Also a Canadian living in the US, and I would tend to disagree. In major US cities, with good health insurance, there are plenty of PCPs, and availability of specialists.
For instance, I had a ganglion cyst that I went to see my PCP for. We decided to give it a couple weeks to see if it would go away by itself. It didn’t, so I messaged him, and was scheduled to see an orthopedic surgeon (probably overkill) within 3 days to have it looked at and drained. Total cost: $0 for PCP; $40 co-pay for the specialist.
Meanwhile, my father in Nova Scotia waited close to a year for a knee replacement surgeon consult and is now waiting for surgery slot, which is expected to be another 6-9 months, despite being in significant pain. That just would not happen in the US.
There are many problems for sure, and I don’t have a universal measure for efficiency, but anecdotally, in my experience, there is just way less waiting in many parts of the US. I also acknowledge how privileged I am to have good insurance, resources to not worry about large out of pocket maxes in an emergency, and to live in a city with some of the best hospital networks in the country.
I agree. I think both system have significant flaws, and that is coming from someone for whom the US healthcare system benefits the most (great health insurance, mid-30s, healthy, well-off, very capable of navigating complicated paperwork, and access to some of the best hospitals). I can't imagine being a lower income, lower educated, aging person with chronic health problems, in a rural flyover state with limited community hospitals. Night and day difference.
On the other hand, some 20% of the total population of Nova Scotia is currently active on the waiting list to get a PCP. You don't like your PCP? Too bad. You want to get a second opinion? Too bad. Your PCP retires/moves/closes their practice? Too bad. They have tried to plug the gap with allowing pharmacists to prescribe certain meds, and expanding PA/NPs. This is probably better than the alternative of no doctors, but its probably a net negative on the system as a whole compared to properly staffing with physicians.
Overall, it seems like chronic underfunding, and underpay for doctors has led to situation in Nova Scotia in which preventative care, or really, care for anything non-life threatening, has deteriorated quite meaningfully.