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Medical wait times by country - 11/16/2012 7:11:38 PM   
tazzygirl


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For those of you under a national health system, I would love for you to chime in. Its been stated that wait times will get longer and people will die as a result of the pending Health Care Law.

I submit the following....

In 2007, the Commonwealth Fund released a report that compared U.S. health care against several other countries based on a variety of benchmarks. The data were principally derived from statistically random surveys of adult residents and primary care physicians from 2004 to 2006, in the following countries: United States, Canada, New Zealand, United Kingdom, Germany, and the Netherlands. This is what the researchers found:

* Canada had the highest percentage of patients (36%) who had to wait six days or more for an appointment with a doctor, but the United States had the second highest percentage (23%) who reported that they had to wait at least this long. New Zealand, Australia, Germany, and the U.K. all had substantially smaller numbers of people reporting waits of 6 days or longer. Canada and the United States, in that order, also had the lowest percentage of persons who said they could get an appointment with a doctor the same or next day.

* The United States had the largest percentage of persons (61%) who said that getting care on nights, weekends, or holidays, without going to the emergency room, was “very” or “somewhat” difficult. In Canada, it was 54%, and in the U.K, 38%. Germany did the best, with only 22% saying that it was difficult to get after-hours care.

* The United States, though, scored well on physicians’ perceptions of how many patients experience long waits for diagnostic tests. 57% of physicians in the U.K, and 51% of Canadian physicians reported that their patients experienced long waits for diagnostic tests, compared to only 9% of U.S. physicians who reported the same.

* The U.K (60%) and Canada (57%) had the highest numbers of persons who had to wait four weeks or more to get to see a specialist physician. In the U.S., only 23% reported a wait of four weeks or more for specialty care.

* The U.S. also did very well on measures of wait times for non-emergency or elective surgery. Only 8% of surveyed patients in the United States reported a wait time of four months or more for elective surgery, compared to 33% in Canada and 41% in the U.K. Germany scored the best, with only 6% reporting a long wait for elective surgery.

The take-away message is that both the United States and Canada do pretty poorly, compared to most other industrialized countries, on how long patients have to wait to get a regular appointment with a primary care physician or after-hours care, but the U.S. does better than most on having shorter wait times for diagnostic procedures, elective surgery, and specialty care. Each of these countries, though, with the exception of the United States, has universal health insurance coverage, funded and regulated in large part by the government, so it doesn’t seem likely that government-subsidized health care, in itself, is the sole factor in determining how long patients are stuck in The Waiting Place. Other factors, like the numbers of primary care physicians and specialists in each country, may be more important.


http://getbetterhealth.com/wait-times-for-medical-care-how-the-us-actually-measures-up/2010.02.02

As well as this....

The Waiting Times Myth

When I discuss health care reform with friends, families, colleagues, or in public, the two most pervasive myths about health care outside the US are that in every other country, care is inferior and rationing is accomplished by intolerable waiting times. As I endeavor to dispel these myths, I am invariably told an anecdote about a person who died in Canada or England awaiting some procedure or other.

Dispelling these myths is two-fold: first, pointing out the rationing that occurs in America either by private health insurers or by lack of wherewithal to afford services, and second, by pointing out that there are more health care systems than “ours” and “theirs.”

Given that an estimated 45,000 Americans are estimated to die every year due to lack of access to health care services, rationing in America is particularly troublesome, and oddly overlooked. There are many reasons for this, but mostly it is the lack of drama and, paradoxically, the pervasiveness of this experience, especially to those of us in health care. Anecdotes are powerful things, and so I have to always tell a few of my own to counter the horror stories they’ve heard about other countries. So, a few cases of my own: a man who puts off seeing a doctor (for what he knows is diabetes), ends up in the ICU critically ill, because he is trying to get on a health insurance plan and hopes he won’t be found out; a down-sized engineer with a year long persistent cough and weeks of coughing up blood, who waits until he is near death to come to the hospital because he can’t afford to see a doctor; and finally a young man with a seizure disorder admitted twice to the ICU for unremitting seizures in just a few months because his neurologist won’t see him because he’s been underemployed and couldn’t pay his last bill. Multiply my stories by nearly a million physicians in America and you see the magnitude and pervasiveness of the problem.

Beyond anecdotes, there is actual data, such as the Commonwealth Fund study showing that "U.S. patients reported relatively longer waiting times for doctor appointments when they were sick, but relatively shorter waiting times to be seen at the ER, see a specialist, and have elective surgery.” Additionally, Americans are less likely to have a regular doctor, less likely to get prescriptions filled, less likely to get follow-up care, less likely to keep a doctor long-term, and have a harder time getting taken care of nights and weekends. In another report, the Commonwealth Fund has shown the US ranks 19th out of 19 countries evaluated on preventing deaths that are amenable to adequate health care, an excellent measure of the overall performance of a country’s health care system.

That there is more than one country outside the US with a unique health system, might surprise some whose rhetoric suggests a vast wasteland of a series of Soviet style medical gulags. OECD data shows that waiting times are a problem in some countries, but only about half of those in the OECD. The others are like the United States in lack of significant waiting times, but unlike us they manage to do this with their entire population covered, and at significantly lower costs.

Now, let's do a little thought experiment. Say you are in a country that has relatively high waiting times for elective procedures, say Canada (but not England so much any more!). Take one sixth of your population and deny them access to care because, oh, they don't deserve it. What do your waiting times look like now? Take another sixth or so, and tell them they have to choose among school, dental care, glasses, food OR preventive health care. Or even life saving health care. OK, now how are your queues? Much better I expect. But what happened to your people?


By Dr. Christopher Hughes

http://www.drsforamerica.org/blog/the-waiting-times-myth#.UKcBGeTAfv4

I submit that our health care system isnt worth shit at this moment. The US doesnt even track wait times like other countries, so its very much like comparing apples to oranges. Yet the bolded part above says it all.

< Message edited by tazzygirl -- 11/16/2012 7:14:47 PM >


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RE: Medical wait times by country - 11/16/2012 7:21:12 PM   
yourdarkdesire


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Tazzy, I live in Canada, and yes, we do have issues with wait times. But it is due solely to a shortage of physicians. I see my general practitioner every three months for a medication review. Other than that I go to a walk in clinic, as my gp rarely does urgent appointments. When I first moved to my little city, there was one walk in clinic, but there were not open evenings, weekends or holidays. Now, there are at least ten. It has greatly reduced the demand on our emergency department for trifling things. Our ER numbers are better, with most patients being triaged, treated and released within four hours.

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RE: Medical wait times by country - 11/16/2012 7:29:31 PM   
tj444


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When i was in Canada I could get into see a doctor any time I wanted but I always used a walk-in clinic. I actually prefered that to hunting for a general practitioner doc.. the walk-in clinic had young docs so they were up on the latest medical stuffs.. (& they were cuter ) I had a chiropractor i would see and I would only be with him for like only a few minutes for him to get my back cracked, so I would call up his office and usually be able to see him in an hour or certainly that day..

There are ways around the health care system in Canada.. I know.. I know.. Canadians dont like to hear they have a 2 tier system but they do.. If you are a hockey player or pro athelete, you can get what you need now, if you are hurt at work, you get in now.. if you want to travel to another province and pay yourself, you can get in now, if someone else pays for your procedure (which is a loophole) then you can get in now (you can not pay yourself, someone else has to).. and of course, if you want to pay 2 to 4 times as much you can travel to the US and get in faster..

People will die in any health care system.. thats cuz what might not have been an emergency situation yesterday could be one today and so some people might not get the attention they need as a result.. and doctors do make mis-diagnoses and so there is the risk of death or a worse situation than they thought..

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RE: Medical wait times by country - 11/16/2012 7:43:46 PM   
erieangel


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A few years ago, I had a surgery planned. It was scheduled and ready to go. Then I went for my pre-op testing, just 3 days before the surgery. My blood test came back funky and the anesthesiologist refused to do the surgery. My surgeon referred me to the Regional Cancer Center for some tests and it took nearly a month to get in to see them. When I finally went in, they did a series of tests with the appointments so scattered that it was another month before everything was completed. I'm glad I didn't have cancer because I could died (at the very least gotten very ill waiting for all the tests). During that wait time, I did some reading on my own and when I saw my surgeon again, him giving me the happy news that I was healthy, I asked him if my medication could have caused the problems with my blood test. I was on lithium at the time. After talking at some length, he told me to speak with my psychiatrist, who took me off lithium and within a week my blood test came back normal. It was a lengthy scare for no reason and I'll never understand why the Cancer Center took so long to complete their tests.

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RE: Medical wait times by country - 11/16/2012 8:23:17 PM   
TheHeretic


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quote:

ORIGINAL: erieangel

I'll never understand why the Cancer Center took so long to complete their tests.




Simple. If the cancer is hyper-agressive, treatment will most likely fail anyway, and it's cheaper if you die before they start wasting money.


ETA: I had a blood test come back with some scary results last week. They had it straightened out within a couple hours. Spooked the wife, when I got the call to get my ass to the urgent care immediately, but otherwise, no problem. Even had the Dr. call me at home the same night.

< Message edited by TheHeretic -- 11/16/2012 8:28:16 PM >


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RE: Medical wait times by country - 11/16/2012 8:24:56 PM   
Aswad


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It's interesting to note that only 9% of the physicians in the US are dissatisfied with the waits, when more than half of the UK physicians, whose patients don't need to wait as long, are dissatisfied with the waits. Also interesting to note that this is seen as a metric in favor of the US, when what it really states is that US physicians don't have the same desire to improve as UK physicians (who are already doing better!).

It would be interesting to see how Sweden compares on these points.

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RE: Medical wait times by country - 11/16/2012 8:31:19 PM   
JeffBC


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The thing that needs to be understood here Tazzy is that the people who say this just plain do not want to know. America shares what??? 3000 miles of border with Canada. If we actually wanted to know what the health care system is like here we would. Our leaders actually DO know which makes you ponder why they won't do anything about it? No, I don't see Obamacare as doing much to solve the problem although it was at least a nice token gesture.

For me, as an American expat living in Canada I just have to laugh at the stories I have heard from Americans who know nothing. We've been here long enough and we circulate with an old enough crowd that we've already seen lots of examples of medical care being delivered... both critical and not. Our own observation is that the critical stuff gets dealt with promptly and efficiently... in at least one case for us... same day. The less critical stuff takes a bit of time but not shocking dissimilar from what I'm used to in the states. And I get all this for a monthly rate that could easily be consumed in a few copays under the american system. In a more or less apples to apples comparison we pay roughly 1/5 what we paid in the US. We also pay less in copays so the actual figure might be closer to 1/6.

Wow! It must be magic. Hard to believe those backward Canadians figured all this out when our brilliant leaders from both parties can't seem to imagine it working... despite the fact that it clearly does.

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RE: Medical wait times by country - 11/16/2012 9:46:57 PM   
tj444


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quote:

ORIGINAL: JeffBC

Wow! It must be magic. Hard to believe those backward Canadians figured all this out when our brilliant leaders from both parties can't seem to imagine it working... despite the fact that it clearly does.

and they figured it out many decades ago..

I like that you are an ex-pat American, you can give an unbiased opinion having lived in both countries & systems..

I dont know if Obamacare will work very well or not.. but cuz the US health system is majorly profit/greed motivated, its still gonna cost a lot more than what Canadians pay..

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RE: Medical wait times by country - 11/16/2012 10:13:01 PM   
Aswad


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Obamacare is a first faltering step into the next stage of civilization; not a perfect step by any stretch, but as profound as any first step, and a century hence, history books will have a section titled Obamacare. Largely thanks to the GOP, it is a near certainty that Obama's name will live on as long as the USA itself does. Or, as Adama put it in BSG, "Immortality, as only the gods once knew.", which has to irk them a little bit, or at least probably will once the dust settles and they realize how they've elevated their "mortal enemy". Whoever actually gets the US to the point of walking steadily will seem forgotten by comparison.

IWYW,
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RE: Medical wait times by country - 11/16/2012 10:19:14 PM   
tazzygirl


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Its sad. I never thought of it that way. I do know that many believe if you keep the "masses" dirty, tired, hungry and in poor health, they can be controlled easily with few promises.

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RE: Medical wait times by country - 11/17/2012 4:05:55 AM   
JeffBC


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quote:

ORIGINAL: tj444
I like that you are an ex-pat American, you can give an unbiased opinion having lived in both countries & systems..

In addition, my insurance both before and after moving was not covered by any corporation so I'm actually aware of the real costs for medical coverage. Really the idea that someone might think of the US system as better is just plain ridiculous. And that opinion is coming from a guy who spent his life as a white collar worker covered with corporate health care. In other words, I had it pretty good in the US and still what I see here is VASTLY superior. I can only imagine how the difference would look to a walmart employee.

I find it telling that when Carol and I were totally uninsured in Canada routine office visits were still cheaper than under our very nice corporate coverage in the states. Yes, that's right.... the CO-PAYS in the US amounted to more than the total price tag of such a visit here in Canada. Obviously that wouldn't be true for a hospital stay but it's still an interesting observation.

The funny thing is that it's not like the wealthy don't have their perogatives here in Canada. Of course they can buy additional insurance and/or make other arrangements and have whatever level of health care they desire. And I'm sure they pay less for the privilege than a similar person in the states would. It's an everyone wins situation.

quote:

I dont know if Obamacare will work very well or not.. but cuz the US health system is majorly profit/greed motivated, its still gonna cost a lot more than what Canadians pay..

That is fundamentally the problem with much of the US. When one considers CEO pay multiples (520:1 or so in the US and 25:1 in Canada) it's easy to see right away where part of the cost savings is. Basically, the US economy has a lot of fat, bloated leeches hanging off of it and they are sucking the life out of it. So at least right now I expect the conservatives are correct. Obamacare is only going to serve as a pipeline to shovel yet more money into the hands of corporate executives and bankers. I doubt much can help America until the tea party and occupy wake up and realize that they have many common causes and work together at least where they agree.


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RE: Medical wait times by country - 11/17/2012 5:12:33 AM   
kalikshama


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quote:

Our own observation is that the critical stuff gets dealt with promptly and efficiently... in at least one case for us... same day. The less critical stuff takes a bit of time but not shocking dissimilar from what I'm used to in the states.


This is my experience with healthcare with the VA.

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RE: Medical wait times by country - 11/17/2012 6:20:42 AM   
Zonie63


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quote:

ORIGINAL: tazzygirl

Now, let's do a little thought experiment. Say you are in a country that has relatively high waiting times for elective procedures, say Canada (but not England so much any more!). Take one sixth of your population and deny them access to care because, oh, they don't deserve it. What do your waiting times look like now? Take another sixth or so, and tell them they have to choose among school, dental care, glasses, food OR preventive health care. Or even life saving health care. OK, now how are your queues? Much better I expect. But what happened to your people?


By Dr. Christopher Hughes

http://www.drsforamerica.org/blog/the-waiting-times-myth#.UKcBGeTAfv4

I submit that our health care system isnt worth shit at this moment. The US doesnt even track wait times like other countries, so its very much like comparing apples to oranges. Yet the bolded part above says it all.


In my dealings with the health care system, I've found it to be somewhat hit and miss. I've learned how to navigate the system and get health care for people I work with, some of which comes down to finding the right doctors. Specialists are hard to come by, sometimes a 3-4 month backlog (or longer).

Actually, a far bigger headache is in finding dental care. Dental insurance is often separate from medical insurance, and it seems to be a lower priority. I don't know if this means we'll be seeing more people with missing teeth and gumming their food, but it seems like we're heading in that direction.

Mental health is another area where funding has been cut, so it's very difficult for people without insurance or a lot of money to see a psychiatrist. (And even for those with insurance, behavioral health is a rather limited offering.) That's another matter of concern regarding all those potential "ticking time bombs" that might be out there.

Then there's the pharmaceutical industry, having to deal with prescriptions and what the insurance companies cover versus what they don't cover and whether or not you can get a "pre-authorization." One has to look at the different insurance companies' formularies to find out what's covered and what's not and compare. I've known people who have had to switch insurance companies for this reason.

It's the insurance companies who seem to be driving the train in all of this. They seem to be doing okay. It seems the CEO of United Healthcare made over $100 million in 2010, the highest paid CEO in America.

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RE: Medical wait times by country - 11/17/2012 8:28:51 AM   
Aswad


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quote:

ORIGINAL: tazzygirl

Its sad. I never thought of it that way.


It was one of the first things that struck me.

quote:

I do know that many believe if you keep the "masses" dirty, tired, hungry and in poor health, they can be controlled easily with few promises.


It's easy enough to control the masses, but education (in all forms, including media) or the absence thereof is probably the most powerful.

IWYW,
— Aswad.


_____________________________

"If God saw what any of us did that night, he didn't seem to mind.
From then on I knew: God doesn't make the world this way.
We do.
" -- Rorschack, Watchmen.


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RE: Medical wait times by country - 11/17/2012 9:04:53 AM   
nameonhold


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I honestly don't want to debate the appropriateness of various wait times for non-emergency situations. The reality of the matter is that the medical community has to deal with a LOT of non-emergency crap that is flooding the systems.

There have been three times over the years that I've legitimately needed emergency care. About 25 years ago, I managed to put a very large spring, not the ball point pen kind of spring, a garage door kind of spring, completely through my hand. That's right, in on one side of my hand and out the other.

I got myself to the ER and walked in with the spring through one hand, and then draped over the opposite shoulder. I walked into the waiting room and the nurse immediately got a doctor. The doctor looked and asked, "Are you in a lot of pain ?" I said, "Yes." The doctor said, "Okay, I just need you to be patient with me for 5 minutes, I just need to clear a bed for you in the ER and I'll get you in there immediately." And with that, another woman seated in the waiting room gets up, walks over, waving her index finger in the air and says, "Doctor I've been waiting to get the bandage on my finger changed for two hours !"

The second time I need emergency attention, I was driving to work, I had a 'medical issue' while behind the wheel. I crashed. The EMTs were on me in 90 seconds. I was in the local ER in under 20 minutes. They had a helicopter there in 15 minutes. They were rolling me out in the parking lot as the helicopter landed. I was in the air in under 3 minutes. I was in the ER of the "Big City Hospital" in 28 minutes. They had me in surgery in under 20 minutes. Altogether, a total of 87 minutes from the time of my accident, through two emergency rooms, traveled 45 miles and in the operating room of the hospital 45 miles away.

The third time, I crashed my bicycle in the middle of a triathlon. Eleven broken bones and a fist full of internal injuries. The EMTs were on me in under 4 minutes. I was in the local ER about a mile away in about 5 minutes. They patched me up, stabilized me, and called the helicopter again to ship me off to the same "Big City Hospital." This time, I just landed in the ER of the big city hospital, no surgery, and it only took two hours, almost right on the button.

Now I don't know about you, but all three of my experiences over a 25 year period of time, involving the medical communities in three different states, in both rural and big city areas, is that, "when necessary" .... the medical community moves their asses PDQ (Pretty Damn Quick), and appropriately so.

I'm alive because some medical folks "wiggled their ass." I'm not sure I've got a lot to complain about. And truth be told, I really don't much care that the doctor tells me I've got to wait a few weeks to do my shoulder surgery because my collar bone didn't heal properly. My collar bone is not a damn emergency today, tomorrow or any time next week. Meanwhile, there are people who need attention pronto. Give the attention to the folks who need it pronto. My "com-padres" and I, we can wait. Do you have a magazine rack Doc ?

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RE: Medical wait times by country - 11/17/2012 9:33:43 AM   
tazzygirl


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ER / Triage is different than what we are discussing as a whole. I would expect based upon ABC's (Airway, breathing and circulation) that your conditions would move up to the top of the list.

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RIP, my demon-child 5-16-11
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Dont judge me because I sin differently than you.
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RE: Medical wait times by country - 11/17/2012 11:24:45 AM   
tj444


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quote:

ORIGINAL: Aswad
It's easy enough to control the masses, but education (in all forms, including media) or the absence thereof is probably the most powerful.


I definately agree with you there, education IS the most powerful..

my mother lived in Europe and her parents and grandparents lost their home & business due to the 2 wars, it was all just taken away from them (they werent Jewish either).. she would tell me "you can lose everything but what they cant take away from you is what you know"..

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RE: Medical wait times by country - 11/17/2012 4:19:09 PM   
leonine


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quote:

ORIGINAL: Zonie63

It's the insurance companies who seem to be driving the train in all of this. They seem to be doing okay. It seems the CEO of United Healthcare made over $100 million in 2010, the highest paid CEO in America.


Well, duh. That's why Obama was forced to leave them in control, just give them some Government money, instead of creating a real healthcare system that would take them out of the loop.

The British PM who created our National Health Service only had to deal with the top doctors' lobby, and at that he had to give them featherbedded contracts to keep them on side. If we'd had a US-style insurance industry, he wouldn't have had a chance.

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RE: Medical wait times by country - 11/17/2012 5:14:13 PM   
erieangel


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But somehow, Vermont has thus far managed to get all stakeholders in agreement for a single-payer system in that state. It is scheduled to go online sometime after the full implementation of the ACA in 2014. And they will have to get a waiver from the Obama administration because they will not be following key provisions of the ACA--like the part that states employers must provide health care if they have 50+ employees. For the first time in this country, health care will be viewed as a right granted to everybody and not attached to one's job.



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RE: Medical wait times by country - 11/17/2012 6:03:49 PM   
defiantbadgirl


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I love Vermont and I'd move there if the cost of living wasn't so high.


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