The Canadian system is built around efficiency. That is why until recently it was illegal to buy private health insurance. Quick service and access is not a priority in metropolitan areas. They use the U.S. as an escape valve when complaints get too loud. The Canadians as well as all other socialist healthcare systems ride off the back of the U.S. citizens to pay for R&D for pharmaceuticals, medical devices, new treatments. Then they pay variable cost only for the same products. The U.S. healthcare systems basically funds most of the R&D costs for the entire world. That's why they are more expensive in the U.S.