Being an American I would certainly be in trouble if I did not have private health insurance. VERY costly, but necessary. On the other hand, I have been told a lot of the top docs in Canada are leaving to come to the states to practice which is leaving Canada with a serious shortage of medical providers. My Canadian friends tell me it is hard, if not impossible, to book a time for a MRI that is less than 6 months away or a timely appointment with a specialist. If the brain drain continues, I fear my Canadian friends will be visiting me in the states and asking help for competent medical care. All things being equal, I think the edge goes to the states on this one if you can afford the medical insurance.