The most significant distinction Dr. Ashley identified centers on patient volume and the structure of daily appointments. A family doctor who has worked in both Canada and the U.S. just laid it out clearly. That’s the ‘free healthcare’ that costs me $16,000 a year, 40 percent of my income taxes, which is part of healthcare in the budget in Quebec!” The other issue that Dr. Ashley won’t have to deal with in Canada is getting approval from an insurer who decides whether or not to approve her designated treatment for a patient.” It is important to note that the employment history, patient volume figures, and billing amounts described by Dr. Ashley have not been independently verified.