healthcare system as it "exposed shortcomings in the private U.S. health system and potentially threatened their profits." He said that corporate PR used the tactic of repeating misinformation about the publicly funded Canadian system by focusing on wait times for elective surgeries. As healthcare debate in the United States reached the top of the U.S. domestic policy agenda during the U.S. 2008 presidential race with a combination of "soaring costs" in the healthcare system and an increasing number of Americans without health insurance because of job loss during the recession, the long wait lists of Canada's so-called "socialized" healthcare system became a key Republican argument against Obama's health reforms. The Huffington Post described it as the "American politics of Canadian healthcare." A 2009 Huffington Post article described how American insurance companies were concerned that they would not be as profitable if his healthcare reforms were implemented. Starting in July 2009, Canadian Shona Holmes of Waterdown, Ontario became the poster child of the Americans for Prosperity support for Republican presidential candidates against then-candidate and President Barack Obama's who ran on health reform and the Affordable Care Act. In 2005, Holmes had paid $100,000 out-of-pocket for immediate treatment for a condition called Rathke's cleft cyst at the U.S. Mayo Clinic, one of the best hospitals in the world, the Singapore General Hospital, and the Charité hospital in Berlin instead of waiting for an appointment with specialists in her home province of Ontario. In 2007, she filed a lawsuit against the Ontario government when OHIP refused to re-imburse her $100,000. The media attention from the Americans for Prosperity advertisements resulted in further scrutiny of Holmes' story. A 2009 CBC report consulted medical experts who found discrepancies in her story, including that Rathke's cleft cyst was neither cancerous or life-threatening. The mortality rate for patients with a Rathke's cleft cyst is zero percent. Since 1990, the Fraser Institute has focused on investigating the Canadian healthcare system's historic and problematic wait times by publishing an annual report based on a nationwide survey of physicians and health care practitioners, entitled Waiting Your Turn: Wait Times for Health Care in Canada. The 2021 edition of the report found that the average waiting time between referral from a general practitioner and delivery of elective treatment by a specialist rose from 9.3 weeks in 1993 to 25.6 weeks in 2021. Waiting times ranged from a low of 18.5 weeks