Lizzybean, I don't think bus fare is way cheaper than air fare. I'd have to check. That's what I thought would be the case to get to Toronto for hernia surgery -- until I actually checked.
I found the spread sheet for my trip to Toronto for hernia surgery. I did a precise cost comparison of alternate ways to get from where I live to Toronto and back, for hernia surgery. Seems the cost of transportation by plane, including cheapest transporation to and from the airport at each end was roughly $330; cost by all public transportation including Amtrak, was roughtly $299. Plus with the air trip I would have had to arrive a day early and stay in a hotel for the first night, at at least $40 -- making the cost of taking a public trans actually MORE than the cost of taking a plane. Wasn't able to find a bus route all the way, but typically train transporation is about the same cost as bus transporation, isn't it? I can't say for sure.
This doesn't take into account meals. By taking public trans I would have had to add in the cost of 2 restaurant restaurant meals in each direction, because the trip covered about 2 or 3 meals worth of time, in each direction, (assuming I brought 1 meal with me from home). That also would involve lots of struggle finding vegan food in a strange place on short notice. It would also mean I would not be able to bring enough clothes for a week's stay in the hospital in Toronto (they want you to bring your own clothes rather than wear hospital clothes), since using all-public trans, I would only be able to bring the baggage I could carry, for the bus and subway trips to and from Amtrak. If I were to take shuttle-vans to and from Amtrak stations, it would bring the cost up to the same as air-fare.
That is because the cost of air-fare from Manhatten to Toronto airport and back was $180. The cost of train fare from Manhatten to Amtrak rail station in Toronto, and back, was $169. Just $11 less. Is $11 cheaper "way" cheaper?
The trip by public trans, one way, was a total of more than 17 hours, including trips to and from Amtrak stations, and including customs checks. Trip by plane, one way, was a total of 6 hours, including trips to and from the airports, waiting at the airport for baggage checks, and customs checks.
I'm going to attach the spreadsheet. Just change the txt extension back to xls, before trying to read it with Excel.
Also note that, in the "train costs" section I am listing a taxi from shirley to Patchogue, because there is no bus at those hours. There is only 1 (Amtrak) train per day from NYC to Toronto, so I had no choice as to hours, if taking Amtrak. There are about 10 airplane trips scheduled per day from NYC to Toronto! Probably more, but I'm just not aware of all of them.
I am listing a taxi for both the train and plane sections, in Toronto, as I am unfamiliar with Toronto public trans, and would not have been able to get to the hospital in time for my appointment, if I had to take public trans at the last leg of my trip there. Train station is further away from hospital than airport, but taxi fares are listed at dif amts because I called taxi companyh at diff times and got sligthly diff estimates.
Note the biggie: Amtrak is $169 and takes 14 hours; airplane is $180 takes 1.5 hours.
The attached spreadsheet is not including the motel expenses I would have, if I took Amtrak. That would bring the amtrak-public transportation trip up to 339 -- more than the trip by plane. Nor is it including the increased food expenses I would have.
I don't want to give the hospital costs for Shouldice publicly but I will give them in an email. But put it this way: 2 hernia repairs at Shouldice costs much much less, including a week of hospitalization, than 2 hernia repairs in the US, where they send you home 2 hours after the operation, -- which is indespensible if you don't like pain, because they can fix any painful, but non life-threatening complications promptly.
Actually, 2 hernia repairs at Shouldice cost less that 1 hernia repair in the US.
If this were about money, my insurance would have paid for hernia surgery in Shouldice -- it costs much less. This is more evidence to me that giving you inferior treatment may be more about punishing people for being poor or disabled, than about saving money for the insurance company, the ostensible reason. You get only the inferior treament paid for by the insurance company -- even if they have to pay more for the privelege of giving you inferior treatment.
Don't forget: Just change the txt extension back to xls, before trying to read the spreadsheet with Excel.