Politics Insider delivers premium analysis and access to Canada's policymakers and politicians. Visit the Politics Insider homepage for insight available only to subscribers.
It's a curious country where the Fisheries Minister makes more headlines on healthcare than the Health Minister.
But there was Keith Ashfield on the front page of the Saint John Telegraph-Journal last week proclaiming: "We need a national debate. I think it's important and I think there is an opportunity for us to be frank with one another and discuss the issues around health care and where it is going in this country."
By the way, Mr. Ashfield is the Fisheries Minister. With a federal government so strictly controlled through the Prime Minister's Office, we sometimes need reminding that there are ministers of the Crown.
The Minister of Health is Leona Aglukkaq. In a government that considers healthcare strictly a provincial responsibility, health has become a de facto junior cabinet portfolio. That is why Ms. Aglukkaq has time to also serve as Minister for the Arctic Council and Minister for Canadian Economic Development.
The job of a health minister in this government is mostly to make funding announcements, do photo opportunities and not make waves.
But back to Mr. Ashfield, and the comments he made at a meeting with the editorial board of Brunswick News (which owns the Telegraph-Journal). Most of what he said was innocuous, if not tedious. We hardly need more talk about health care; we need some action.
But to suggest a national healthcare debate is needed is not the party line; if anything, it is diametrically opposed to Ottawa's approach.
The New Brunswick Medical Society and the Canadian Medical Association both pounced on Mr. Ashfield's comments, saying they agree it's time for meaningful transformation.
"Improving medicare for Canadians should be a national imperative," said Anna Reid, the CMA president.
So why did the Fisheries Minister venture into the minefield that is health care?
Mr. Ashfield is Fredericton's MP. The provincial government in New Brunswick just announced that it is freezing the healthcare budget. There is going to be fallout and the public is going to get angry.
The reality of Canadian politics is this: When the voters are mad about the state of health care they are as likely as to take it out on federal politicians as provincial ones. Mr. Ashfield, who has served in both the provincial legislature and federal Parliament, knows this all too well.
If he hopes to retain his seat in the next election, he has to start distinguishing himself on a file that matters a lot to voters. And he's not alone.
In the months and years to come, many more Conservative ministers and backbenchers are going to break ranks and speak out on health care, especially as the pressure is ramped up in the ridings and home provinces.
In his chat with the editorial board, Mr. Ashfield had to answer some tough questions on federal health funding. While health transfers are increasing significantly – 6 per cent annually – that will change soon enough, falling to 3 per cent in 2016. The funding formula is also now based strictly on population size, a change that will really hurt a province like New Brunswick, where the population is shrinking and aging.
The reality is that finding money to pay for health care is difficult now, it's going to be a lot harder in the years to come, especially with Ottawa stepping back.
It is no surprise that New Brunswick Premier David Alward, a Conservative, has been one of the most outspoken critics of Ottawa's hands-off attitude.
When Mr. Harper refused to meet with the premiers to talk health care last year, Mr. Alward said: "I do believe that it is important that the federal government be engaged in issues that are vitally important to Canadians such as health care.
"I believe that we're stronger when we're all at the table and when both the federal government and the provinces are at the table."
You're going to be hearing a lot more of this in the near future, as the provinces implement budgets with very little new money for health care and First Ministers gear up for a key meeting this summer in Niagara Falls.
The premiers, who want to squeeze more money out of the federal government, are betting this message will resonate with the public.
For years now, the "Gone Fishin'" sign has been hanging on the healthcare file in the PMO.
The Fisheries Minister, for one, seems to think it's time to retire it and get back in the game.
André Picard is The Globe and Mail's health columnist.