When Canadians look at the United States, we sometimes feel that money plays too large a role there. It's particularly obvious in health care.
American families often face an agonizing dilemma -- whether to pay for treatments that are medically vital, but financially ruinous. Whatever its deficiencies, our own health-care program spares us that choice.
And so, until recently, did our system of veterinary medicine.
Pet owners have always paid for their animals' health care. Yet bills were manageable: Perhaps $35 for a visit or $50 for a treatment. Just about everyone could own a dog or cat, and afford to take good care of it.
But over the past decade, there has been an explosion in the cost of advanced pet care. And with it come the forced trade-offs we dislike about American society.
In part, the price surge can be traced to the increasing use of treatments once confined to humans. Some veterinary hospitals now offer a full range of high-end diagnostic procedures like CT and MRI scans. Their fees range from $1,000 to $1,500.
Sophisticated surgical procedures and drug therapies are being offered for the treatment of major ailments, like cancer and diabetes. These can cost $7,000 to $8,000 and more, with no guarantee of a cure.
Even in humans, those are expensive undertakings. But veterinarians must equip and operate clinics out of their own pockets. And they lack the bulk purchasing power of provincial health ministries, so their drugs and supplies cost more.
The result is an affordability crunch that leaves many pet owners genuinely agonized. How far should they go in caring for a sick animal?
Some believe the answer is straightforward: There is no price too great to save a beloved pet. For high-income families, that may be realistic.
But what about retired pensioners living on a fixed income? How do they balance this equation?
Veterinarians, understandably, take the position that if a pet owner can afford advanced medical care, they are obliged to provide it. And the B.C. College of Veterinarians -- the professional oversight body -- offers little help. The college's policy manual states that "a client's ability to pay should not reflect on the fees charged for the services rendered."
Then there is the legal aspect. In B.C. it's a criminal offence to withhold necessary medical care for a pet. Officials with the Victoria branch of the humane society report that several charges are brought each year.
Moreover, inability to pay is not a defence. So not only is there a moral dilemma, but law enforcement issues might arise as well.
There is an escape. Legally speaking, pets are considered household property. An owner who cannot afford expensive medical care can have a sick animal put down.
And it's unlikely that anyone would be charged with failing to provide top-end treatments, like cancer surgery or diabetes therapy.
Yet over time, that might change. The humane society is campaigning to award pets a legal status of their own. And what is considered advanced care today might become the bare minimum tomorrow.
While more discussion is needed, there are issues that require immediate attention.
First, some agreement must be reached about basic care and what it should cost. Pet owners with modest incomes should have the comfort of knowing they can provide the essentials.
Second, care providers need guidelines about what can reasonably be asked of their clients. It's all too easy to pressure anguished owners into paying for services they cannot afford.
Unless we deal with these difficult matters sensibly, pet ownership could become unaffordable to any but the most affluent.
That would be a great misfortune.