Vet Bills and the EU Charter

Over the past decade, there has been an increasingly intense debate on veterinary costs and animal welfare in both Europe and North America. Most EU Member States do not regulate Veterinary costs. However, there are EU regulations that affect the cost structure of veterinary medicines and services, particularly through the European Medicines Agency. In several European countries, Market and Competition Authorities are looking into the matter (the UK, the Netherlands, and Sweden) because costs for the same veterinary practice vary greatly and prices are rarely made transparent. Other EU countries, such as Germany, do regulate vet prices, and veterinary treatment costs are largely standardized. This divergence means that the cost of regular veterinary care, as well as access to such care, can vary significantly depending on the EU country and the specific area within that country. Many companion animal owners are distressed about veterinarian costs, and the “high veterinary care costs have received attention in the lay press and from competition authorities.” Prices are considered unfair, arbitrary, and not animal-friendly. If any of the Charter rights are to have real effect, and if Article 37 on sustainability is to be understood as a living concept when it comes to animals, the largely unregulated veterinary market in many EU countries deserves some closer scrutiny.

Cooperate ownership and veterinarian clinics

A recent veterinary study reveals that investment companies have been entering the European veterinary sector since 2011, consolidating the market by establishing dominant chains of veterinary care providers backed by investment firms. These firms are investing in veterinarian clinics, and the costs are unimaginable. Cooperations are taking over the market for the veterinary industry, often closing down small veterinary practices. This is a familiar story in the US, but not specific to it – has also developed in Europe. Often, animals are insured, but depending on the insurance policy, the deductible can be very high. From a strict EU consumer perspective, it is also not always clear to pet owners what exactly it is they are paying for. As an animal owner, you trust your veterinarian. This raises an important question: Can pet owners afford to treat their animals? As insurance premiums have risen significantly in many countries, and as the deductible portion is sometimes as high as 50%, this is not at all straightforward.

Corporate pricing strategy and risk capital are common problems in the animal welfare sector in the USA and Canada as well. For example, in the Canadian example, corporations are acquiring more veterinary clinics, and six corporations dominate the Canadian market; two of them, Vet Strategy and the US-based IVC, have acquired many clinics in Europe. Another one is the US-based Altano group. These corporations own big veterinary hospitals in Europe. In Sweden, one of them is the Evidentia chain, which frequently appears in the news due to its high prices. As a result of pressure to bill clients, there have been allegations of medical neglect. Additionally, in Sweden, the prices for veterinary services are often significantly different; more and more corporations are acquiring animal hospitals, driving up prices, and hiring a majority of the available veterinarians on the market.

What does the Charter have to do with it?

The EU Charter refers to the freedom to conduct business, as stated in Article 16. Limiting incentives to work is usuallynot a good model for ensuring quality healthcare. However, the current model that is taking shape seems unfair and unbalanced and also fails to respect EU competition laws. Moreover, the Charter also speaks of healthcare (Article 35) and the right to dignity (Article 1). Additionally – Maneesha Decka did in this symposium (here) – the right to education could come into play, which would help increase knowledge about animals and, hopefully, lead to the avoidance of veterinary care altogether. Also, Article 37 of the EU Charter demands a high level of environmental protection and states that the improvement of environmental quality must be integrated into the Union’s policies and ensured by the principle of sustainable development. It is seriously questionable whether this normative standard is taken seriously if the entire existence of an animal depends on the economic power of its owner. Many pets and animals are part of our households, and by not extending sentiments such as fairness and justice from the Charter to animals, they are not treated with the respect they deserve.

In Germany, the veterinary market prices are at least partly regulated, and vets are prohibited from overcharging, as there is a list of fees that creates some foreseeability for the customer as well. Germany also applied to the Commission for permission to provide state aid to increase animal welfare in livestock breeding, with a clause that allowed it to be applied to more animals. The EU should consider a regulated sector where the state subsidizes part of animal care, as is the case with human care, or a tax if you will. In some cases, veterinarians recommend multiple X-rays in situations where a consumer with no experience or in-depth knowledge may struggle to make an informed decision, and declining treatment for their beloved animal is something that the veterinary business often thrives on. Of course, there may be cases where the vet should say no to pet owners as well.

Language requirements are not always proportionate

Another concern worth highlighting is the limitation of competition. This arises, among other things, for the language requirement some countries impose. Again, consider the example of Sweden. Sweden has a shortage of veterinarians, and there is only one higher education institution in the whole country. From an animal welfare perspective, it does not make sense to demand a Swedish language requirement. If there are no veterinarians within 4-hour drive or more, does it really matter if your animal receives help in English? It does not seem so. Several animal clinics have been closed down in recent years, and there is no emergency service available. As a result, if one’s animal becomes sick after five on a Friday, one will have to wait until Monday morning. One reason, as mentioned, is the trend of big cooperatives that close down small veterinary clinics to limit competition. Another reason is the shortage of veterinarians, and due to language requirements, it is challenging for non-Swedish speakers to access the market. When there is an animal welfare concern, there is no proportionality to uphold this language requirement. Allowing English should be an option, and most pet owners, at least in Scandinavia, speak and understand English and would much rather receive treatment for their animal in English than nothing at all. After all, it is the animal that is the patient, not the owner.

Charter rights in practice

Currently, in many European countries – similarly to North America – there is a lack of transparency, and clinics generate significant profits depending on the insurance one can afford and the veterinary clinic one lives near, which can determine the life or death of one’s animal. In some cases, animals are put down simply for financial reasons. If we believe that dignity should mean something in the context of animals, this is problematic and needs to change.

I have three recommendations to address this deficiency: First, more EU countries should take a closer look at the German model, where veterinary prices are regulated (even if they allow for some variation depending on the situation). Secondly, the language requirement for veterinary practice – as is the case in some countries, such as Sweden – should not be so strict. If there is a shortage of veterinarians, it is better to receive treatment in English than none at all. After all, the animal is the patient, and it seems that insisting on a strict language requirement limits competition. Thirdly, if we want to treat animals with respect, it should not be up to large corporations to decide whether we can afford to treat them or not.