Several things make Canada cheaper than the US.  As I pointed out, above, they do not have the same level of technology available,  Waiting times for diagnostic checks are longer.  You cannot sue a doctor, hosptial or pharmaceutical company for punitive damages.  And, it is harder to sue for outcomes that could have been expected.  The period of time that drug companies for exclusive patents on new drugs is the same seven years as it is in the US.  But in Canada, that seven years begins at the end of clinical trials, when the drug is approved.  In the US the period begins at the outset of clinical trials, giving the drug companies up to three years less time to recoup R&D costs.  By the way, some Canadians have sued to be allowed to buy health insurance, like in the US.  Just this month the Canadian government cut $60-billion from health care and told the provinces to do more with less.  All is not happy up North.  Waiting times will get longer and less care will be given.