The second reason insurance is so cheap is that people are reluctant to torture their pets for a scant chance at keeping them alive. Oh, sure, people do chemo on their dogs that they later regret. But most of them don’t keep doing it for years. When your pet is suffering relentlessly, you let them go. Especially since there is no elaborate government-funded system of pet nursing homes where someone can provide extended 24-hour care for a dog that can no longer walk or go to the bathroom by themselves. Since most people can’t quit their jobs to care for a sick cat, and wouldn’t want to put their cat through that year of misery anyway, much of the expensive “end-of-life care” we hear about falls out of the health insurance system.
I have to say, it raises questions about how such decisions are made about human beings. It's often said that about half of your lifetime medical expenses will take place in your last six months of life; what is all that money buying?