I live in a city of 80,000 in the most populated area in Canada.
In June I went for a routine checkup. Doctor asked some questions and said at my age a stress test would be a good idea. Got that about two weeks later and just before Mopars at Carlisle I went for the results and was told I should get an angiogram and possibility of a stint or two. Went for the angiogram around the first week of August and was informed stints weren't gonna cut it, I'd need by-pass surgery and it would be done within a month. Was scheduled for just after Labour day but was told it could be cancelled if there was an emergency. There was ... twice. I was finally admitted and got my quadruple by-pass on September 12th. Having been through it I'm quite confident that had I needed it sooner I would have got it, and that I wasn't bumped because someone had more money, clout or insurance than me. Oh, total cost of all the visits and operation ... whatever parking was !! And whatever my meds I need ... $100. for the year.
As for your buddy, a lot depends on his family doctor. Everything here works on referral or "emergency". If his doctor doesn't think his case warrants further scrutiny and a referral then he's pretty much screwed unless he's brought into emerg on a stretcher. You don't just walk into a hospital, flash your provincial medical card and tell them you want two new knees, a hip and a heart transplant.
Anyhow, we're off topic.