The UK has only one-seventh the number of ICU beds per capita as the US, which surely must affect care delivery. Wunsch et al examined 172,785 ICU admissions in the Project IMPACT database (US) and the Case Mix Programme (UK). It appeared harder to get into an ICU in the UK (from the ER or the medical floor); patients were sicker when they did; fewer over age 85 made it in; and a higher percentage died (38% vs. 16%). Very few Brits were discharged to LTACs or SNFs (6%) compared to Yanks (29%). AJRCCM 2011;183:1666-1673.