Life used to be a lot simpler. When Ontario replaced OHIP fees with a head tax on employers they pretty much lost the ability to verify Residency.

Back before 9/11 there was a daily wave of border crossers at Detroit / Windsor heading North every morning, using an OHIP card as "proof" they were Ontario residents.

Similar things happened in Ottawa /Hull. Some Canada Health Act covered services have an annual limit and there are variations between provinces. A common scam in border towns was to register under both OHIP and RAMQ to get bogus double coverage.

Lousy drivers in BC face increased insurance premiums. A common scan is register in Alberta, even though that is illegal. One lousy driver called a radio call in show, indignant that a BC Police officer told him that he could be issued points in BC and have his right to drive suspended. The lawyer patiently explained Licence Reciprocity to him. One banned driver in BC Cited another person's DL and name from memory when stopped.