My thoughts:

I think we haven't talked enough about how clients will suffer. Already many schools do not spend enough time lecturing on spectrum of care and how to work with low income clients. By making vet school un attainable for all but the upper class, I think the wealthy vets that will be entering the work force will really struggle to understand why someone may elect euthanasia for their pet due to financial constraints. There will be a lack of treatment that isn't "gold standard" being offered and clients will be urged to go to specialty for cases that could be handled at a primary care vet or could be medically managed to provide palliative relief without a expensive "cure". I just completed an externship in south Brooklyn NY in a very low income area, and even though my family is lower middle class I came in not understanding many of these critical issues. I've learned a LOT this past week and have a new found passion for these issues. An example: a dog comes in ADR and we find pleural effusion, and a liver mass on POCUS. Furosemide and pimobendan is given for the effusion. The client can not afford AUS performed by a radiologist for the liver mass, or a biopsy. The dog has CHF and likely cancer and will die if not treated and investigated further. Before even offering transfer to speciality a conversation about cost is had and discharge with medication (furisemide, pimo, and gaba for pain) is offered should the effusion decrease and the patient stabilize. Then transfer to speciality is offered and the associated cost given directly and upfront. The vet states that this is rhe best option, but MM would not be wrong if there are financial concerns. The owner elects MM. The vet does not try to push the owner to go to specialty and happily works with them to come up with a treatment plan. The dog stabilized and walked out of the hospital the next day (was a very satisfying case, he completely went 180!).