While we have a projectgroup for examining transcultural aspects of health care, and integrating them, there seems to be little time to integrate that embrassing set of people, known as the patients. The long waiting lists are forcing ever more people to seek treatment abroad. The latest trend is to go to Alicante in Spain for orthopedic surgery. It is expected that about 600 Dutch patients will fly to Spain to have a new knee fitted, up from about 100 this year. Taxes may be high in Holland, but at least we get the best and longest waiting lists money can buy!