The American Veterinary Medical Association’s (AVMA) indemnity arm will continue to exclusively promote a private pet insurance company despite a survey showing that most Veterinary Information Network (VIN) members polled object to the arrangement.
In separate statements to the VIN News Service, neither the AVMA nor the Group Health and Life Insurance Trust (GHLIT) directly addressed the survey results, which show that 70 percent of roughly 1,700 VIN members polled are “very uncomfortable” or “uncomfortable” with the AVMA GHLIT- Pets Best partnership decision.
Ninety percent of the survey’s respondents are AVMA members.
The statements do address, indirectly, negative perceptions pertaining to the GHLIT-Pets Best arrangement. In its statement, AVMA reiterates that GHLIT, although ultimately governed by AVMA, operates autonomously from the membership organization. To drive that message home, the Executive Board “would like to make it clear the AVMA in no way benefits monetarily from GHLIT ... AVMA does not endorse a specific pet health insurance company.”
The GHLIT’s version starts off by explaining that the Trust and Pets Best share the same underwriter, and their “exclusive relationship” is with Aetna Insurance Company of Connecticut. That account contradicts AVMA’s July 2008 initial notice of the arrangement: “Pets Best Insurance and the AVMA Group Health & Life Insurance Trust on Friday announced an exclusive relationship with a goal of educating veterinarians and consumers about pet insurance."
The GHLIT statement continues by explaining that the goal is to information veterinarians about the value of insurance for pets:
“By forming this relationship, we are taking an active role in shaping the future of pet insurance so it continues to provide valuable protection for consumers and provides veterinarians with the ability to maintain their client relationships while performing veterinary medicine without cost being a driver of care. ... We are committed to our pet insurance initiative and will continue to assist the veterinary community in gaining a better overall understanding of pet insurance.”
Still, those explanations have done little to quell critics’ contempt. Some AVMA members polled by VIN feel that the AVMA GHLIT is using their good name to endorse and legitimize a private insurance company. What’s more, detractors say a nonprofit like GHLIT has no business exclusively promoting a private insurance carrier, especially as allegations of nepotism and unfair business practices tarnish the deal’s reputation.
“The alliance between the GHLIT and Pets Best — and necessarily and irrefutably including the AVMA — is troubling to me,” says Patricia Khuly, a practitioner in Miami and VIN member. “... Our profession should not appear to favor any one brand in veterinary industry arena. Moreover, the appearance of impropriety raised by the potential for nepotism in this arrangement further accentuates the imperative for the AVMA to remain truly neutral. To my mind, neutrality is not achieved through verbal or written refutations of the reality of the relationship.”
The controversy Khuly alludes to first surfaced last July, as GHLIT made public its partnership with Pets Best, one of roughly 15 pet insurance carriers serving the U.S. market. The deal was designed to promote pet insurance inside and outside the profession as well as draw up general operating guidelines for companies in an effort to stave off insurance problems that have plagued human medicine. The GHLIT standards for pet insurance favor companies that operate with a system that reimburses clients instead of negotiating for reduced fees, which is the model in human medicine, according to the Trust’s white paper “Pet Insurance: Managing the Process to Promote Quality Medicine."
Despite those seemingly proactive intentions, the arrangement quickly soured in the minds of veterinarians and insurance competitors who consider the deal unethical and a conflict of interest. For starters, the partnership stipulates that GHLIT, a nonprofit tied to AVMA, will reap a portion of Pets Best profits to pay for overhead costs tied to marketing the venture. The criticism elevated when word got out GHLIT CEO Libby Wallace’s father is former AVMA Executive Vice President Dr. Bruce Little, now a member of Pets Best’s board of directors.
Wallace previously has explained to the VIN News Service that her hiring was unrelated to the Pets Best-GHLIT partnership or her father's prior position and adds that she has all the required skills and experience necessary for her seat.
That does little to placate critics like Dr. Christine Leone, a practice owner and AVMA member from Oakwood, Ga., who calls on GHLIT to end its partnership with Pets Best “immediately.”
To the general public, GHLIT’s endorsement of Pets Best appears as though AVMA and veterinarians, by extension, are in bed with a private insurance carrier, she says.
“The fact that the GHLIT will benefit financially on insurance sales because of this endorsement is disgusting to me as a holder of GHLIT insurance. ... The mere appearance of a conflict of interest between our national professional organization partnering in any way with a third-party payer of the very services that we provide is blatantly unethical,” Leone writes in a e-mail to the VIN News Service.
“I don’t even want to get into the fact that the former executive VP of AVMA sits on the board of this particular insurance company and his daughter is an executive with the GHLIT trust,” she adds. “I believe this kind of thing goes on at big businesses everywhere, so it doesn’t offend me anymore.”
What bothers Leone and others is the idea of pet insurance in general making its way into veterinary medicine.
“I may not live long enough for the market to become saturated and the insurance industry to begin controlling the fee schedules and decisions made in veterinary medicine, but it seems to me that if we as a profession go down this road, pets and their owners will end up in the same quagmire that the current health care system is in,” she says.
Proponents of pet insurance refute that suggestion. Pets Best founder Dr. Jack Stephens says the model of pet insurance that he promotes is a failsafe way to assure that indemnity programs can’t drive down the cost of services by circumventing the provider network systems on which human health insurance is built.
Pets Best, for example, administers an insurance plan that reimburses policyholders for 80 percent of their veterinary bill after a deductible, with no benefit schedule or fee restrictions.
Dr. Doug Kenney, a Memphis-based practitioner who authored a book on pet health insurance, believes that the 3 percent in royalties that GHLIT earns from Pets Best policies — earmarked for marketing and public education — did a lot to seal the partnership arrangement. GHLIT leaders appear genuine in their attempts to steer pet insurance away from the managed care model that’s infiltrated human medicine, he says.
Yet their efforts might be in vain.
“In reality, what can our national organizations do to take an ‘active role’ in shaping pet insurance? They can’t force pet health companies to follow their guidelines,” he says.
As for the GHLIT-Pets Best deal, Kenney fears that “otherwise arbitrary decisions” that are not in the profession’s or pets’ best interests might develop from the relationship.
“In the GHLIT white paper it says, ‘When recommending pet insurance endorsed by the AVMA-GHLIT to your clients ...’ Translation: Pets Best is the insurance company that you need to recommend to your clients. ... This goes beyond an endorsement,” he says.
Veterinarians like Dr. Adam Langer, active on VIN and in AVMA, doesn’t believe the partnership means AVMA or even GHLIT is trying to push a single pet insurance company down the throats of veterinarians.
For those who object to the deal, he recommends contacting GHLIT trustees or AVMA elected representatives.
“Concerned AVMA members could even seek to be appointed to the Trust board themselves,” he suggests.
Just how many will go that far will remains in question. Langer suspects that contrary to the VIN survey results, the large number of critics that the polling alludes to might not truly exist. He questions whether the survey reflects a large enough sample size to truly represent the opinions of more than 78,000 members.
“In addition, the discussions on VIN message boards might have influenced more VIN members who oppose the GHLIT arrangement to participate in the survey than VIN members who support the arrangement or members who don’t care, resulting in a potential systematic bias being introduced into the survey,” Langer says. “These limitations should be kept in mind when reviewing the results of the survey and deciding whether the results are representative enough to be generalized to all AVMA (or VIN) members.”
Dr. Doug Kenney also suggests that the controversy might be overrated.
“An endorsement by or partnership with any of our national associations will not cause me to recommend any specific company to my clients,” he says. “In the end, it’s the pet owner who ultimately decides what company they will purchase pet insurance from.”