I think you've made some good points. A better political environment is definitely a strong consideration given the way the world is evolving now. As for taxes, don't forget the US is one of the most onerous one on taxes. You are taxed even if you do not stay a day in the US once you have a GC/Citizenship and for career opportunities go and work in a different geography. Unless you stay in Texas, you have to pay state taxes so overall tax burden is anything but low. The highest marginal tax rate is quite high (I paid that for many years while in the US). I have to disagree here. I think the tax rate is lesser in the US compared to Canada. For example, our family ranks in probably top 10-15% in the US household income. But with deductions, exemptions and marginal tax rates, our effective tax rate is 20-22%. This also include the state taxes. I believe Canada is more close to 30% for similar circumstances.
Healthcare is broken in the US and expensive (Canada is much better). Also the path to a citizenship (and getting reunited with family) is materially shorter as you rightly note (in half a decade, your passport troubles could be entirely behind you). Definitely. I can't believe how US healthcare is sustained in its current status. People pay so much money and still end up paying out of pocket for a lot of the services. I believe medical bills are the leading cause of bankruptcies in the US. I think the politicians have cornered this market and there is next to zero chances of changes. Having said that, is it a problem to get appointments for preferred doctors in Canada? I haven't done much research, but if having free healthcare limits my ability to see a preferred doctor, it's not a desired situation as well.
Economy is probably the only negative consideration about the move. Canada is nowhere near as strong or vibrant or innovative. But the right people can always manage to find or create good opportunities anywhere. Besides, the degree of difficulty would be lower as Canada would likely be a less competitive pool than the US. Also with NAFTA, you may be able to bypass the H1B queue and work in the US easily afterwards. So you wouldn't be giving up on the US completely. This is also true. However, the pharmaceutical industry which I work in, it concentrated in Toronto area. This is a problem because the cost of living in the area. My understanding is that it's like living in San Francisco area and making a salary comparable to Texas or Atlanta area. I don't know how I would be able to maintain my current lifestyle. The only viable option I see is to stay in Canada and work for a US employer remotely. That exchange rate is going to come in handy for this.