@greenspaces4peace Yes, I have heard that the "wait time" for treatment in Canada can be extraordinarily long. Wait times have increased here since the Affordable Care Act was enacted in 2015. More people with coverage means more patients for the doctor to see.
There are a couple of things I want to comment on regarding the example of your friend and the treatment that she received in Utah...
I suspect that your friend ended up in an ER (Emergency Room)? ERs are legally required to provide life-saving care regardless of ability to pay (which means some type of health insurance). Whether or not one would receive further testing, procedures or hospitalization once the life-threatening condition is taken care of very much depends on ability to pay.
There are two (related) elements of our healthcare system that come into play here. The first is that health insurance companies and health care providers have contracts with one another for the provision of services. Not all health care providers have contracts with all insurance companies. These contracts stipulate how much the insurance company will pay for particular services, and when the health care providers agree to the contract, they are agreeing to accept that payment as "payment in full." That amount will include our co-pays, co-insurance, etc., so a lot of the time the insurance company doesn't actually pay that amount. Here's where it gets really fun...
The amount that is paid for a particular service changes from one health insurance company to another and one health care provider to another. Literally, the amount that the insurance company will pay for the same service at provider A is different than they will pay to provider B (with the same credentials). We never know until we get our statements what the cost was. Our co-payments don't change as they are a flat $ amount, but co-insurance is usually a % of the charge, so that's always a lovely surprise.
Now, if you receive medical care from a health care provider that is not "in network" with your insurance company (or you do not have health insurance), they do not have to limit what they charge YOU, to what your insurance company is willing to pay, so anything over that amount is billed directly to you. So the same service will cost an out-of-network patient considerably more than an in-network patient. Example: years ago (2001/2002; before Affordable Care Act was enacted in 2015), I dropped the employer coverage that we are permitted to continue (at full premium cost) for 18 months after leaving an employer, because the premium went through the roof and I simply did not have almost $300 a month for health insurance. At the time my only regular healthcare cost was one medication that my insurance company was paying the pharmacy $75.00 a month for, so was planning to just pay out of pocket. When I got to the pharmacy, they said, "That'll be $300.00" !!!!!! Literally 400% of what they had been getting for the same thing when I was using insurance. (That's when I got interested in how our insurance/healthcare system works.)
Obviously I don't know the details of your friends billings and payments, and I have no idea how travel insurance works regarding payment of medical services. Nor do I know (with certainty) what facility she went to initially, or was admitted to from the facility she initially visited. What I do know is that if the facility was going to be able to charge their top tier prices and they would be covered by insurance, they were going to treat her. (Because they seldom actually get paid that much for their services.)
The bottom line is that access to healthcare in the U.S. is very uneven. Folks on Medicaid often find it difficult to obtain care because so many healthcare providers do not accept Medicaid patients (government reimbursements for services are lower than private health insurance). Even folks on Medicare (government insurance for folks 65+) face challenges for that reason. Different health insurance companies have different thresholds for determining whether or not a particular service is "medically necessary." If they say it is not, they will not cover the service. I am sure that your friend had no one but her doctors deciding whether or not the treatment that she received was medically necessary. That alone saves a lot of time when seeking treatment for any condition in the U.S. It would not usually be that efficient.
Sorry this was so long...It's all really complicated. And by the way...I'm glad that your friend was able to get that taken care of so effectively and quickly. I hope to never know, but I understand that kidney stones are very painful. I hope that her daughter has hers taken care of now, too.