As I read it, the point being made is that healthcare costs are so out of whack in the US that they have to potential to bankrupt you manifold without insurance. If you have no savings, then certainly the question of who pays the mortgage is valid. However, healthcare is a good social net in Canada so when you get this arm-falling-off-cancer, you use your savings to pay for the house as long as you can and hope the healthcare safety net maximizes your life.