> The US should not even be mentioned in any conversation about the ROI of health spend.

I would agree with at least this part, if I didn't live here. I'm reminded of the MRI post from a few days back. I think the stat was that Boston had more MRI's than all of Canada combined.

How much healthier are people the United States than Canada - for all that extra spend? I'm fairly certain the number is negative.

EDIT - I googled it. The Canadian life span is four years higher than the average American and they're healthier than the average American when they get there. So, yes, the number is negative.

Massachusets has more MRIs than Canada.

Thank you.

Wild, I looked it up. It is true. LLM tells me:

    > Canada has a total of 432 MRI machines according to the latest official national survey.
    > Per capita: An average of 10.8 units per million people, which is well below the Organisation for Economic Co-operation and Development (OECD) average of 19.4.

And Massachusetts (specifically Boston and Cambridge) has an insanely high concentration due to multiple medical schools and several very large hospital systems.

Real question and no trolling to Canada: How does Canada have such good healthcare, but so few MRIs? My point: Canada is certainly rich enough to buy and operate more. Do they not need them? Does the US just have way too many? (That is my guess.)

A few things. 1) Canada is not as wealthy, per capita, as the USA. Per Google: > The GDP per capita in the United States is roughly $94,400 USD, compared to Canada's roughly $60,300 USD (as of 2026 estimates), creating a significant and widening economic gap.

2) Canadian healthcare spends less per capita. Per Google: > The United States spends roughly double per capita on healthcare compared to Canada. Cost Comparison Per Capita • United States: Approximately $14,885 USD per person. • Canada: Approximately $7,301 USD per person (varies by estimates, with public-only spending around $5,000 USD). • Percentage of GDP: The U.S. spends about 17.2% of its GDP on healthcare, while Canada spends about 11.3%.

3) The USA believes in diagnostic testing at a higher level than Canada. Per Google: > Utilization and Intensity: The U.S. tends to utilize higher volumes of intensive diagnostic testing and specialized medical interventions.

4) Related: hospitals are private in the USA, and they buy MRI machines to bill for high-margin diagnostic tests. As you noted, the Boston CMA is a world leader in healthcare and education, and thus has a higher concentration of MRI machines.

5) Canadian healthcare simply is not as sophisticated as the health care in the USA. There have been multiple episodes of high profile / wealthier Canadians going to the US to skip waiting for treatment and getting procedures that are just not available in Canada at the present time.

So it's great, it's saved my life a couple times, but it's not a 1-1 drop in for American healthcare. Every system has trade offs, that's the lesson of engineering.

I am not wholly convinced by your reply. If Canadian medical staff are paid proportionally less that US medical staff, then difference in PPP matters little.

    > Canadian healthcare spends less per capita.

Due to FX rates and PPP, probably Japan spends the least in G7, yet their public healthcare system is globally outstanding. It has superb quality in the largest cities and surrounding areas (Tokyo, Yokohama, Osaka, Nagoya, Fukuoka, Sapporo), on par with UK's NHS, which the global "gold standard" for cost effectiveness. The key: Don't let medical staff income get out of control. Ignoring truly exceptional medical staff (brain surgeons, etc.), most people in medicine should earn slightly more than middle class. If you can maintain it, then you can really control medical costs. The US is wildly out of control if compared to G7 (and close relatives, like Netherlands, Belgium, Denmark, Norway, Sweden, Finland, Korea, etc.).