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Hudak borrows from Harper's playbook to explain his health care policies

Tim Hudak has now spoken at some length about his plans for health care.

Don't expect him to make a habit of it.

The Progressive Conservative Leader is not looking to cause any great excitement with the latest plank of his platform, unveiled Tuesday morning. He does not expect it to win him many votes in Ontario's Oct. 6 election. He just wants to avoid it causing him to lose votes, so he's borrowed a page from Stephen Harper's playbook.

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Once upon a time, conservative politicians seemed eager to engage in debates about the fundamentals of the public system. Even Mr. Hudak's predecessor, John Tory, ventured in the 2007 provincial campaign that the private sector should play a greater role in service delivery. But their strategists have decided that these are debates they can't win - and that, given the success of their opponents in sowing fear about their intentions, they don't even want voters thinking about health care during campaigns.

That makes for quite a communications challenge, since - as shown in a new Nanos Research poll - health care remains the public's biggest policy concern. But in this spring's federal campaign, Mr. Harper showed there's a way. By unequivocally saying he would do exactly what the parties to his left would do - continue to increase health transfers to the provinces by 6 per cent annually - the Prime Minister was able to neutralize the issue.

Now, Mr. Hudak is trying to do that provincially. His promise to spend an additional $6.1-billion on health care over a four-year term would mean 3 per cent annual increases, which is what Dalton McGuinty's governing Liberals have said the cost curve should look like. And what he would spend that money on - long-term care, homecare, attracting more doctors, monitoring health outcomes - are uncontroversial priorities the Liberals share.

Only in promising to eliminate Local Health Integration Networks - the regional authorities set up during the Liberals' first term - does Mr. Hudak propose to break in any significant way from government policy. To the extent that he broaches the subject of health care at all during the campaign, it will likely be about "putting patients first" rather than spending money on what he describes as a needless layer of bureaucracy.

But the savings from scrapping LHINs would be so small, relative to the roughly $50-billion that the government spends each year on health care, as to be irrelevant. And the Liberals' attempts at regionalization have been so tentative that, outside a few communities where there have been controversies about service integration, most Ontarians wouldn't notice if LHINs disappeared overnight.

Of course, whichever party is in power will eventually have to make some much tougher decisions. Increasing spending by 3 per cent annually shouldn't be too difficult, given the increased federal transfers. But given that health costs have generally climbed at double that rate, it's doubtful the province can permanently flatten the curve as both parties project - especially given the pressures posed by an aging population. By 2015, the debate about whether to dramatically reform the health system (and if not, whether to increase taxes or cut services elsewhere) may be unavoidable.

But in 2011, Mr. Hudak will be all about reassurance. And while Mr. McGuinty has taken some reasonably ambitious measures to make the system more efficient - including last year's fight with pharmacies over drug prices, and fledgling efforts to change the way doctors go about their jobs - his message will similarly be about stability, coupled with dark forecasts that Mr. Hudak is not as benign as he appears.

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The provincial Liberals may yet find more traction with those warnings than their federal counterparts did against Mr. Harper. Health care is an even bigger issue provincially than it is federally. Unlike the Prime Minister, Mr. Hudak is an unknown quantity. And it remains to be seen if the numbers in the provincial Tories' platform, which will include significant tax cuts, will withstand scrutiny.

But the Tories have evidently given much thought to how they can take the province's biggest policy file off the table as Ontarians choose their next government. It won't do much to shed light on what the system will look like down the road, but it will give Mr. Hudak a better chance to be the premier tasked with shaping it.

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About the Author
Political Feature Writer

Adam Radwanski is The Globe and Mail's political feature writer. More

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