When it comes to titles like this that are considered protected, it is actually how they work.
In your example, he isn't allowed to use that title in the new state until he's joined their organization (or they have an agreement with his original state)
As an extreme example for why the timing does matter, If he was licensed properly for 1 year, then let it lapse but continued to do design work as an engineer for 25 years, and then relicensed himself for one last year before retiring, the work he did during that period of being unlicensed isn't covered, and the board of engineers would go after him for that.
For what it's worth, there are specific provisions in the laws to allow retired people to continue using the title P.Eng with a "Retired" tag added onto it.
I've used the system pretty regularly. To be fair, I live in a small city (150,000) within the golden horseshoe, so definitely better care compared to many throughout rural areas.
In the past few years I've had the birth of a child including all the various follow ups and shots, a stress test, blood work to rule out several heart issues, a halter monitor test, an ultrasound of my heart, three sets of baseline blood work, and four family doctor appointments.
The biggest fee at each was parking.
I don't disagree we have tons of room for improvement. Our contributions each year (ie personal amount of taxes we pay for healthcare in Ontario) have not been sufficient to keep up with the growing and aging population. We desperately need greater cancer screening and diagnostic services, as prevention and early detection can save billions in future chemo/rad or operations. Rural areas and family doctors need a rework, as many people are without one due to fewer and fewer docs entering that field.
That said, I would never take the US system over Canadas. The enormous stress illness would place on a family doesn't seem worth it for the meager tax savings, and the low wait times seem to only be avoided in the US system by paying out of pocket, which is not feasible for many.