In some cases. Part of it is simply size, we are the numbers of the state of california spread out over a landmass bigger than the US. Centres in cities have top notch specialists.
Near us about 4 hours drive is a world class childrens hospital with amazing doctors. They do all the stuff the US speciality centres do but you have to travel to get there and pay hotels etc.
The rural provinces like mine just don't have enough people to support that. 850,000 people spread out over huge area. Biggest city is 100 K or so. Emergency services access means lots of small hospitals spread out, less efficiency of scale.
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Today's Featured Article - Old Time Threshing - by Anthony West. A lovely harvest evening late September 1947, I was a school boy, like all school boys I loved harvest time. The golden corn ripens well and early, the stoking, stacking,.... the drawing in with the tractors and trailers and a few buck rakes thrown in, and possibly a heavy horse. It would be a great day for the collies and the terrier dogs, rats and mice would be at the bottom of the stacks so the dogs, would have a busy time hunting and killing, all the corn was gathered and ricked in what we c
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