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But it is also well documented that when a region has over capacity in some test facility, say MRI, costs in that area also rise. Often prescribe-rs over use the facility in an effort to support it. And all too often the physician forwarding patients has a financial position in the facility.

This is primarily a problem created by government due to a predominance of third party payers. In a patient-focused free market system, this entire issue would be irrelevant.

There also seems to be the problem of over concentration of services in a few desirable big cities leaving other areas under served.

This is a natural result of human nature. In an efficient economy, those who choose to live in sparsely populated areas will pay more for certain services or do without. There is no way to fix this problem without massive inefficiencies or massive misuse of resources.

Again the medical community seems to need govt assistance to do the obvious to provide good care.

No. Government has created a problem (predominance of third party payers with associated incentives for fraud or overbilling) and now is trying to fix the problem. It does so by denying health care to people.

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