The American Medical Center's three-year virtual monopoly on Western-style health care in Moscow will face its first major rival in May when a Canadian-managed clinic opens its doors.


The result of the new competition may be substantially increased services and lower prices for consumers, as the centers target the same group of expatriates and affluent Russians who can afford to pay $60 to $200 for a visit to the doctor.


The Montreal-based clinic, called M?diclub Moscow, will have 24-hour emergency service, a full radiology department, a Western-stocked pharmacy, dental facilities, and two to three Canadian general practitioners, plus visiting specialists, said Dr. Michel Charest, president and director general of M?diclub Montreal.


More doctors will be brought in to the Michurinskaya Ulitsa facility in southwest Moscow as membership expands, he said. He declined to name the amount of the firm's investment.


The American Medical Center, meanwhile, has announced its own multi-million dollar expansion project that will put it into larger quarters in northern Moscow, increase its range of services and, for the first time, broaden its activities into the non-profit sector, said chairman Dennis Sokol, of the center's parent company, Hospital Corporation International. He also declined to name the investment level.


With M?diclub Moscow's opening date about six weeks away, the price wars are already beginning.


"Our prices will be about 25 percent less than AMC and our members will have additional discounts," Charest said.


The American Medical Center, meanwhile, is reviewing its price structure, to give members greater advantages and expand the price range, so that brief visits cost less, said Dr. Myles Druckman, the chief doctor.


"We have heard the complaints and we are completely aware of them, and we are working hard to make the system as fair as we can," Druckman said. "We want to develop a system that is easier for patients to understand all of the costs."


The price for a non-member to make a brief visit to M?diclub will be $60. By contrast, the current price for a non-member's brief visit to the American Medical Center is $150.


The membership fees also vary considerably, but this time M?diclub is costlier. An individual M?diclub membership will cost $1,000 for the year, and $2,000 for a family. Membership at the American Medical Center costs one quarter as much.


To sweeten the deal, M?diclub includes full annual medical and dental check-ups and 25 to 30 percent lower charges for appointments by members, Charest said. Until now the American Medical Center has had a near monopoly on Western-style health care in Moscow. Its capabilities, meanwhile, have been limited to general-practice problems, with anything more complex usually being either referred to Russian hospitals or having the patient evacuated abroad.


Other firms have moved in to meet the pent-up demand, but most have been even more limited than the American Medical Center.


Mediclub Limited, a service owned by the British-based Cherry-Orchard Investments and unrelated to the new organization, launched a membership drive in the fall. The club's owners have experience in direct marketing, but none in medicine. They send Russian doctors and an interpreter into their patients' homes, or serve patients in a central Moscow clinic.


Another option is the two-year-old European Medical Center, which has a single full-time French doctor available. Some embassy doctors also occasionally see patients from outside their mission.


But for the increasing number of foreigners setting up offices here, the American Medical Center, with its seven Western doctors, has been the primary choice since it opened in 1991.


"When I first came, the first people to come here were the pioneers, they were willing to put up with all the problems and inconveniences," Druckman said. "Today we have what I call the 'settlers,' and the expectations are much higher."


The American Medical Center's current facility is housed on the third story of an office building on Shmitovsky Proyezd, near the Mezhdunarodnaya Hotel. Without an elevator, access can be treacherous for the injured or sick.


As its membership has swelled, the clinic has become increasingly cramped. In the past six months alone, the list of corporate members has expanded from about 180 to 250, Druckman said. Its new facility is to be located in a building on Maryinoi Roshchi Ulitsa.


Once renovations are completed some time in early 1995, the center will have a 24-hour emergency room, dental facilities, a cardio-pulmonary unit, overnight beds, a laboratory, pharmacy, and even a day-care center with a separate entrance.


By midsummer, the American Medical Center plans to offer free services aimed at the poor every Sunday, Druckman said.