I don't share your views that more money in primary care will reduce the need for life-saving surgical procedures.  That is based on my real world experience in performing surgery and seeing that over 90% of cases could not be prevented.  For many health concerns prevention isn't as effective as we all hope it could be.  I do agree we need to be careful about funding sexy innovations that are costly.  The article doesn't say that every urology program in Canada should get a robot.  He is saying that a single large academic teaching program in one of the top 10 medical schools in the world should probably have one.  Then maybe the evidence that everyone is looking for could be obtained and the procedures validated.  Worst case scenario is the process of innovation and teaching is supported where it should be.  The absence of evidence is not evidence that we shouldn't use robots in surgery.  How do we get the evidence we need for our patients in Canada if we don't have access?