Spending Like Cats and Dogs
A lot of people are posting this graph showing the rise in health-care costs for people and the rise in the health-care costs for people's pets. It's being used to argue a lot of very big, very specific, points. But it has some problems.
For one thing, the graph shows national expenditures. The rise in costs makes sense only if examined on a per capita basis. If Americans have more pets today than we did in 1984 -- and we do -- then that mucks up the data. There's also the question of whether the populations are alike: If pet ownership is clustered among wealthier Americans, you'd expect them to be less sensitive to the cost of doggie drugs.
But whatever the graph's problems, the sudden acceleration in medical spending on pets does offer insight into spending on people. If you took a limping Fido to the vet and were informed he had a malignant tumor in his foot and three months to live, you would cry, and feel terrible about it, but that was basically that. But what if you were told that there's a $5,000 treatment that could potentially save your dog?
Suddenly, you have a choice. It's not just how much your dog's life is worth to you. It's how much it's worth to you to feel like you didn't decide to let your dog die. A treatment that isn't strictly "worth it" in economic terms -- a treatment that may not even save your dog -- may be worth it to you, because you want to feel like you did everything you could. You want your economic decisions to line up with your emotions.
The rise in health-care spending is not simply that we have trouble saying "no." It's that the march of health-care technology has forced us to make a lot more decisions. Conditions that would have simply, sadly, killed people 30 years ago have treatments -- which may or may not be effective -- today. And it's hard to say "no" to those options. But the crucial point isn't when we accept or reject the treatment. it's when we're faced with a treatment to accept or reject. It's when death begins to look like a decision.
That seems weird to us with pets because, well, they're pets, and because these are new questions when you're dealing with cats. But with other human beings, these are old decisions. We started making them when they weren't that costly. We've made so many of them that we hardly noticed. Indeed, we've outsourced it: Now the doctor pretty much makes the decision and the insurer pretty much pays for it. Which has helped us not notice how many more of these decisions are being made and how much more they're costing and how uncertain they are. But even if we did, what could we do? We say "yes" because that's the only answer that makes sense when you love someone. Put another way, the Beatles were only half-right:
You can't buy love. But you can certainly spend in a way that shows love.
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