This makes Canada seem much better than it actually is. Major spending in Canada (healthcare, education, most transportation infrastructure and cultural programs, etc.) is handled by the provinces, in Canada’s federalist system, so most of the indebtedness is at the provincial level, not the federal level. So total debt levels are more like 75% of GDP, not 37%. https://www.fraserinstitute.org/commentary/governm...

Yes, different measures give different results. If you included the present value of the US deficits in medicare/medicaid in the next 60 years to make it match Canada's lack of that problem, it would look pretty scary. You just have to use whatever you can get that gives something close to apples and apples.

For example, yes, there is a lot of provincial level debt in Canada, as that Fraser Institute article presumably notes. (they're kind of the Mr Potter conservatives of Canadian think tanks and despise the Liberals). It's not generally from health care costs, though, which is substantially funded by the federal government. It's more that they just don't balance their budgets well, generally. Conversely, there isn't material debt at the level of Canadian cities (Calgary issued its first true bond last year), nor the nightmare pension liabilities that (say) Chicago has. Gross debt to GDP from all levels of government are quite a bit higher in the US, even before being netted.

Sticking to the broad strokes, the Canadian debt and deficit situations across all levels of government, counting both assets and liabilities of pension commitments, are far from perfect but night-and-day better than that in the US and modestly better than most other rich countries.

Jim