Opinion: The Canadians who emigrate to get U.S. health care

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Because this study tracks the accounts of observers, age dynamics require careful qualification. We cannot definitively map the exact age of the actual Canadian emigrants, but we validated a sociological pattern that transcends the age of the observers themselves.

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Specifically, health-care concerns surface prominently among younger observer cohorts, shattering the cliché that wait times only worry seniors. Among observers aged 18 to 34, health care emerged as a top-tier driver, second only to job opportunities. This exposes a profound generational crisis: when younger adults in major Canadian hubs are already crushed by high housing costs, youth unemployment and stagnant wages, the out-of-pocket expenses for medical services excluded from provincial plans become a breaking point.

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With a chronic shortage of family doctors and expanding wait times, many of these individuals understandably pivot when corporate America offers robust, employer-sponsored medical coverage alongside a job contract.

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This collective perception of those who relocate to the U.S. manifests as a word-of-mouth anti-marketing campaign against Canadian institutional capability. This negative “vibe,” which should stir a wake-up call in Ottawa, actively shapes the grapevine conversation among young professionals in the United States, dictating whether they view Canada as a viable country in which to build a secure life.

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The hard macroeconomics justify their skepticism. Over the last decade, Canada and the United States underwent a severe economic divergence.

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Between 2014 and 2024, Canada’s real GDP per capita grew by an anemic 0.4 per cent annually, marking the third-lowest growth rate among 38 advanced OECD nations. The U.S. expanded at nearly five times that pace. In 2014, Canada’s GDP per capita sat at 83.1 per cent of the American level; today, that figure is 71.4 per cent.

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This precipitous decline demands immediate policy corrections.

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Provincial leaders must halt treating emigration as a demographic edge case. We should benchmark individual Canadian provinces directly against high-growth U.S. jurisdictions instead of hiding behind national averages. We require targeted statutory reforms focused on competitive tax structures and health care access improvements. Finally, because 38.5 per cent of observers report that the relocators intend (if they can) to return, Canada should establish concrete return-migration incentives to recapture this squandered human capital.

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The grapevine we discovered delivers a warning, but it also presents an open door. Many of our expatriates crave a reason to return. By vindicating our institutional capability in the face of U.S. skepticism and aligning it with our national ideals, Canada can reclaim its halcyon position as a global magnet for talent, ensuring our best minds build their futures right here at home.

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National Post

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Jack Mintz is the president’s fellow at the University of Calgary School of Public Policy, and Neil Seeman is a senior fellow and associate professor in the Institute of Health Policy, Management and Evaluation at the University of Toronto. They are co-authors of Beyond the Borders: Unraveling Reasons for Canadians’ Relocation to the United States, published by the University of Calgary’s School of Public Policy on July 2.

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