I work in the health care system, and I see first-hand how caring the doctors and health care professionals are, and how they will move mountains if necessary to help anyone who needs help. If you think that sounds a bit melodramatic, it's not. I have seen doctors spend hours with patients who have been diagnosed with serious or life-threatening illnesses, making sure the patients get the help they need with medical attention, diagnostic examinations, treatment and even providing outreach workers to help the patients psychologically in addition to their medical help. In British Columbia, a patient can have an x-ray done at a northern outpost, the x-ray can be posted to a grid and read instantly by a radiologist in Vancouver. The same applies to other laboratory and diagnostic tests. And if treatment is required, the patient receives it immediately. There is a province-wide computer network of all patients' medications, so no patient can "doctor shop" for duplications of medications, or inadvertently take medications that have adverse effects on each other. In other words, we have actually progressed from leeches and blood-letting.
So, I was quite pleased to read the following article in today's Vancouver Sun newspaper:
(Vancouver – March 10) Research published today in the New England Journal of Medicine sheds new light on which Hodgkin lymphoma patients are likely to relapse after receiving treatment.
BC Cancer Agency researchers have discovered that the number of macrophages – a type of white blood cell that normally scavenges foreign material – found in a patient’s tumour had a strong correlation to treatment outcome. The greater the number of macrophages; the greater the likelihood of a relapse.
Hodgkin lymphoma is a cancer of lymphocytes which typically affects young adults, but can occur at any age. It is a highly treatable form of cancer, with about 75 to 85 percent of patients cured with initial treatment. However, if the first therapy fails, secondary treatment usually includes a bone marrow transplant, which is only successful for about one-half of these cases.
“The study demonstrates that high numbers of macrophages are associated with treatment resistance in Hodgkin lymphoma suggesting a way to identify the 25 percent of patients who currently don’t respond well,” says Dr. Joseph Connors, one of the study researchers and clinical director of the BC Cancer Agency’s Centre for Lymphoid Cancer.
The research was conducted with funding from the Canadian Institutes of Health Research with additional funding from BC Cancer Agency Centre for Lymphoid Cancer, the Michael Smith Foundation for Health Research, the Lymphoma Research Foundation, and the Cancer Research Society of Canada.
In a perfect world, no one would ever get sick, but unfortunately that's not the case. As I have said many times before, I am puzzled as to why a wealthy country like that big country to the south of us has such spotty health care -- two different systems for the haves and the have-nots. We love our cousins to the south; they're Canada's best friends, and we hope they get their health care problem fixed, and we hope they get it right. Whatever works for them is definitely the best solution. And what works in Canada may not work for them, but perhaps we here in
Cheers,
33 comments:
ARRRRGGGGGHHHH... don't get me started on the backward, punitive, arcane, discriminatory, wholly inadequate ways in which healthcare is and is not doled out in this country to the south> There IS not system. YES, we could learn from YOU, from France, FroM Great Britain, from Sweden, from SO MANY countries.
I pay $700/month for health insurance. I pay $35/month for my meds. $45/PT session or doctor's appointments... $1000 deductible for any one day hospital procedure. I cannot have my colonoscopy this year--I'm in a high risk pool--because I haven't the money to pay for it. And I have insurance.
Oh, Jo, it is terrifying to be chronically, seriously ill in this country. You know I am selling my house. Why? Because I haven't the money to live. I am applying for social security disability for the third time in my life (I worked OFF it twice) so that I can possibly get Medicare and ... because THAT doesn't cover enough, supplemental coverage. It will still be less than HALF what I pay now.
I keep my insurance but I have to charge it. And I cannot renew it because the policy is dependent on my being able to work, which I cannot. And so it goes.
Big government has a purpose. One of those is to see to it that citizens can ave access to necessary health care. Okay. I don't have to have access to Botox. FINE. And of course, forget about dental care...
Sorry. Jo,my parents used to be apalled at the lack of universal coverage when I was a little girl.
I'll be interested to see what people write. Sorry. I went off a bit here, but... when I was working, made good money, I STILL believed healthcare should be universal, and "premiums" should amount to paying something in our yearly tax returns, to assure that EVERY person could have colonoscopies to prevent cancer, could have whatever tests or procedures are necessary to preserve life AND quality of life.
Hats off To Canada. Is your system perfect? Oh, I am sure it is not. BIG WHOOP. Are people working to improve it? My guess would be, umm yes.
Good night.
Jeanette, you are a case in point...! We don't even have to think about health care here in Canada. It's waaaaaay down the list of things we have to worry about. A story such as the one you just told me would be absolutely unheard of here in Canada. I don't understand why the U.S. is afraid of socialized health care. There must be millions and millions of Americans in your very same situation!
Jo, you are preaching to the choir. Everytime I watch a program called "Critical Hour" (show all about Level 1 Trauma Unit)it takes place in Canada (Toronto I believe) all I think about thruout the entire show (amidst the gore and top of the line Medical equipment) is 'wow, they don't have to have the absolute fear and despair that one feels of being in a hospital with a fairly traumatic injury and not have health insurance" I am not kidding. I think about it as they do all the services that top notch medical facilities do. Does mean in America we don't care about our own people? Maybe to a degree some don't. And don't worry Jo, most of us in America by no means buy the "load" of propaganda the supreme "beings" are trying to sell
very interesting topic and I will be checking back to see what the other commenters have to say.
I live in fear everyday that we will lose all we have worked for due to my health problems, and we have the 'cadillac' of health care coverage. The co-pays alone could bankrupt us. It must change, it just has to.
Hi Jo,
A friend of mine (Canadian) recently travelled to Europe. She met some travelling Americans who were most interested to ask about our health care system. They were under the impression that we Canadians are not allowed to choose our own doctor. She cleared up that misconception as well as a few others. She said it was not the first time she'd met Americans who had questions about our system. THEY bring it up!
They do get a bit hung up on the "socialist" concept, but when we explain that they already have a socialized public school system, socialized police forces, socialized military....they get the idea. Everyone pays through taxation, the service/benefit is available to all, no one gets a bill...makes sense, doesn't it?
I've heard of people in the states declaring bankruptcy or losing their homes over medical bills. I've heard of people not going to emergency because they couldn't afford it. I've heard of people being denied medical coverage because of pre-existing conditions. Can this all be true?
I hope some more Americans join in this conversation.
Jo, they don't get it and never will. It's part of their national personality ... remember this is the same country who's mantra is "the right to bear arms" ... so, don't expect their health care system to change any time soon. The Insurance companies rule down there.
As for our health care system ... well, it's pretty good, but definitely leaves alot to be desired. when I nursed at Lion's Gate, a doc ordered a scan on a patient who's e/c was flank pain, and pins and needles on stretching. The radiologist denied doc's request, stating insufficient clinical evidence to support need for scan. The doc arranged for the patient to have scan at St. Paul's ... this included arranging expensive transportation, escort, etc etc. In the end? Yes, the scan showed Multiple Myeloma.
Nice, huh? (NOT).
The very last day I ever hospital nursed was a day that a patient (who'd had a brain stem CVA and got prematurely transferred to my ward from ICU) coded after pulling on his trach. and causing it to go intersitital. Why did this happen? Oh, because staffing refused to send me an aide to sit with said patient so as to prevent him from pulling out his trach. How many patient lives is a little overtime worth?
I cannot tell you the number of times when patient care suffered severely because of ignorant bean counters at the management level who have NO clinical experience!
In some ways, I think our health care system is inferior, because it reduces everyone to the lowest common denomentator ... and also to the bottom line.
And, that's why I left the nursing profession ... and refuse to ever return to nursing practice, depsite the very enticing $40/hr wage I could earn.
Re: Great Britain ... I lived there for a time. I would not ever, ever, want to receive hospital care there! It's a pathetic, scary, unsafe health care system. Seriously.
And this is so sad ... because health care is a basic life requirement and we all have a bunch of nitwits running the show. No one ever thinks to ask the nurses, do they?
GRRRRrrrrrr. And now, I shall get down off my soap box!
:^)
Oh the more I read about the system in the US the more I am pleased about our universal system in Australia. Every country struggles with an effective health infrastructure but at least I, and you too, know that we will not be left out in the cold. For example, my father is on an old age pension here, if he gets ill he gets picked up by an ambulance which costs him nothing, he goes to hospital and it costs him nothing even if he is required to have operations. The care is very good all things considered. As for me, I get charged extra in my tax if I do not have private medical care. Even if I don't, I have my choice of doctor, I get a rebate for medical visits and I would get treated at a hospital. The only issue would be elective surgery. If I did not have private health insurance I would have to be put on a waiting list. If I had insurance I could get in relatively quickly. I understood also that a lot of Amercians went to Canada for health care treatment.
It's a universal issue and I hope that those in America get a more equitable system.
The health insurance companies are such blood-sucking parasites, it'll take a revolution to dislodge them. They're not giving up oodles of this free money made off human misery - who would?
They're the ones smearing Canadian health care.
I don't understand what insurance is doing in the medical field anyway.
On the other hand Americans themselves aren't demanding a fair deal, that's why they're not getting one.
Wow, those are some interesting comments! I also hope we Americans can get our health care fixed, but I'm not optimistic. I had to wait until I turned 65 before I could even consider retirement, because then I could have some help with Medicare. I cannot bear to watch any more, because I keep hoping and then being let down... I would be a Canadian if they would have me (they won't).
This morning I watched a commercial put out by the insurance companies here in the states.
It shows a man who was badly injured in a car accident and said he had to have several surgeries.
The commercial went on to say "If this had happened to YOU what type of medical care would YOU want? A state run, government, inefficient system that treats all people the same?
Or a privately run, highly specialized, state of the art professional medical care system that keeps abreast of the latest technologies and provides the best care in the world?"
Hmmmm.... let me think about that. Poorly run government system or state of the art prviate care? Hmmmm......
Don't you love it? There is a saying: If you tell the same lie enough times, people will believe it.
Both my parents are extremely conservative. Anti-socolized medicine. Both of them cheered on their 65th birthdays, when they FINALLY qualified for Medicare. Because as my mom said, "It means that I can actually bring home a paycheck instead of all of it going to healthcare preimum."
But ask either of them if they think we should have publif option and their answer is a resounding. "HELL NO!" I honestly don't get it. I don't understand this kind of thinking at all.
I have delt with illogical health insurance compaines since I was 16, when I qualified for health insurance, but my newborn daughter didn't. And now, I have the luxury of living in a city with one of the best cancer treatment centers in the world... but its not in my insurance "network". Oh I still go there for treatment of my rare illiness, but I will forever be swamped in medical debt because I have a $2000 a year dedubale. (Which I have reached every Janruary for the past 5 years.)
And if people like my parents can have a daughter who is forever dealing with the very real struggle of having to pay out of pocket medical costs she can't afford, and they themselves feel like the weight of the world was lifted off their sholders the day they no longer had to pay $800 a month for medical insurance and can STILL honestly tell you that they are AGAINST a public option, then really... there is no hope.
McIndesm, I cannot even imagine being ill or injured, and having to worry about paying for the medical treatment. The whole concept is foreign to me. And Canada's medical care is one of the best in the world.
JoJo, I hear stories like yours evry day, and it amazes me that in the United States those things are allowed to happen. I fear, though, that the health care reform is going to fail, and you folks will all end up right back where you started, sadly...
Kathryn, oh, yes ... the pre-existing conditions are a loop-hole the insurance companies in the States use in order to deny coverage for almost any medical condition. It boggles the mind. How on earth has that been allowed to go on for so long???
Roxanne, that radiologist at Lion's Gate Hospital should have been fired. If a doctor orders a test, another doctor is not allowed to refuse it. I'm sure there was an enquiry into that one, especially since the patient was found to have Multiple Myeloma. I have never heard of that happening before...! Shocking...!
Lilly, your system in Australia sounds very similar to ours. And your medical care is amongst the best in the world too. No one gets substandard care because they "can't afford to pay for it". And yes, it's ironic that more Americans come to Canada for health care, than vice versa -- including Sarah Palin...!
Wolynski, I think Americans are buying into the lies being told by the insurance companies. Did you see "Sicko" by Michael Moore? He said it best. Americans deserve better, and this is their chance.
DJan, I hear stories like yours all the time too. It boggles the mind that in the wealthiest country in the world, so many people can't afford basic health care.
Russell, "A state run, government, inefficient system that treats all people the same?" Isn't that silly? Of course everyone should be treated the same. Here in Canada, the rich and poor get the same health care.
Katy, I think the folks in your country have been brain-washed against anything that has the label "socialism" attached to it. But as Kathryn says, you already have a socialized public school system, socialized police forces, socialized military, and everyone is okay with that. Why not socialized health care? It doesn't make sense not to have it.
Oh Jo you know this topic is near and dear to my heart.
I loved reading the comments. Kathryn's comment hit me the most. She mentioned how our dear cousin's to the souch see health care as "socialist" The word Socialist to our dear cousins seems to be such a dirty evil word. I get the very strong impression they see it next to...hold me back I am going to say it......"Communism". I remember not to long ago watching an American documentary when the politicians were saying just that...they put fear into them saying that social programs are the next thing to communism. I just don't understand that train of thought.
I grew up with universal health care, and I am so thankful for it. Like you I have seen doctors go above and beyond the call of duty. I won't go into a long story here but my mother inlaw was diagnosed with terminal lung cancer in December. She ended up in the hospital, the doctor there who did know my mother in law at all spent hours on her case, calling specialists at the hospital and in Victoria, he coordinated so much of her care, which he didn't have to do but he did. She has a numerous other aliments and had it not been for a universal health care system I am sure they would have been long into the poor house.
I hope as you say our cousin's to the south find a system that is equitable for all.
"Jo, they don't get it and never will. It's part of their national personality ... remember this is the same country who's mantra is "the right to bear arms" ... so, don't expect their health care system to change any time soon. "
*Oof* Tinkerbell, I can understand this feeling, I truly can. The U.S. media behaved appallingly during the first round of healthcare debates. Many of our citizens followed suit, and believed things that were blatantly, and in a very obvious manner, untrue. Canada was insulted, and rightfully so. I swear, I was practically accosting Canadians on the web, and in the streets to apologize like crazy to them. I was mortified, many of us were.
But my gosh, that's a sweeping generalization you put up there that truly doesn't encompass the vast majority of the people I know. Please don't let our loudest, most ignorant examples of U.S. citizens determine your view of us all.
We are most definitely not all like that. Yowza.
Jo, you already know my feelings about this, because we've discussed this so much. I swear I felt like I owed almost everyone in Canada a round of drinks when the Republicans were busy mortifying us all in the eyes of the world on this issue.
Here's a simple fact: In Canada, when you are diagnosed with anything from the minimal to the severe you have a luxury beyond our wildest dreams at this point: Turning your concern to your actual health, first, last and all things in between.
In the U.S. when we find out anything is wrong with us, we have to worry about everything other than our health first. Losing our houses, jobs, savings...no matter our finances. That is a sickness in and of itself.
Canada worked, and worked on the system you have, and produced something amazing, and admirable. It took time, it took effort and it took the recognition that every individual has a right to health are.
We have a disease in the U.S. where we lost sight of the fact that our society has an obligation to the citizens. Many of us are willing to pay to correct that, I am. No one, regardless of economic status, should ever have their first thought about their health be tied to the ability to maintain their material life before they can give a thought to their physical one. It's obscene.
Anyway, I owe you a gin and tonic if we're ever in the same area. The insult to Canada was even worse for those that work in the field.
I guess it never occurred to anyone that Canadian doctors pursue medicine as a career, not to become fabulously wealthy as their end goal, but to actual care for people who are unwell.
Like it should be.
I WANT US TO LEARN FROM YOU!!! This is such a frustrating conundrum here. It's utterly ridiculous that we can't get it right. I'm afraid you're right: the insurers, the pharmaceuticals, and anyone who stands to make a buck are the real policy makers. DUMB!!!!! I may have to emigrate to our friendly neighboring country to the north.
I know I commented. I'll be brief. Thank goodness for those who mentioned we already enjoy socialism--Social Security and Medicare BOTH. It will be the only retirement I have for sure... You mentioned there are probably millions in my situation. True. And some are far worse off. The loud, wealthy voices are those who are heard in Washington, and are those voices other countries hear through the media. The rest of us are busy trying to live. Some of us write letters, we try to be heard. If I did not have people roots here, I Would try to move to Canada... although probably Canada is inundated with Americans who have had it.
Yes, indeed, there are MANY things we can learn from our beloved neighbors to the north. MANY.
Jo- yes, as a Texan I feel like I have a front row seat in the US adverstion to socialism. Getting public services in Texas will always be a fight to the death. We have a large system of toll roads run by priviate companies (heck, just last year they put toll lanes on our federally funded freeway). We have public schools, but we also have a large system of "Charter" and "Magnent" schools that are funded by private business (and are less regulated). Speaking of less regulation did you know that Texas has the largest private prision system in the world? Even our juvinille centers are run by private contractors. Guess how many abouses we have seen becuase of this? If Texas could privitize the public libraries I'm sure they would. Don't even get me started on our Govenor's relationships with corporations...
Here in the states, one side is always saying how Canada has terrible health insurance and that they are all miserable. The otherside knows better! It's really stupid. I don't know why that side makes up stories about Canada.
I haven't had health insurance for seven years. My only hope to have and afford good insurance is to get married. I found a guy with a great job and insurance. Now I am just waiting for my ring. lol
My father lost his house last year because he was injured beyond repair. He had a back surgery which has caused nothing but horrible pain. Prior to that his boss dropped his health care. My father was incomeless for over a year. He is finally getting social security and soon, workers comp. A bit too late though.
I cannot imagine what we in the UK would have to put up with if the National Health Service (NHS) were not available to all at the point of delivery.
It's not a 'free' health service as nothing in the world is ever free, but it WORKS here. Not perfectly, but generally very good.
Back in the mid-to-late 1940s there was similar booing and ridicule from many in the medical profession about the proposed NHS. It will NEVER work. That was the general cry from those who were scared about what it would mean, to THEM, more than to the population as a whole.
However, we were lucky to have a staunch and very strong politician by the name of Aneurin Bevan, a Welsh firebrand who brooked no argument against this revolutionary new health plan.
He was a genuine and caring man. A strong man in every sense. He got it through (thank heavens) and it is still working today.
Yes, you can STILL have your health insurance privately if you so wish (and can afford it). You will frequently still be treated by the same doctor or surgeon as a private patient or as an NHS patient. The only difference being that you will be seen somewhat more quickly as a private patient.
I wish President Obama success in his efforts to drag the USA into the 21st century where universal health treatment is concerned. More power to your elbow, Sir. Don't let the Barstewards drag you down! Keep at it; do an Aneurin Bevan on all the dissenters. Good fortune to you!
Only glad one did not make any survey upon the health-care system from over here, Athens, Greece.
ach dear Jo, you might only imagine how much I'd like to live in your "backwoods" instead of the concrete wall from here.
Please have a wonderful start into the weekend.
p.s.: thank you for the idea of getting a bit "searching" into this for the Daily Athens site.
Anyone who knows anything about Canada knows that it has an excellent healthcare system. The conservative Republicans are so desperate to thwart anything good that our current American President tries to do, that they have resorted to making things up.
The previous health insurance plan I was on cost me $550. per month, and my employer's portion was also 550. per month. For that price, ($1100. dollars a month), the coverage we got was TERRIBLE. There was a $2000. annual deductible - nothing much was covered until we incurred and paid that amount each year - so in effect they were getting $1100. a month for covering close to nothing.
America needs healthcare reform NOW but the radical right is fighting tooth and nail to stop it- what do they care? They can apparently afford good insurance - to hell with the rest of us, I guess.
America could learn a lot from our neighbors to the north!
PS - I think the world would be a wonderful place if everyone embraced "socialism"... why are they so afraid of a world where everyone shares everything and looks out for one another? They call themselves Christians -(there's the biggest farce of all!) while decrying every precept that Christ actually taught!
We in the US are just as puzzled about that as you, Jo.
Ugh! It has been shoved down our throats that we cannot have health care like Canada because their health care is soooooooo bad. My husband and I even disagree on this because he has read over and over in newspapers about how Canadians are dying everyday because they have to wait years for treatment. Meanwhile I am saying "Let's move to Canada...I hear Vancouver is nice!" (I have to admit my first love is Prince Edward Island)
We need more of our friends to the North to stand up and yell "Listen to us! We figured it out!"
Beautifully put. Our NHS system in the UK gets a lot of stick but at least sick people get the care they need regardless of whether they are rich or poor.
You say, "I am puzzled as to why a wealthy country like that big country to the south of us has such spotty health care -- two different systems for the haves and the have-nots"
Money, my non-greedy dear, money. There's not enough profit to be made when things run too smoothly. Health care here has nothing to do with health care. It's all about corporate profit.
we have much to learn from your
great country!
and i feel terrible that ignorant
folks cast dispersions anywhere.
i have missed your blog and going
to follow so i can keep better
contact.
blessings,
lea
I am terrified when it comes to health insurance. Currently I am paying $1400 per month to cover my husband and myself through Aetna, a company whose rates have gone up drastically since health care reform was proposed. Two weeks ago we received our new rates and unless something changes, every penny I make will go towards my health insurance AND we will have to use my husband's disability income to make up the difference.
It is unconscionable and it sickens me.
I envy you your security!
We fight powerful interests for the same human right here in the states.
Well done, Canada!
I couldn't agree more with all you've said, and as you know, I am a citizen of that large country to the south of yours.
Many years ago, my 3-year old daughter broke her leg in a lovely park in the middle of the St. Lawrence River in Toronto. We took her to Sick Children's Hospital, one of the world's finest teaching hospitals, where she was X-Rayed, examined and casted. The bill came to about $30 American. My husband asked the clerk if a zero or two had been omitted, and was assured that it had not. Six weeks later, our pediatrician in the US removed the cast with an electric saw, for which we were charged $600.
As a side note, I was utterly charmed by the park's signs which said "Please do walk on the grass," while in my country's parks, every sign is preceded by "NO." Canada is a highly civilized country for which I have nothing but admiration, and I sincerely hope that those running mine will do what is right for us and take a lesson there.
Mary Anne, I'm sorry to hear about your mother-in-law. It sounds as if she is receiving wonderful care, however. And yes, the US is terrified of socialism/communism, and I'm not sure why. The McCarthy era still lives, unfortunately.
Alane, "Anyway, I owe you a gin and tonic if we're ever in the same area. The insult to Canada was even worse for those that work in the field." I will certainly take you up on that offer! *heh* And yes, I think Canadians are confused as to why our health care system is used as an example of "bad" health care. The reality for us is quite the opposite, whereas for the folks in the US, many people do receive bad health care, based on affordability. It doesn't compute.
Carol, c'mon up, we love Americans! And we do hope you guys get it right. It's mind boggling that health care should be big business.
Jeanette, yes, you know, if US legislators took the time to study our health care system, they just might learn something from it. Who know!
Katy, I had no idea there was such privatization in Texas -- even schools and prisons. To me, that is much more frightening than socialized schools and prisons...!
Michelle, good luck with the ring, and keep us posted...! You deserve it. :-) And I'm sorry to hear about your father. That is a case in point -- it would never happen in Canada. Ever...!
Philip, the UK health care system was one of the systems featured in Michael Moore's documentation "Sicko". Your system is excellent, because it is the best of both worlds. And yes, it needs someone determined and with a lot of backbone to push a good health care system through.
Robert, I don't know much about the health care system in Greece. I do know some excellent Greek doctors here in Canada, however.
Deedee, your insurance cost $1100 a month!!!??? That is almost a year's worth of medical insurance here in Canada. And for that you weren't even adequately covered. That is a case in point. For that very reason, that is why you folks need proper health care. Holy doodle...! And yes, I think Christ was definitely a socialist. :-)
Kenju, well, I'm glad some folks can see it for what it is. Goodness!
Nicole, "My husband and I even disagree on this because he has read over and over in newspapers about how Canadians are dying everyday because they have to wait years for treatment." Oh, goodness, no. That just makes me sad to think you folks are being told that...!
Kitty, your system in the UK is amongst the best in the world. People could learn from it. :-)
Pauline, the US health care system needs to be completely deconstructed and re-built. And the "for-profit" aspect needs to be completely removed from it. It's mind-boggling!
Lea, I think first of all people need to learn the truth about our health care system. Perhaps it is not perfect, but it's not as bad as people are led to believe. Far from it...!
Kate, I find it unimagineable that you pay $1400 a month for health insurance. That is more than most people pay for their mortgages here. And it's not even as if you are getting any of that money back, or are earning interest in it. It is just going into a black hole. To any Canadian, that would be absolutely mind-boggling...!
Cloudia, I hope you folks are able to get the health care you deserve. You have definitely earned it.
Susan, my goodness, what a story! That is unbelievable. $600 to remove a cast. Here it would be free. I don't think people should be getting obscenely wealthy from other folks' misfortunate. And yes -- *chuckle* -- we are very polite.
Indeed! The Canadian health care system can teach us a great deal and it's all positive!
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