Yes, we can provide additional details in that area.
To be clear, the assessment does not do a cost-benefit analysis on an individual basis. It is an assessment based on the results of the medical examination and supplementary testing, from which a medical officer assesses the severity of the illness and the degree of service that would be required to treat it, which then forms the initial medical recommendations that are given to a visa officer.
At that point, however, as part of a procedural fairness step, individuals are able to prepare a mitigation plan to identify if they are able to offset the costs that are related to things that can be paid for here in Canada.
In other words, under the Canada Health Act, if individuals cannot pay for medically necessary treatment, individuals who are applying to come to Canada can say that they would be able to offset the costs of prescription drugs or of other social services that can be provided through the market. To the degree possible, this is a way of identifying their ability to make a contribution to offset those costs.
Other countries have considered approaches that use something more resembling a cost-benefit analysis—specifically, Australia—but they found that it was unworkable because it involved too many unsupportable assumptions as to what an individual's employment trajectory or income would be over the years following their arrival, so they abandoned this approach.