In Canada, studies find that the wealthy and powerful have significantly greater access to medical specialists than less-well-connected poor. High-profile patients enjoy more frequent services, shorter waiting times and greater choice of specialists. Moreover, among the nonelderly white population, low-income Canadians are 22% more likely to be in poor health than their U.S. counterparts.These results should not be surprising. Rationing by waiting is as much an obstacle to care as rationing by price. It seems that the talents and skills that allow people to earn high incomes are similar to the talents and skills that are useful in successfully circumventing bureaucratic waiting lines.No Exit. The worst features of the U.S. health care system are the way in which impersonal bureaucracies interfere with the doctor-patient relationship. Those are also the worst features of Canadian medical care.