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.).