I'd love to go on at length about the federal budget. Unfortunately, I'm in transit this afternoon, and should probably wait till I've had a chance to read the thing before commenting on it.
So I'll restrict myself for now to a subject that may actually have a greater bearing on people's lives, at least in Ontario: the province's alleged revolution in health-care delivery.
In Wednesday's paper, I argued that Dalton McGuinty's government needs to start levelling with Ontarians about the very tough health care choices ahead. Less than 24 hours later, it was being reported that the Liberals are considering "radical health reforms" that would force hospitals to compete against each other for funding to deliver services.
On first glance, you'd have to think the government is much further along than I gave it credit for. Or, I suppose, that it took less than 24 hours for McGuinty to respond to my column by overhauling his health agenda.
But much as I'd enjoy the latter, I'm rather skeptical either is the case.
The truth is, the "patient-centred" model of funding being floated isn't really all that new; it's more or less been the centrepiece of the government's waiting-times strategy to date.
What would be new would be taking it much broader, and doing so with cost containment - not just quality of care - as a central goal. But that level of reform seems unlikely to be imminent.
The problem is that in every competition, there's a loser. And in the health sector, those losers make a lot of noise.
If a hospital stops being funded to provide certain surgeries, or emergency care, or most anything else, it will attempt to rally the community around its cause. And that's not even to speak of those cases where an entire hospital has to be shut down, which would probably be the case for the odd one unable to compete in enough areas.
If it's actually serious about changing the funding model, the government will have to stick to its guns - even if there's an outcry in a hotly-contested riding, or there's a particularly sympathetic victim of a funding stoppage, or its own MPPs join the protests.
Rest assured that all of those circumstances will arise. And as of now, there's very little evidence that McGuinty's Liberals - or Tim Hudak's Tories, or anyone else - are prepared to withstand that kind of pressure.
You can't really blame them, because for the time-being they won't win those battles in the court of public opinion. And so we return to the point I was getting at in my column: The prerequisite to making sweeping health care reforms is to condition the public for them, such that there's an understanding that it's about saving the public system rather than tearing it down.
There's also, of course, the small matter of getting it right. Integrating the system through a competition model is all and well and good, but it has to be flexible enough to take into account the huge differences between different communities. Obviously, the reforms that might work in the GTA could cause huge problems if they were rigidly applied to northern Ontario.
Now, it may be that the Liberals have taken a small, tentative step toward having the conversation they need to have, both with health care providers and the general public. But there's a long way to go before there's a political climate conducive to following through on anything particularly "radical." With this month's Throne Speech and budget, we'll find out how serious McGuinty is about getting to that point.
