Insurance isn’t universal yet, but I do think it’s already causing price distortions in the veterinary market. I have used pet insurance for about a decade, and I have (anecdotally) seen both insurance become much more common and prices increase significantly. I think those phenomena are likely linked. My dog had several obscure, severe medical issues throughout his life, and while I loved him dearly and would have treated the issues regardless of cost, the insurance made it much easier to say “yes” to more complex or repeated treatments without doing any financial analysis.