I mean, I am somewhere between the "do ALL the things" and QOL is best. Like, I am going to the dental specialist if a pet needs that (just did a few months ago as my cat recovers horribly from anesthesia so wanted her under as minimal amount of time as possible), it was just shy of $2000. Personally, I think just dental issues alone/dental specialist alone will more than make up for anything paid into insurance and I don't consider these "minor" problems. I will pay to have a fracture repaired, which depending on the fracture can be anywhere from $1500-3500. I would definitely pay for internal medicine consultation -- IBD/GI lymphoma diagnostics/treatment which aren't very invasive or extravagant (which let's be upfront, many cats actually need this work up but rarely get it, occasionally vomiting a "hairball" is NOT normal). I would definitely do I131 treatment for a cat (which a decent number of older cats will develop hyperthyroid, fairly common old cat issue). I am not going to do radical radiation for SCC treatment. Not going to treat certain cancers, not going to go kidney transplant route for renal disease, etc. I don't think it is "out there" to go to a dental specialist, or work up an IBD with IM or repair a fracture, heck even an amputation is over $1000. So even the "minor" and common old age issues are going to add up quickly
I mean, I get it, that $100-200/month does add up and theoretically you can put that into a savings account instead and have money saved up, however, if that dog gets hit by a car at 6 months old-- even at $200/month, you'd only have $1k in savings for that incident. At $100/month it would take just over 4 years to have $5000 saved up in a savings account for that pet. It takes time, very slowly, whereas insurance, you have only a one month waiting period and if you need expensive treatment it is going to be covered. Plus, let's talk human nature-- most people are awful about saving money and leaving it alone. If anything else goes wrong, you know that pet health savings account is going to be used for the car battery, broken AC unit, cracked windshield, new fridge, new tires for the vehicles, etc. Plus 4 years to save up $5k, one acute illness, one chronic injury, one accident and that $5k is gone and you don't get to recover it in a few weeks or a month like you would with pet insurance. It will take you 4 years to recover that money at least. So to me, the difference between pet insurance and just put it in savings is that pet insurance doesn't limit the number of chronic/acute/illness/accidents you can cover, whereas the savings account method means you can cover maybe 1-2 major issues over the lifetime of your pet and only if they space themselves appropriately so you have time to re-build that savings account.
I get it, yes, obviously insurance companies are out to make money, like every other business, and, yes, some people will pay out more than they put in, otherwise the companies would go bankrupt. But that is true for all insurance: home, car, renter's, human health, etc. I just overall, think that unless your pet is one that drops dead unexpectedly or only develops that acute illness at the end of it's life and just doesn't recover, the insurance is going to pay out more than you put in. They make money off those who do have healthy pets that unfortunately, only get that one acute disease or chronic arthritis that slowly can't walk anymore and then is euthanized.
It is very much a personal decision, but, overall, I will never not recommend insurance. I think it helps more people than it doesn't, in my opinion and it more readily allows me to be able to provide care to my patients.