Vetnuus | January 2025 19 The situations that really pose a challenge are those where the patient owner really has no money for treatment. As filtered out in the model, some of these patient owners can make the money available through predictable payments for pet health insurance, but those who cannot do so cannot afford either treatment or pet health insurance and are thus excluded from the scope of pet health insurance. The ethical question, however, remains if these individuals should have a pet if their funds are so limited. Dispensable funds are a factor that cannot be influenced by the veterinary surgeon. Willingness to pay, on the other hand, may be influenced by empathetic communication from the veterinary surgeon. Communication needs to be improved not only in the consult room but also in the public, so there would be a better appreciation and understanding of the cost of pet health care. Further Perspectives and Conclusions for Practice As described in the article, PHI can be a positive contribution in the field of small animal medicine and serve as a valuable support in the treatment situation of small animal medicine. However, in Germany, so far significantly fewer dogs and cats are insured than is the case, e.g., in the UK. So how can the product be made more attractive so that more pet owners take advantage of it? Looking at the general functioning of an insurance company, it is a characteristic of the system that with a larger pool of insured persons, the monthly premiums decrease due to risk equalization: “The [risk equalization] in the collective finds expression in the fact that, under otherwise constant conditions, a growing collective size offers advantages. These advantages consist in the fact that, as the size of the collective grows, either the random risk itself is reduced or, with a constant (controlled) level of security, the insured total loss can be financed more favourably on average, making it cheaper for the individual policyholder to purchase insurance coverage” [29]. This means if the product were more attractive (both in terms of price and content), more people would likely take advantage of it. However, this only works with an increased pool of insured dogs and cats. Would mandatory health insurance for animals be a possible solution at this point? Fundamental challenges are already encountered in the design of the content [30]. Considering the models of health insurance from human medicine as a basis, a mixed model of Bismarck and Beveridge would be conceivable. PHI would therefore be subsidized by government funds. This state of affairs can be questioned as quite unrealistic, at least soon for our pets. Thus, excluding this subsidy, we are left with a pure Bismarck model, i.e., payment of health care costs from premiums without government subsidy. While this fact in itself sounds superficially feasible, it does not solve the fundamental challenges mentioned at the outset, which essentially relate to the design of exclusions and the assessment of premiums. How can the findings now be profitably used in practice? As the NAPHIA Press Kit recommends [16], the veterinary practice is the number one source of information for animal health insurance. With education about potential veterinary costs and recommendations to inquire about PHI, more pet owners will be made aware of the benefits of pet health insurance. Abbreviations DF Dispensable funds NAPHIA North American Pet Health Insurance Association PHI Pet health insurance RCVS Royal College of Veterinary Surgeons UK United Kingdom WP Willingness to pay Authors 1. Stiftung Tierärztliche Hochschule Hannover Institut für Tierhygiene, Tierschutz und Nutztierethologie (ITTN), Bischofsholer Damm 15, Gebäude 116, 30173 Hannover, Germany; peter.kunzmann@tiho-hannover.de 2. Stiftung Tierärztliche Hochschule Hannover Klinik für Kleintiere, Bünteweg 9, Gebäude 280, 30559 Hannover, Germany; holger.volk@tiho-hannover.de Correspondence: michelle.becker@tvd-finanz.de References available on request v Article
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