front), that can be risky to business. Also, there are legalities surrounding the extension of credit that many of us aren't aware of, and if you have to send it to collections, you are also losing off the total bill if it is ever repaid.

My brain is now fried, thanks sumstorm!

 

[AggieHorseVet]

I understand that many people cannot afford top-notch, highest-quality care for their pets, especially in a time of emergency. I do think that sometimes, euthanasia is the best option, especially if the owner is going to have high costs that extend far past the immediate treatment of the pet.

However, what about pet insurance? If we, as veterinarians, encourage our clients to get their pets insured, then something horrific, like a broken leg, need not be a reason to euthanize. This would mean hardship for the family and the pet, but the financial side of it would be covered. The cost of these insurance programs are usually quite low, and the value they have is immense. I know that of the clients we have on insurance, they are much, much more likely to treat their pets in an emergency situation, not to mention for general wellness exams, blood screens, etc. that are covered by the insurance for early-detection purposes.

Let's work on preventing the financial issues before they come up instead of reacting to them with less-than-ideal options.

 

[sumstorm]

insurance still requires the client to come up with payment out of pocket. which means unless it is a trusted client there may still be problems with payment.

also, I've seen some people burned by the restraints

 

[DVMDream]

Three years is fairly quick to bring up credit, but it takes longer if you have a bankruptcy on your credit which I know quite a few people who do, my parents being one example. They were told that it could easily take over 5 years for their credit to be "decent". Also, this was 15 years ago that they were told that so things could have changed.

The doctors I work with will offer payment plans for 99% of cases including well-established clients and those that have just come in for their first visit. Many of these bills are in the $300-$700 range. A few are for less than $300 and a few are for the $700+ bills. When I mention 3% are sent to collections this is what I mean:

In one year (maybe it was six months) $150,000 was enrolled into payment plans of that $150,000 only $5,000 was "written off" or sent to collections. Seems like a fairly small amount in comparison to the total.

Obviously, there will always be dishonest people who don't care and won't pay their bills. It happens everywhere, but to say that someone who doesn't get approved for care credit is somebody that would probably screw you over is a massive generalization. For all you know, their credit could be bad for various reasons: having your credit score pulled too many times in a certain time frame can drop it drastically, maybe the person just had their house go into foreclosure because the economy is in the sh**** they had re-financed the house right before the economic downturn and now they are paying a really high payment on a house that was appraised at $300,000 (right before the housing crash) but now would only be appraised at $175,000 (after housing crash) and their mortgage company wouldn't budge to make the payments cheaper, maybe they had a family member become very sick and went from being a two-person income family to a one-person income family.

I had a client recently who had just purchased a house and tried to apply for care credit (the same company that runs care credit gave her a loan for her new house) and she was denied. So we gave her a payment plan, no problems at all, bill completely paid off two weeks later.

To each their own, either you offer a payment plan or you don't. It is a personal decision in the end. You can never tell who will be the one to pay you back and who won't. Credit score is an indicator of previous payments, but there is more than just payments that goes into a credit score. Take credit scores with a grain of salt because it does not always tell you if you are dealing with a decent person who will pay who has had some bad **** happen recently or a person who just doesn't give a **** and won't pay.

 

[EllieGirl89]

I have to agree with the notion that bad credit =/= a client who will not pay. My parents are a perfect example. When I was 12, we moved to a new house. They sold our old one on land contract. I don't know exactly how that works because I was pretty young, but I do know that the guy who bought the house pulled out on month 22 of 24 of the contract, leaving my parents with two mortgages that they simply could not pay. Bankruptcy ensued, through no fault of my parents' own and their credit score took a huge hit. It took a long time for them to pull it back up and they worked really, really hard to do so. But during that time, my dog needed double cruciate surgeries and the vet was kind enough to put us on a payment plan. My parents paid every penny of that vet bill.

 

[camcam]

You might not agree with how its harder on the families to say we can not afford it we have to let them die but I lived it.

There is a lot more guilt from the families who took home the animal then decided that they have to let them die becuse they don't have the money.

 

[kitty613]

You might not agree with how its harder on the families to say we can not afford it we have to let them die but I lived it.

There is a lot more guilt from the families who took home the animal then decided that they have to let them die becuse they don't have the money.

Did any vets ever offer to euthanize for free? (I know this may seem fruitless now talking about it) Anyway, I know this isn't commonplace, but it does happen.

 

[chickenlittle]

Of the four clinics I've worked at since vet school.

1 - Stated policy was to euthanize at no charge for any suffering pet. If they couldn't afford even the office visit, we'd still euthanize if the pet was suffering.

2 - No free euthanasia. I never had a case there where an owner declined a needed euthanasia.

3 - No free euthanasia, but our euthanasia price was insanely cheap ($30 I think, with no exam fee). We had a lot of "price shopper" euthanasias - that was hard, because we did a LOT of euthanasias per week. I did once have a guy decline euthanasia for a kitten and I offered to pay for it out of my own pocket. He agreed (which pissed me off, because there he was in his expensive golf shirt, Dockers pants, and boat shoes).... but my office manager ended up not making me pay when she saw how bad off the kitten was.

4 - No euthanasia without an exam and euthanasia fee. Our prices are high, so I do feel that we have some people who turn down euthanasia when it would probably be in their best interests. I always try to mention/suggest that there are other clinics that will do it more affordably.

 

[sumstorm]

If you file for bankruptcy, depending on the type, the longest it will sit on your credit report is 10 years (chapter 7) and 7yrs (chapter 13). I am not saying you can go to stellar (ie 780+) credit that quickly, but it is possible to get it up to the mid 600's (from the high 200/mid 300 range), which are the typical credit cut offs. I handled ~500 clients as a volunteer (over 5 years), most with bankruptcies, and I didn't believe it till I witnessed it, so I appreciate the skepticism. The top mistake individuals make is NOTembracing the life changes that doing ther repairs take. IE paying every bill either in full or at least 2% above the minimum at least 7 days ahead of the due date (preferably 14d to give processing buffers.) The worst thing anyone can do credit wise is have a major credit blip (repossession, foreclosure, bankruptcy) then keep having late payments or no payments. There is actually a + scoring for pay aheads (vs neutral for on time.) We had to tell folks they had to do really hard things if they wanted to fix this, like working a second job, never eating out, getting rid of cell phones, shopping at garage sales, getting rid of the 2nd vehicle (or selling the 'new' vehicle with its payments and taking the shortfall to get in a cheaper vehicle). But it is possible to do in a very short time, and if it is possible for very impoverished folks (3-4 people living in one room shacks) I can't see why families that have more can't do it. Our program was about helping folks get to the point that they didn't need to rely on social support (food stamps, housing vouchers, etc.) but we helped anyone that wanted help. I learned about it at a home buyers seminar, used it to help my bf at the time, then became a volunteer.

That is why, if things are going south, and our savings buffer is starting to erode, we need to be extremly proactive. My husband and I put our house on the market within 4 days of his lay off notice; we opted not to sell because he had a job within 1 month, but we were ready if necessary. It was a heart breaking decision, but it was better than burning ourselves for a longer period of time. We saw a lot of folks do the opposit...ignore the elephant till it was suffucating them.

At least to me, $5k (or $10k if that was for 6months) is a large portion of an associate vet's pay (8% before taxes for a $60k salary.) If I want to have a great associate, I'd rather have that extra $$$ to pay them. Also, that is the write off...what was the cost of collection and the oppurtunity cost of interest? Would you really, if you went to a vet clinic and they said 'we'll either pay you an extra 5-10k or we'll let our clients carry credit' which are you going for? And I realize it is never that simplistic, but eventually that money has to come from somewhere.

Some of the examples you are listing don't make sense. I do know if your credit report is pulled more than 5 times in a quarter, you can take a hit...but why are you having your credit pulled that often in a quarter? And then the hit is ~20 points....so if you have a really good credit score, that is an annoyance...it becomes a problem if you have a borderline credit score.

Also, the loss of value in your home won't impact your credit report on its own. Not making mortgage payments will. My home can burn to the ground, and as long as I make the morgage payments it won't impact my credit. Now, if I get the attitude that it isn't fair that I have to pay more than the current value, and stop paying, it will impact my credit. We knew when we listed our house it would be a short sale....we'd be selling it for less than we had in it, and we have it 3/4 of the way paid off...and that we'd have to make up the difference (ie keep paying morgage payments after we no longer had a house) or we could turn it over as collateral (but you have to do that before you are late in payments.) I'm not saying these are easy decisions.

I'm not saying 100% of people who can't pay at this moment will never pay. I'm saying that many of those folks who will pay in two weeks can also mine for that money among friends, family, etc. Also, no matter what, there is a cost of that transaction, but because I'm not a financial institution, I can't legally (in most states) charge an additional fee for that cost. Maybe I have little tolerance for someone that can come up with the money out of the next paycheck but couldn't bother to save it from the last paycheck.

I will say, area impacts this hugely. We have to deal with credit stops, kitted checks, and other hassles at the clinic I worked out in the south, while the clinic my mother works at does 90% credit business and never have repay issues (less than $1k in 5 years) because it's a community where everyone knows everyone. But to me, $5k isn't an insignificant cost. I wouldn't be willing to take it off the top of my income, and wouldn't want to take it off the top of my techs, receptionists, and associates.

 

[DVMDream]

I will say, area impacts this hugely. We have to deal with credit stops, kitted checks, and other hassles at the clinic I worked out in the south, while the clinic my mother works at does 90% credit business and never have repay issues (less than $1k in 5 years) because it's a community where everyone knows everyone. But to me, $5k isn't an insignificant cost. I wouldn't be willing to take it off the top of my income, and wouldn't want to take it off the top of my techs, receptionists, and associates.

Thanks for all of the credit info. It is really interesting as I know about quite about of it, but some of the info. I did not know about. I knew bankruptcy was only on for about 7-10 years but I couldn't remember which. Anyway, I will agree that area does has a huge impact on this. No, $5K is not insignificant, but flip the coin. $145K is a HUGE amount and that is an amount that was made because those people were allowed to have a payment plan. Imagine, the loss of money there could have been if those people were not allowed to have a payment plan. Losing $145K is worse than losing $5K and you were able to give the proper treatment to those animals that did need it and to the owners who wanted to pay but just didn't have that $1,000 laying around at that moment. But area makes a huge impact and in the end it is a personal decision for each veterinarian to make on their own.

 

[vetme]

(that probably will not change in a long time, if ever and I say in general because there are some people out there who put their pets as a higher priority than even themselves.)

Yep I have seen this...There is a guy in this area that is homeless, but his dogs are always healthy.

 

[Chinola]

Yep I have seen this...There is a guy in this area that is homeless, but his dogs are always healthy.

Sometimes homeless people get free vet care. We have a vet down here that goes to wherever a homeless person with a pet is and gives them free vet care. He has a specific name for the portion of his practice that does this. However I've heard lots of stories of other vets helping an individual homeless person that came to their attention that didn't do it on a regular basis. They provide spay/neuter, vaccines and other types of more expensive care for the homeless person's pets.

 

[Bill59]

Bad credit does not equal non-paying people.

Actually it does. The way people get bad credit is by being nonpaying. If CareCredit -- who is in the actual business of loaning money -- determines the client is a poor credit risk, why should the veterinarian loan them money?

Are you going to ask your other clients if they are willing to pay higher prices to make up for the bad debt? Is that fair?

How about your hardworking techs and staff? Are you going to ask them to forego a raise?

 

[sumstorm]

I had a client recently who had just purchased a house and tried to apply for care credit (the same company that runs care credit gave her a loan for her new house) and she was denied. So we gave her a payment plan, no problems at all, bill completely paid off two weeks later.

Missed this...GE Money (care credit company) specializing in higher interest lending to lower credit individuals...so if she got her morgage from WMC (the morgage arm) then she would be considered at higher risk if she had just taken on a huge debt. The debt itself probably didn't change her credit score much, but it tipped her debt:income ratio. From WMC: "
While WMC currently operates in the sub-prime market, offering loan options to consumers with less-than-perfect credit or other unique circumstances, the goal is to provide a broader array of products to its client base and enter the near-prime. "

We have owned, between us, 7 houses, purchased from mid 80's to 2 years ago. We also maintain a mid 700 score individually. I do have a black mark for non payment on my credit that I am waiting to process the drop off this year. While I was dropped from my highest CC last year (because of infrequent use, but when I did use it, it was big stuff like home remodeling), it took less than 24 hours to have another card in it's place for the same upper limits. The thing a lot of folks forget to do is review all your credit reports (from 3 companies) and challenge anything that is a black mark. IE call the compan up where you had a late payment and ask them to neutralize it. If you have a non-payment, challenge it (the company has to prove you had a non payment, that is why mine is dropping off, a medical clinic claimed non-payment from an insurance claim, but never notified me, then the owner decided to be a SAHM, and when the clinic was asked for proof, they couldn't come up with it.) If you have a bankruptcy, you have to review and make sure all of the debts discharged in bankruptcy actually say that in the credit report.

 

[eventualeventer]

Wow, less than 5% default rate on payment plans sounds really low. Good for them.

I don't have comparable numbers for the private equine practice I worked for, and their billing system was different (billing after the fact for farm calls so the doctors didn't have to deal with trying to collect on the farm), but I suspect it would have been higher than that. There were individual clients who carried more than $5K balances ongoing (they'd pay a little, then rack up more charges on mostly non-urgent things) until the practice started cracking down on doing elective work for people with outstanding balances.

Regardless of eventual payment status, I think these clients (who were often the wealthy clients) knew what took me a while to learn - that it's not just annual income that matters, but cash flow. If they could avoid putting it on their credit card so they wouldn't have to pay interest, it became the vet's problem to figure out where to get salaries, drug costs, and overhead in the intervening months while awaiting payment. That's all well and good if a practice is thriving, but if times are tight it becomes more of an issue, since your front desk staff and your drug distributor aren't going to wait for Mrs. Smith to pay her bill before cashing their checks.