I recently saw a patient who moved here from Canada. Her history is one long horror story. She has had radicular pain for 5 years. For 4 of those years they kept sending her to PT, did some spine injections, and gave her increasing doses of methadone and gabapentin.She is now taking 60 mg of methadone every 6 hours and 1600 mg of gabapentin every 6 hours (well over the manufacturer's recommended maximum of 3600 mg/day).She was finally referred to a surgeon, and then waited 9 months to get her MRI, which shows impingement on the S1 nerve. She has no left Achilles reflex and is insensate to pin in the left S1 distribution. The Canadian surgeons recommended another 6 months of PT.She says it's almost impossible to find a specialist for anything, even if you self-pay. If I could stand the weather I'd set up a cash-only pain clinic in Detroit and have the Canadians drive over from Windsor. In the winter they could drive straight across the river like the bootleggers did.I managed to get her MRI done the same day she saw me and I will probably get her over to a surgeon by next week. I cannot wait until Mr. Obama gives me the opportunity to have "free" access to the same shitty level of care that Canada has.