In a system where healthcare providers earn a la carte fees for services, their only economic incentives to keep patients healthy are reputation maintenance and fear of malpractice lawsuits.  They have conflicting incentives to generate more service fees through superfluous treatments and iatrogenic disease.

In a system where doctors are salaried government employees, there is no such conflict of interest.   Their bonuses can be based on how healthy they keep their patients, not how many procedures they perform.

In practice service fees will cause some patients to delay diagnostic procedures until intolerable symptoms develop.

 Much like the software industry, where the startup cost is high and the marginal cost is very small, service fees that grossly exceed the marginal cost lead to inefficient use of resources (idleness of medical imaging equipment or narrow distribution of software)