I believe the Canadians who can afford high health care expenses prefer to pay to get in line before the poor people. In the meantime the rest of their citizens love that they have access to health care. I doubt that their system would deny emergency treatment if necessary.
Most unwealthy people use the short form to figure their taxes and none of the loopholes are available to them. By the way, the 20,000,000 people who at last have access to insurance are very happy for the ACA.