It's very difficult to convey how alien and horrifying accounts of how American health care works sound to a Canadian. Seriously, if I didn't know they were real - if, for example, I didn't know an American reviewer who died because she had to choose between paying her mortgage or having a doctor investigate her incapacitating chest pains - it would seem like something from a particularly silly Kornbluth and Pohl Garbageman novel. About the only thing about the US that seems even less believable is the collective enthusiasm for frequent mass murders.