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if i understand gov red tape at all eventually you will start by visiting some clerk where you will be given a number, then see some sort of para-doctor who will fill out the forms and you wait for an answer, then go on to see their version of a PCP who will try to treat you first even if you should see a specialist, then be referred to a specialist who will no doubt be far away, hard to see, and have long waits. If you choose to skip this whole process and pay outright you will be violating some law unless you are special in some way - like being rich or a politician.