I'm a Canadian who owes tens of thousands because I had an emergency operation in a different province (BC) from where I have my health card (Ontario).

Curious. It seems either Canadian healthcare isn't the panacea we Americans think it is or there a number of Canadians who post here that don't know about their plans.

My thought is the situation is analogous to each US state and their safety net medical programs. Means based? Is this correct?

As far as I can tell (some reading, some 2nd-hand stories) Canadian healthcare is not a good model at all. It may be better than the US, but that's faint praise. I'd look to the French, Swiss, or Scandinavian systems for better models.

I'm pretty sure OHIP will cover your health expenses, but at the Ontario-based care rates.. You just have to submit receipts to OHIP. Everything extra would be out of pocket, and I see how that could be pricey.