"Some Canadians for instance go to the US for operations because the Canadian system is overused and the American system underused yet Canada's costs are still lower per capita."
The Cdn Govt run system is terminally inept in many regions . . . wait time can be up to a year. Canadians go to the US for Prompt Service.
If the list were of "Quality of Healthcare" . . . Canada would be 30 something on the list . . . lots of Bucks spent . . . NO BANG ! ! !
Most European systems have a very high Private Sector Component . . . some over 50% . . . this creates competition, efficiency and almost NO waiting for service.