We’re Not Number One; We Just Smell Like It

Okay, so after living in Ottawa for almost 2 years now, I finally have some access to medical care. I spent my first few months here calling around to all the doctor’s offices, clinics and hospitals; checking the online registries; talking to anyone and everyone about available family doctors. Mostly I just got laughed at – the very idea of a doctor accepting new patients was, apparently, absurd.

Only one clinic offered to put me on their waiting list. I waited. A few months ago (after 19 months on the list), I was summoned to fill out some paperwork in order to be short-listed. Then last week I was called in for an interview and assessment. Now, I will be assigned a Nurse Practitioner and will be able to make an appointment for a check-up. I’ll only get to see a doctor if something goes drastically wrong. That’s fine. I’d much rather deal with a Nurse Practitioner anyway. So, hurrah for me! I get health care!!

The US is hot into debates over health care reform at the moment. Opponents are warning American citizens that affordable health care will bring plagues of locusts on their heads and/or turn them into Canadians.

We shake our heads and smugly brag about our fabulous “free” health care. Afterall, we’ve been told since birth that we have the best system in the world, right? Oh there’s always some lacklustre discussion about making a few changes to our system, but it usually involves pumping more money into it…because it’s so damn good, it deserves to suck up tons of money.

We’ve been lied to. Canada doesn’t even have the second best health care system in the world. We’re not even in the top ten. We’re 30th according the World Health Organization (The US is 37th). And, Canada has the fifth highest expenditure for health care of any country in the world.  That doesn’t sound so good, does it?

Most European countries have great health care systems. Here’s what makes them great:

  1. Their health care system puts people first and responds to people’s needs. A novel idea, no?  They emphasize:
    • Respect for persons (including dignity, confidentiality and autonomy of individuals and families to decide about their own health). The latter is something I’d dearly love to be a part of. It makes me crazy that I get sent for tests and am not allowed to see my results or know anything about them until The Doctor has time to haul me in for an appointment to tell me there’s nothing wrong with me or that I have only weeks to live.
    • Prompt attention, access to social support networks during care, quality of basic amenities and choice of provider. (Choice of provider? What kind of crazy utopia are they running over there?) 
  2. Financing for the health care system is taxed according to net income and health care money is invested in training of health care providers and promotion of preventative health care. Hospitals receive funding and resources according to the type and number of services they provide rather than receiving a block of money which they have to use to pay the electric bill or something  instead of paying for nurses.
  3. Public and private health care services are integrated which, contrary to popular belief, has strengthened both systems. The competition has created innovative, responsive care and eliminated most of the inefficiencies our public health system enjoys.

And here’s an interesting fact. The World Health Organization has determined that populations with good health care systems also enjoy better health! Which, in turn, puts less demand on the system, making it even better. I shake my head in awe at the pure old world genius of it all.

So, hey ya’ll American friends — if you’re looking to vamp up your health care system, don’t look up here for ideas. Go talk to your best friend, France, because they’ve been number one for pretty much ever.


38 responses to “We’re Not Number One; We Just Smell Like It

  1. I’ve been saying for years (only I am no one so no one listens to me) that we should fund our health care system on a supply and demand model, NOT on an insurance model. The insurance model is so wrong on many levels. You just have to think for a second about what insurance is all about and how they hate to pay claims and you can see we have to make changes. Of course, I am no expert (it’s just my intuition talking) so I don’t have a plan but surely there are some brainiacs in universities who have already thought about this stuff.

    Interesting that Lebowski doesn’t like the French system. Having been in the Ontario system since August in a BIG way, I can say I have been treated well, especially by support staff but I am very vocal and proactive AND I have a life-threatening illness so I think I may be treated differently from those who just need maintenance.

  2. Funny… before coming here many people told me “…but they have a very good health system” and although I was not ever sure about it, I started to believe just because every single canadian I met was always so proud of it…

    Now I finally found one that is not! Good to have another opinion!

    Have a great day XUP… great post as usual!

  3. you are correct. it’s only that we always compare ourselves to the us of a that it appears we’ve got it goin’ for us. but we do not. glad you got some care though.

  4. Lebowski – I’d be interested to hear your experiences. Also, are these experiences from the perspective of a native French citizen, an expatriate, or a tourist? I think that’s going to make a big difference. Also, what services you required.

    Julia – You’re so right and I’m listening AND agreeing. And yes, since my daughter was diagnosed with her illness, she’s been able to access care. There are extraordinarily long wait times for procedures and appointments and a couple of 10 minute appointments usually take us all day with all the waiting in between, but they’re not ignoring her. But not being ignored is not exactly the pinnacle of good health care. I do know a couple of older people who desperately need heart surgery that ARE being pretty much ignored. On the other hand, I have also heard that they do manage to rally in emergency and life-threatening situations — most of the time.

    TTP – What have your personal experiences been so far and how do they compare with back in the old country?

    Raino – I’m happy I finally have access to basic medical care, too, but am still outraged at how getting that access became my part-time job and how many stupid answers I got from provincial ministry of health leaders (i.e.: Well, we have lots of kids in medical school right now, so when they graduate in the next 5 years things should open up a bit…THAT’S their plan? Are they doing anything to keep these students here once they graduate? NO.)

  5. Hear hear!!! I finally got a family doctor after years on the wait lists of most clinics in Montreal. Finally the doctor at my usual clinic had an opening – just as I had pretty much decided to start using that evil parallel private system in desperation.

    I don’t know how it is in Ontario, but in hospitals here, people are lying on stretchers in corridors for days waiting for a bed, Emergency room waits are up to 20 hours and health care workers are forced into double shifts because several years ago they retired tons of people to save money. The system still hasn’t recovered.

    When I look at the system my friends deal with in France I’m green – and not because I’m sick.

  6. Bobby’s had a cold since last Monday, so over a week now. At first it was accompanied with 5 days of ‘the trotts’. We hemmed and hawed over taking him to a walk in clinic just to make sure he was okay and decided against it because we knew the wait times would be ridiculous and that he would probably get something worse from the waiting room.

    Brent was all “I’m SURE we can call someone to come to our house”. I asked him when he had moved to a magical land…

  7. A few years ago, when we were in Paris on vacation, my bronchitis came back in a big way (might have had to do with all the smoke, but whatever). I needed to see a doctor and he actually came to the hotel for the exam. He called down to the pharmacist, who had someone deliver the prescription, we paid the doctor and that was that. I have never seen anything so efficient or so about the patient. There was none of that bullshit “I am a doctor and am therefore better than you” shit that you get here in the U.S.

    I was extremely impressed with their system. We need a major overhaul here. Unfortunately, our health care has become about making money, not treating patients with dignity and respect. We don’t make it affordable—even with health insurance—and then we wonder why people flood our emergency rooms and urgent care centers for basic care.

    Just another reason (the first being wine and food) I’d move to France.

  8. Ah, I remember when doctors regularly made house calls. Or the 80s, when you didn’t mind if your family doctor was running late because you knew you’d get all the time you needed to ask about everything you needed to ask when it was your turn. I’d be more than happy to sit in a waiting room for a couple of hours if I knew I wasn’t going to get the bum’s rush out the door at the end of it.

    Technically I think I still have a family doctor, but I haven’t visited her personally since she pissed me off in 2002 or 2003 — I deliberately go to the clinic when she’s not there on the rare occasions that I have to go.

    Routine care sucks now, which is why I avoid it whenever possible. For emergency care, most people that I know have gotten really good service. I know that I got extremely prompt and good care during the 2.5 years of my treatment after my PE. It made me realize just how sucky my family doctor’s care was. My mother got treated VERY quickly for her breast cancer, though her appointments for lithotripsy for her chronic kidney stones take so long that she’s already passed the original stones plus some by the time she gets there.

  9. Piping up here for the UK. Our system is expensive to fund throught the tax system but I think it is pretty good, all in all. I would hate to have to worry about finding money if I or my family were ill. The whole idea of having to pay directly for health care is anathema to the vast majority of Brits. The downside is a bit of lack of choice and waiting lists for some treatments, and of course you are paying for it indirectly through taxes.

    But if I decided right now (it is 7pm as I type) that I wanted to see my family doctor, I could walk into his surgery at 8.30 am tomorrow and be seen. Free. If I am really ill I could call him out overnight. Free. And if I am really REALLY ill, the hospital is 5 minutes down the road and is also free. In fact, if I am on very low income and have to go to hospital, they will refund me my travel costs.

  10. Jazz – Things are pretty much the same in Ottawa. I know lots of people flood our emergency rooms because the Gatineau hospitals always seem to quote 15 -20 hour wait times. Ours are only 12-18 hours, so I guess it’s worth the 20 minute drive. It’s good to hear you confirm the fantastickness of the French system. I’ve heard good things, too and got a little worried when Lebowski said something contrary.

    Tiana – Poor Bobby! And what a zany fantasyland husband you have! Doctors coming to the house – ha ha ha. If Bobby isn’t better, I’d take him over to CHEO. Tuesday mornings are supposed to be fairly calm at the emerg over there. Or any time that’s not Friday through Monday or evening. They look after babies pretty well there – better than at a clinic.

    Mo – Violetsky and I are buying a villa in France when we retire. You are most welcome to get in on this if you want. It’s going to be great.

    Louise – I remember doctors coming to the house, too…vaguely. I was very young. It’s not good that so many people are going without routine health care/preventative health care. There would be much less pressure on the system if people didn’t have to wait until they needed critical care to see a doctor.

    Loth – Ya, we have all that “free” stuff, too, except no options and no doctor’s making house calls and really, really long wait times unless it’s a life and death thing, in which case they can usually squeeze you in the same day.

  11. I’m curious about what Julia refers to when she says “we should fund our health care system on a supply and demand model, NOT on an insurance model.” I’m not familiar with this terminology; can someone clarify?

    When I think of “supply & demand” and healthcare, it’s in reference to the doctor shortage. Lots of places (like small towns) can’t get doctors to practise there, presumably because high-falutin’ doctors don’t want to live in those small towns, or they can get better wages in the big city. Though it’s hard to find a doctor in downtown Ottawa as well, as XUP notes.

    The main solution is to increase wages, on the idea that this higher wage will outweigh doctors’ repulsion of the area, or will encourage more people (who otherwise couldn’t afford med school) to take out debt to go through medical school on the promise that they’ll be able to pay it off with the higher wages after graduation. This is the same insane logic that assumes you can prevent crime by increasing penalties (on crimes with low reporting, charging, and conviction rates).

    The Cuban model (I highly recommend the documentary “¡Salud!”) takes people from these impoverished or underserved communities, and pays for their medical training on the promise that they practise in their community. The key is taking people from the community.

    In fact, the City of Ottawa is proposing to follow this model to replace its retiring food inspectors: http://www.ottawacitizen.com/Health/Plan+would+tuition+food+inspectors/1492939/story.html

    I should really get this eye twitch checked out….

    – RG>

  12. Thanks. I can see how the governments (Fed & Prov) aren’t keen on the supply & demand model, then, because it would be a nightmare to budget for. Makes sense from a customer/patient standpoint, though.

    – RG>

  13. My experience was as a resident of “La Belle Patrimonie”
    For a minor issue I ended up going to 4 different doctors before I got pissed off, flew home went to a local GP, was diagnosed and treated. Compared to France here was really quick and clean.
    The french system broke down to the point that you go to see a GP for a referral to several other doctors. All this of course is sucking at the public tit.
    Socialist bastards…

  14. Nobody really realizes how screwed up the health care is screwed up, until they (or a family member) have had to go through it themselves.

    I’ve had to wait 11 months for knee surgery. But that wasbn’t life-threatening. My Mom almost DIED during chemo/radiation. Because they just didn’t have the proper resources to care for her in the hospital.

    The problem is, the P.M. and all the Ministers never see this. They get special treatment, and get whisked through the system really quickly. (Remember Alan Rock and his prostate cancer?)

    Maybe the politicians SHOULD be forced to wait like Joe Public. Maybe THEN, they’ll actually do something about Health Care.

  15. PS. Getting a family doctor is so difficult where I live, that I’m keeping the old one I have.

    Even though now it’s 2-hour drive.

  16. Re: access to your own information….

    Hubby was sent for blood tests for cholestorol last year. He asked his Dr if he could get a copy of the results and, get this, the Dr wrote “copy to patient” on the top of the medical test request paper.
    They mailed a copy to our house.
    Just like that.

    He was sent for the same test again, a few weeks back.
    So, I wrote “copy to patient” on the top.
    They mailed it to our house.

    He still hasn’t been into the Dr to discuss.

    Don’t know if this works for all types of tests…but it’s worth trying….

  17. Perhaps should add that both the Dr and the medical test clinic mentioned in the above post are located in Ottawa. He went to the test clinic on Carling, near the civic hospital.

    On a different note – when I first arrived in Ottawa, no Dr’s were taking patients. I went to one of the Appletree walk in clinics. My permanent Dr is now at Appletree. It’s a kinda weird situation – you can’t make advance appointments (so no booking an annual a year in advance and comfortably forgetting until they give you the reminder call). Each time I need to see the Dr, I have to go on the Appletree website, see if he is working that day, at what location and during what hours (and check the wait time). When I show up at the clinic, I have to get in the walk in lineup like everybody else. It seems kinda random for a permanent Dr, but it works pretty well.

  18. A Canadian I used to know was a STAUNCH defender of their healthcare system and when, in my presence, a fellow Canadian said she could not get her back looked at for 3 months, right in front of me, an AMERICAN, no less this person got all flustered and and stuttered and stammered and and said, “That’s not true, that’s not right. I know people. I’ll get you in.” I’ve never seen a reaction like that. Apparently some Canadians really do believe they have the best healthcare system in the world. I’ve never been poor or destitute, so I’ve never had a problem with the U.S. healthcare system. The first time I broke my foot, I didn’t have insurance but it was only about $150 for the appointment and x-rays. On the other hand if I had not had insurance when I got pneumonia, that would have been a bitch. Not to mention the car accident when I was 19. That was 1980 and the hospital bill was about $11,000 (which is probably about a million dollars today). Of course if you’re really poor and not just a dumbass and don’t have insurance, that stuff is covered. Are you asleep yet? 🙂

  19. I live in BFE in california. Health care is awful here. I moved.here 9 years ago, and still haven’t been able to see an M.D. They won’t even put me on a waiting list!

  20. Congrats on FINALLY getting in (it’s like you’ve been trying to get into some fancy yacht club or something) but WTF? That is AWFUL. Our health care sucks so much ass down here right now, but you are correct: I think we do have a rose-colored glasses idea of what it’s like in Canada. I had NO idea. My employer is “self insured” which translates to they try to argue every single bill submitted to them by all our doctors in the hopes they can beat us into “pay it ourselves” submission. Our deductibles are for crap but I have not been without a doctor. Sometimes I have to cough it up myself (uh, so to speak) but I always know I can get care if I need it. I can’t imagine being in limbo all those months. That’s so scary.


  21. This is so fascinating. I can’t tell you how many times I’ve been in a room debating the problems w/ US health care and someone says “we should do it the way they do it in Canada.” Then I hear stories like these.

    The US obviously has some big problems (my little family of four pays well over $1,200/month for health insurance, plus we have tons of “out of pocket” expenses on top of that), but on the plus side we can get care pretty much the instant we need it.

    I’m not sure what the answer is. Perhaps moving to France is something to consider after all.

  22. Wow! This post got lots and lots of response.
    Me, too.
    1.) NP’s are the best kept secret in Canada. I go to a Community Health Centre, and I bet you do too or to a Family Health Team.
    2.) Tommy Douglas started us on this road. But he knew it would get rocky. He said that universal access was the first step and the second stage was to promote good health (my paraphrase) or it would not work.
    3.) We are running out of money to throw at the system; we are going to have to work smarter.
    4.) My one experience with an American hospital was very positive but I went in covered by GSMIP Out of Country insurance. Note, however, that they did not ask me about the insurance until they had assessed and treated me.
    5.) Our hospitals are not well run, in the main, nor used properly by Canadians.

    One of my hobby horses. Sorry!

  23. Hellfire, I thought you people were up there living in wellness heaven.

    I’m down here where every medical thing costs one billion dollars. I can get an appointment but everybody is brisk and business-like. I can get whatever I have to have…but I’m not ever sure I really have to have it AND my insurance is OUTRAGEOUS! I’ve had the same dentist for years, but the doctor’s keep changing as they all retire early (40s, 50s) because they have ONE BILLION DOLLARS.

  24. Lebowski – Interesting.

    Friar – Yes, I always find it amazing at how quickly the VIPs get medical treatment too. People must let them know that it isn’t that way for everyone, surely? I wrote to my MP, MPP, the minister of health and the ontario health ministry expressing my profound disappointment with the health care situation, especially in Ottawa. Halifax was a dream next to this city. They all wrote back with a lot of explanations and promises and some feeble attempts at assistance (call the registry of physicians and surgeons .. d’uh). I was seriously considering going back to Halifax to see my GP there every year, so I totally get your 2 hours.

    Yowie – Oh ya, you can always get copies of your tests. I’m talking about when you first go in for your tests. Why do you have to wait weeks or even months before you can get the results? Why do you have to wait for your doctor to call you in to explain them to you? The technicians are fully qualified to tell you what they see on their x-rays, aren’t they? Or failing that the results should be sent directly to you and your physician at the same time.

    Geewits – I believe I know which staunch defender of the Canadian health care system you are talking about if she’s a blogger because I’ve seen her defend the system on other people’s blogs. I was hoping she’d add her input here, too. Lots of Canadians have private medical insurance as well – often through their work to cover things that the provincial insurance doesn’t cover. Each province has slightly different coverage areas/levels as well. So, if I have to spend some time in a hospital and I don’t have private insurance, I’d probably spend it on a stretcher in the hallway. With insurance I can get a semi-private or even private room. And with an evelope full of cash and a nice bottle of scotch I might also be able to bribe an actual doctor to come and give an opinion on my condition. (Okay, I’m kidding about the last one). The only worry about the US system is that there is a middle ground of people who aren’t poor enough for assistance, but just don’t have enough money to pay medical insurance. It’s not cheap as I understand it? What would it cost for a comprehensive coverage for the average family of 4 for instance?

    Elizabeth – BFE?? You’re in the US and you can’t get a GP? I didn’t know that was possible – that’s where all our doctors go when they finish med school.

    Lesley – It would be awesome if you came to France with us, too. We could go to the doctor every single day and since we’ll be pretty old by then, we’ll actually have something to talk about with him/her each time. Then in the afternoon we’ll have a siesta on the beach after a lunch of bread and cheese and fine wine. A couple of times a year we’ll go to Paris to buy shoes. I can’t wait.

    Kimberly – Ah, thanks. I had just asked Geewits about the cost of medical insurance. That’s a lot of money, which I’m sure a lot of people can’t afford. What happens when someone who can’t afford the insurance, but also isn’t poor enough for social assistance ends up in the hospital? Is that automatically their one way ticket to homelessness? Cuz that would suck. We used to have a pretty good system. I don’t know what happened over the last 30 years.

    Mary G – Never apologize for having a hobby horse. And yes, my NP is at a community health centre. And it completely drives me crazy when they keep talking about shoving more money into the health system – it’s basically a triage system now – stick a band-aid on the ones that aren’t in imminent danger of dying; patch up the ones that are dying; bury the rest. Prevention seems like a huge part of the answer. Educate people; make healthy lifestyles more affordable and more attractive; make complemenatry practitioners more accessible. Really a large percentage of the problems that are clogging up our system are lifestyle related. Then there are a bunch that are environmentally related – a whole other ball of wax.

    Laura – Our doctors aren’t poor either, though I suspect our dentists are less poor. So, we obviously have the advantage in that when something terrible happens to you here, you’re going to get basic treatment without having to sell the house, the spouse and the kids. But like I mentioned previously, there are things our system doesn’t cover which sometimes includes life-saving treatments or tests or even surgery. People end up going to other countries to get them if they can afford it. Other people just make do with what IS covered and die.

  25. A big problem with medical care is that some greedy Canadian doctors move to the US where they get paid more. So we end up with fewer doctors.

  26. After my doctor retired last summer, I got on the waiting list for the West Carleton Medical Centre (a family health team) where I live. Took 9 months on the waiting list, but now I have a doctor, plus access to nurse practitioners, after hours clinic care, x-ray and blood lab, etc. I’ve called in the morning with a suspected case of strep in my daughter, and been in seeing an NP at 1 p.m. that same afternoon. I just booked my mamogram for next week and was given a range of times. I am really happy with the care I’m getting there.

    My pet peeve is when people describe health care in Canada as socialized medicine. It isn’t. In a socialized medicine situation, the doctors work for the government. In Canada, they own their own practices, just like in the U.S. The difference being that they have to deal with only one insurer — the government, rather than 10 or 20 different insurers (HMOs). It’s called a single-payer insurance system. And it means lower overhead for the doctor, since the practice only needs one person (in most cases) to deal with the insurance paperwork.

  27. Hannah – Well, having known a few people who went through medical school, they do some long years of pretty grueling training and end up with a HUGE debt. So, they have the option of working 12 hour days, 7 days a week seeing patients for 5-10 minutes at a time, in what is usually and outmoded facility for a not bad amount of money OR getting a big chunk of money up front just to go to the US; getting paid very well, working reasonably normal hours with a much lighter patient load in a state-of-the-art facility. Tough choice.

    Alison – Good for you! Did you not have to go through all this rigamarole with the short list and the interviews? I tried to book my physical, but now I have to go in for an intial consultation with my new NP first. They do say once I’m in their system, I can get an appointment within 48 hours and they have a full range of services available, too. We’ll see. I’ll keep you posted. Thing is, I don’t think a private insurance company would pay for 4 visits like this before any actual medical work has been done or pay for a doctor calling you in to give you test results or something where a phone call would have sufficed. Ours is certainly not a bad system in principle – it just seems to have imploded for some reason.

  28. @Hannah
    I’m with XUP. I dont’ think Canadian doctors are greedy…I think they’re underpaid, and they deserve to have a fair wage. They go to school for so long, they work their butts off after the graduate, and if they screw up, it’s a matter of life or death, literally.

    I’ve spoken to GP’s. After they pay their staff, and overhead and everything, they don’t make that much money. Not as much as you think. About the same (or less) as paper-pushing middle managers or sales reps, who have much less responsibility.

    When I lived in Montreal, doctors closed clinics out of protest. Towards the end of the month, the quota was used up and the govt. basically only paid them $~10 per patient.

    That’s a joke. Considering assembly-line workers make the equivalent of $70/hr with benefits.

  29. I’m glad you’re finally getting in to see someone! As much as I complained in that one post about our *former* doctor trying to charge us an arm and a leg (above the spleen and kidney we are already paying), we have access to wonderful healthcare here. I get test results. I was able to find a new doctor in the span of a day.

    I know most Americans aren’t as lucky. I’m thankful for what we have.

    We get what we pay for…I guess.

    Still. Good luck with your system!!

  30. Congratulations.
    I’ve also had a few problems getting a GP.
    It is the “interview” process you now need to go through that adds insult to injury (if you have one – if you don’t, it’s even worse, as you may be asked why you want a doctor?!). I was rejectd by 2 MDs as being “not suitable” One deemed me to be to be not a good patient because I indicated I wanted to also see a naturopath and combine the two. I could have lied, which might have complicated things considerably were I in need of prescription drugs, or had a serious illness.

    It’s good to have all these extra people with us in France – hope they are good cooks.

  31. “What happens when someone who can’t afford the insurance, but also isn’t poor enough for social assistance ends up in the hospital? Is that automatically their one way ticket to homelessness?”

    –Pretty much. In fact, Congress changed the bankruptcy laws to make it harder to file for bankruptcy due to medical expenses, because so many people in the United States were going bankrupt from medical costs.

    And heaven forbid that you become uninsured because you can’t afford to carry insurance, and then try to get back on. It’s basically impossible if you have any kind of pre-existing condition (and I’m not talking cancer or AIDS here, I’m talking like a hung toenail). In California, there’s a special program just for people who are trying to get reinsured, but have pre-existing conditions which cause them to be rejected. The waiting list for a consultation to see if you qualify? 18 months.

    It is interesting to hear a perspective on the Canadian health care system from an actual Canadian resident; I know ours sucks, and I firmly believe that a socialized (oooh….boogity boogity) system is the way to go, and clearly it needs to be carefully structured to avoid situations like yours.

  32. CP – Your system seems to work pretty well as long as you have the money to be part of it. It’s everyone else that’s in trouble apparantly.

    Violetsky – I thought I was making an appointment for a physical, but I have to have a “consultation” first. THEN, maybe I get some actual health care. And, no worries – I can cook and I love doing it. Also, Mo and Lesley are still young, so they probably won’t be joining us for a few years. But on the upside, they’ll be able to look after us when we get to about 100 or so and start slowing down.

  33. Meloukhia – I hope your government is wise enough to study all the options and create a combination of what’s best in all of them

  34. in some circles, we’ve been led to believe that your health care system is superior as well. based on what i’m learning from you and other canadian-folk it sounds really bad there.

    i prefer the nurse practitioners too, they seem to be much more effective.

  35. Pingback: The Canadian Health Care Battleground: One Soldier’s Story « XUP