
That study which was in the NEJM, I think, noted that the frequency
of heart surgery on patients over seventy increase with income in
California (I guess richer people have more heart disease in 
California -) ) whereas the frequency of surgery on patients over
seventy in Canada was relatively uniform across income distribution.
Heart surgery was more frequent in California, but mortality and
outcomes were essentially the same.


The only potential problem I see with the private MRI facilty in Calgary is the
self-referral problem to the facility for the doctors who have a financial
interest in it, which is basically unethical...but in Canada because
of our small population, there is likely only to be a few private
facilities involving only a small number of doctors,
and thus I don't think the self-referral problem, which is an epidemic in the
US, could ever get out of hand here.


It is an experiment that will be certainly be watched carefully.


What likely happened is the sponsors of the private MRI which include
doctors anticipated that Alberta would need more MRI's, and instead
of waiting for the health planners to realize they needed another
one or two, saw a business opportunity...where they would have a
secure business from the public insurance side of things, and they
could supplement people and businesses who want to pay cash.