The Ottawa Heart Institute, the site of more than 200 heart-transplant procedures since 1984, is preparing for the retirement of its founder, Dr. Wilbert Keon, in 2001. The institute has developed a national and international reputation, but also faces the same funding challenges as other Canadian health care facilities. Although the cost of the institute's high-tech procedures is challenged by some, Keon makes no apologies. "I haven't the slightest problem rationalizing what we do here," he says. "There are many areas in our health care system that should be tightened up before we cut services with demonstrable benefits." He also thinks there might be room for private care within Canada's publicly funded system.