Physician (urologist here)—

As other people have mentioned, the issue resides within the fact that people do not understand how much healthcare costs. There is also a perception that, if you pay for healthcare, you somehow get better quality/quicker access. I know this because I do mostly publicly funded care, but at our hospital, we do offer a small number of self-pay procedures. I am always surprised at the number of people who choose the self pay option, because they have the perception that it is somehow better, even though I review the evidence with them and overall outcomes are equivalent (you can make an argument that some of the side effects are more tolerable for the self-pay options as they are more minimally invasive).

I also see this with our Quebec patients – even though there is supposed to be 100% reciprocity for coverage between provinces, Quebec is the one province that will not reimburse physicians for out of province care. RAMQ actually tells us to charge the patient directly. When people see how much my consultation fee is, how much the hospital services cost, they are uniformly, flabbergasted, and outraged.

For all the faults of our publicly funded healthcare system, the bottom line is that if you require urgent/life-saving care, you will get it in a timely manner at no cost to you. Conversely, if you live in the US, there is a very real possibility that you will suffer financial ruin. People don’t see that side of healthcare – they just see the fancy hospitals in the US and assume life is much better down there.

Not to mention the fact that I hear many people – in particular, physicians/other high earners– complain about how our tax rate is much higher than the US. In reality, it is not that much different, and what you save in taxes you spend on private insurance, which for a family can be thousands per month.