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Agreed. Medically-assisted suicide cannot be offered to anyone who doesn't have all of the health care they need without bankrupting themselves. Therefore I don't think it's ethical to ever offer it in a country where health care is a financial transaction for the patient.
Otherwise the government might as well be handing the patient a huge bill in the left hand and a gun in the right.
From a patient perspective, though, it might make more sense in a society where healthcare is limited to allow people to choose to just die. Without it they’re forced to live a life of suffering and pain based on a taboo.
I think there’s a case to be made that medically assisted suicide is always an ethical option to have available to anyone.
If there was actually a shortage of healthcare that couldn't be solved by mere reappropriation of funding, then sure I could see that. But universal healthcare is absolutely doable in the US (can't speak to Canada and any limitations there).
Therefore using death as an option for those who can't afford health care that is priced aggressively is akin to genocide of poor people. And the price of this health care could simply be adjusted and the death option subsidized to the government's whims. Couple that with the persecution (legally that leads to financially) of certain classes or groups of people by a hostile government and you have a recipe for a government to conduct ethnic cleansing while having an "out" in that the poor, sick people are choosing to die.