You are kind of proving my point: for Canadians to come to the US for more money as you state makes a lot of sense. You get to keep your Canadian citizenship and if things go badly, you move back. Also, re. 'employers pay for your medical insurance', the trouble is how long said employer will keep you around if some unforeseen illness comes about. COBRA, for which the premiums are very high, is good for another 18 months, assuming you have enough money saved up to pay for it along with the medical expenses brought about by the adversity.

I think my motorbike vs. Camry analogy is reasonable. Vast numbers of people ride motorbikes every day and live for decades without encountering a problem .Others can end up having their lives turned upside down as a result of some accident. A social safety net is not designed for everyone to bounce on but to catch the most unfortunate in society and help them cope as best as possible at their time of extreme adversity. My point is that the US, especially with the impending destruction of the Affordable Care Act and Medicaid defunding, is about to lose its very short-lived and already weak safety net. If you can go back to Canada when adversity strikes, you are in good shape. Most people don't have that option.

You can use a relatively small amount of your salary to buy income protection or disability insurance in the US, and pocket the difference.

I am aware that most companies will automatically buy a certain amount of disability insurance for employees with option to buy more, often as a pre-tax deduction. These cover, afaik, something like $1 million in expenses for the specific circumstance of disability. However, I think the overall sub-thread was discussing healthcare. It is not clear to me that a long-term debilitating disease, such as (heaven forbid) cancer, would be covered adequately by such plans. Certainly, even healthcare prior to the Affordable Care Act could deny coverage based on pre-existing conditions or if there ever was any lapse of coverage; for such circumstances, assuming the disability insurance applied, the money would get spent pretty quickly. Real disability expenses are often much more expensive than anticipated - the referenced link [1] shows the expenses for Texas governor Gregg Abbott, who was disabled by a falling tree trunk while jogging at age 27; he managed to negotiate a pretty good settlement with the homeowner and you can see that his disability, for which he was too young or unprepared to have purchased disability insurance, had cost $6 million as of 2013.

My intent was to outline the fact that the US safety net is weak and there are plenty of corner cases that one could fall into from which recovery will be tough. Reduction in Medicaid will only worsen this. If you have coverage that you feel covers you in a majority of worst case scenarios, then you are in good shape but hopefully you are up to date on your read of the coverages. The Canadian safety net, in my opinion, saves one a little bit from this planning.

[1] https://www.dallasnews.com/news/local-politics/2013/08/02/gr...