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So the Canada Health Act and the B.C. Medicare Protection Act state that Canadians may not buy their way to the head of the queue for medically necessary treatment.

But people routinely do just that in British Columbia, where 84 private surgery and diagnostic clinics thrive.

Using the popular MRI as an example, here's how it works:

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Patient A has an undiagnosed shoulder injury. The patient's doctor recommends an MRI as a medically necessary test.

Unless it is urgent, the referral in the public system means a wait of months for the test. The patient can go to a private clinic that will do the MRI, for perhaps $1,000. So long as the individual does not then complain to the Medical Services Commission about the fee afterward, the Canada Health Act won't pay any mind. And B.C.'s medicare protection act exempts MRIs.

Now, diagnostics in hand, the patient can enter the public queue for treatment if needed, but will have got to that point faster than had he or she waited for a publicly funded MRI.

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