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Doctors perform a surgery at Mount Saint Joseph Hospital in Vancouver on Sept. 22, 2010.JOHN LEHMANN

Federal leaders need to stop fetishizing the 6-per-cent annual increase now given to the provinces for health care. Michael Ignatieff has promised to continue it, pretty much forever. The Tories have also endorsed the 6-per-cent figure. The NDP? Don't even ask.

Before the miracle of compound interest does us all in (6 per cent a year means a doubling in 12 years), where is the leader who has a plan for sustaining a high-quality health-care system that the country can afford? Never mind a plan. Where is the leader willing to talk about the prospect of hard choices, the necessity of reform and the use of federal bargaining power to shape a system this country can pay for?

Funny, the provinces tend not to include 6 per cent in their annual health-related spending projections. Ontario projected 4.4 per cent growth this year, 3.4 per cent the next and 2.8 per cent the year after that. Quebec has allotted 5 per cent a year for five years. With the wind of another oil boom at its back, Alberta is allotting 6 per cent this year and next and 4.5 per cent in each of the two following years. Mr. Ignatieff and Mr. Harper are raising expectations.

"There is no spending priority of government that is more critical than this," Mr. Harper said yesterday. "This is an unshakable commitment. . . to keep that health care system strong." True, those words are open to interpretation. But, as with Mr. Ignatieff's more unequivocal statements on the subject, they don't suggest a leader girding for a tough negotiation.

Opening the door to the vault is not the job of a leader. It's to demonstrate that, when the public's bottomless appetite for more and better health care meets the reality of an economy that could drop off a cliff (again), he can use federal leverage to promote sustainable change. (With apologies to former prime minister Paul Martin, who bequeathed this country the 6-per-cent increase from 2004 to 2014, and said he was buying change.)

Six per cent is not in the Constitution. It is not part of the Canada Health Act. It is, unlike the Mounties, the lakes and rivers, the linguistic duality and Gordon Lightfoot, not an integral part of Canada.

It would be nice if someone said as much.