When I lived in the states (Vegas) for a year in 1999, I couldn't believe what it was like. It made me really appreciate Canada. Although Canada isn't perfect, nor is the health care system, it has a good start.
I feel pretty bad for my US friends who have a difficult time affording SRS, as well as other things like Laser and FFS.
SRS isn't universally covered in Canada. Most provinces do not cover it, or do not provide any actual funding or a means to get SRS in a real time frame. Several provinces have "de-listed" SRS from Health Care funding. So, there are plenty of Canadians who do not get funding, or wait for years and years going no where. Canada is also home to the Clarke Centre (Ontario), which, from what I hear, wasn't a great place to go to get funding in Ontario. Ontario, btw, is one of the provinces who has de-listed coverage.
The only province that I'm aware of that fully covers SRS is Alberta. They only cover SRS in Montreal (Bassard/Manard) except for certain medical cases. I have a friend, for example, who has diabetes, and Montreal will not take her -- so she is going to Arizona to see Meltzer. They also cover the cost of travel. They don't cover, however, Laser, FFS, breast augmentations, and so on.
The process here has a waiting list. It can be a long process, but the average is about two years from the time you start living full-time. A lot of it depends on how well adjusted you are and luck. Some people get things done quickly, while others wait for years. I've heard of people waiting much more than two years. The other option, of course, is to pay for your own surgery.
I'm already in the process and hopefully my funding application will get in this Summer, and approved by the end of this year. I'm very lucky that laser has worked for me, and lucky that I don't need FFS or an adam's apple shave, etc. I just need a new hair cut... my hair is all fried and full of split ends.
I couldn't imagine how hopeless I'd feel if I had to pay for everything from my own pocket, including SRS.