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.