NEW YORK - When my 8-month old puppy nabbed a chicken thigh bone off a plate and swallowed it whole, I was worried about many things, but the veterinarian bill was not one of them.
Standing at the front counter at the emergency clinic that Sunday night, with my children tearing up next to me, I was presented an estimate of $1,500 for manual extraction - which would jump to $2,500 or more if poor Brownie needed surgery.
Life or death depended on my willingness to put the tab on my credit card immediately.
This is the kind of situation that insurance was made for, and I had it. So I paid the bill and submitted it later for 90 per cent reimbursement, reducing my liability for this common puppy indiscretion to $150.
My easy answer to whether pet insurance is worth it? Damn straight it is.
Many people look at this calculus on a simple return-on- investment basis - Am I going to get out of it more than I put in? But the more pertinent question to ask is: How much are you willing to spend out-of-pocket for medical care for a pet?
The actual industry term for making the opposite decision is grim: "economic euthanasia."
Although Americans collectively spend more than $14 billion a year on pet care, our individual thresholds tend to be low. An annual survey of clinics by vet news website DVM360.com found that the stop treatment point for most clients was $1,433 in 2016.
The reason pet insurance got started in North America in the first place was to help owners avoid making life or death decisions about pets based on their ability to pay. Dr. Jack Stephens, a veterinarian from Boise, Idaho, started the first policy in 1981 because he was haunted by a dog he had to put down because the owners could not afford treatment.
Stephens founded PetsBest insurance, which now covers about 80,000 pets. That is just a fraction of the current coverage market of 170 million pets, which in itself is less than 1 per cent of the total pets in North America, according to IBISWorld's 2017 market research. The biggest players in the field are Nationwide, Trupanion and PetPlan.
In other countries, particularly in Europe, pet insurance has a much bigger impact, covering about 30 per cent of all pets in Sweden and 23 per cent in the United Kingdom.
"You always think it will catch on faster," Stephens said.
One big issue keeping pet plans from taking off is the same thing that plagues the human health insurance market and is causing such chaos in Congress: risk pools.
For insurance to work, you have to have the right mix of healthy and sick, whether it is cars, people or pets. With the right mix, companies are able to offer affordable coverage for common risks without going bankrupt.
Pet insurance plans used to resemble extremely limited catastrophic health plans, with stringent coverage and limits on pre-existing conditions. But today, they are more like silver-tier human health insurance.
My monthly insurance premiums for the puppy add up to about $700 annually for the top-tier plan, which includes wellness, accident, injury and prescriptions, with a $250 deductible. That was about my budget's risk limit.
Because I signed up as soon as I got the dog, I was able to capture almost all of her initial puppy vaccinations, which got me to my deductible quickly. I paid just $35 for her to be spayed.
After about five months, I was running slightly ahead of the cost, as the insurance had paid out more than I had paid in. The chicken bone incident put me about two years ahead.
"Everyone approaches it from a return-on-investment perspective, but when you think about it, there's no other insurance for which we do that," said Kristen Lynch, executive director of the North American Pet Health Insurance Association, the industry's trade group.
There is also no other pet product that incurs the same kind of financial scrutiny, Lynch notes.
Pet owners spend hundreds of dollars on toys and leashes, for example. "They constantly spend money on clipping and grooming," Lynch said. "They don't put a limit on it.
"But when it comes to vet spending, they'll say they'll wait it out," she added.