In the recent Cabinet shuffle, it is pretty clear to most observers that Premier Harris wanted to put a more assertive fiscal face on his government, which has been under severe criticism (from the left and the right) that it is listless and not in control of the public purse.

In response, two strong fiscal conservatives, Jim Flaherty and Tony Clement were put in charge of the Finance and Health ministries, respectively. Both face daunting tasks. Minister Flaherty must deliver on the campaign pledge to increase health and education spending while continuing with promised personal and business tax cuts.

Unlike his predecessor, Ernie Eves, Mr. Flaherty does not have a booming economy to help him with these competing objectives. But this task pales in comparison to the challenges that are bearing down on his colleague, the new Health Minister, Tony Clement.

To start, the Harris Tories poll abysmally when it comes to health care. Prior to the Walkerton tragedy, it was the issue that PC strategists feared the most. And before Tony Clement could even crack a briefing book in his new office, Liberal leader Dalton McGuinty took to calling the new Minister of Health, "Two-tier Tony."

Not because of anything he had said or done. Instead, apparently this title is deserved simply because Tony Clement is a founding member of the Canadian Alliance (CA). Someone should tell him that the CA basically adopted the NDP position on health care during the last election.

But Mr. McGuinty has learned one thing from his adversaries: define your opponents before they can define themselves. Politically, good ol' Dalton can play this silly name game, but Ontarians would be much better served if he offered constructive suggestions (as he has on institutional reform and ending government funded partisan advertising) for our ailing our health care system.

Look at the facts. Health spending has increased just under six per cent per capita (5.96% to be exact), on average, for each of the last three years. And the health portfolio now consumes 36% of provincial finances. The Conference Board of Canada has noted that health care expenditures will consume 50% of the province's budget by 2020.

In addition, this past February, the Canadian Taxpayers Federation - in its pre-budget submission - projected that at current trends, even with solid and uninterrupted economic growth (3% forever), health spending will consume the entire budget by 2038.

Think about it. Unless health care is funded and delivered in a radically different manner, Ontario will require just two ministries in under 40 years: Finance to collect taxes, and health to spend them. Then what do we do about education, roads, transfers to cities, and the host of other services our tax dollars are supposed to pay for

To his credit, Minister Clement is busy compiling information and seeing to understand (a recent trip to the U.K.) how other countries deliver health care. The Ontario/Canadian experience, with a justifiable crisis of confidence in our system is not unique. The U.K., Australia, Japan, Italy, France, not to mention the U.S., are also struggling with insatiable patient demand, physician attrition pressures, and skyrocketing drug and technology costs, not to mention demographic issues associated with ageing populations.

As well the Minister is speaking openly about a broader mix of private and public providers. Good for him. Aside from the smears from Dalton (who has no plan) McGuinty, Ontarians have a more open mind to health care reform. It's not about public vs. private, Canada vs. U.S. models or right-wing vs. left-wing, it's about what works, period. Let the debate begin …