A Well-Packaged Canine Health Care Plan

HMOs for pets? Indeed. The tentacles of managed health care have penetrated the animal kingdom. A facility called Pet Assure opened in New York City just last month--an “advance” being viewed with some skepticism among the hundreds of thousands of uninsured Homo sapiens.

I am among those who have never qualified for medical coverage. Preexisting conditions such as “headache” and “bruise” have rendered me uninsurable. But it is of some solace that my dog, Ernst, will have affordable and accessible health care.

The only pet HMO in my area is Dr. Belton Etc.

A licensed veterinarian, Dr. Belton had switched careers, having been caught up in the packing and shipping frenzy of the ‘80s. But recently, he found himself missing the animals. Though caring for his beloved creatures could never match the joy of charging $55 to tape a box, he nonetheless longed for the camaraderie he once enjoyed with the tick and tweezer crowd.

Ernst had been injured during a confrontation with an itinerant toad who caught him off guard and bit him on the nose. Ernst had an allergic reaction: His symptoms included a persistent itch and a level of sluggishness that I myself have managed to reach only once (1968, Mexico City).

I brought Ernst in to see Dr. Belton. The nurse asked me to fill out Ernst’s patient history and to describe any changes in sleeping or eating. I also was asked to list any abnormalities in “bowel-movement activity.” This confused me since I was unaware of any bowel movement “activity” other than the bowel movement itself.

I had not noticed anything out of the ordinary in regard to Ernst’s eating. At least not since 1994, when I reversed the positions of his food and water, out of a perverse need to reestablish seniority. His response was typically understated. Ernst’s daily sleeping tally had remained right in there, at 24 hours.

Soon, Dr. Belton called us in to the examination room where he scolded me for failing to mark down Ernst’s family history. I told him that Ernst had disassociated himself from his two brothers and three sisters. My understanding was that it had to do with a dispute over a willed piano, but I always suspected there was more to the story.

*

As Dr. Belton looked Ernst over, I read up on the mange mite. According to the literature, and passersby, the microscopic parasite lives its entire life cycle on the host animal. Pending legislation, however, promises to phase out this wanton dependence.

Dr. Belton studied Ernst’s toad wound and determined that my hound was allergic to toad dander, or possibly to pearl onions. He recommended an allergist. Together we perused the list of sanctioned specialists. One name appeared:

Allergists--For Zone 4 (includes all of North America; some Arctic referrals considered):

Dr. Belton (not accepting new patients, and seeing old ones only reluctantly).

Further examination of the HMO provider book revealed that Dr. Belton also was listed as a maitre d’ and flutist.

In his role as trusted gatekeeper, however, Dr. Belton refused to refer himself. He did offer us some sample medications. I thanked him profusely.

He said I owed him $75.

“My understanding was that the samples were free,” I said.

Replied Dr. Belton: “I thought you wanted them boxed.”