In the coming weeks every household in British Columbia will receive an obnoxiously large brochure concerning the government's "health care conversation." The four page brochure contains some interesting health care facts, demographic statistics and reserves the back page for members of the public to "join the conversation."

More than a few dollars were used to design, print and mail out the brochure. Add to that, the cost of television and print ads, regional forums, surveys and the "health care conversation" is expected to tally ten million tax dollars.

Generally, the Canadian Taxpayers Federation (CTF) is the first to criticize such consultations-or "conversations" in this case-as a waste of tax dollars and chalk them up to nothing more than a dog and pony show. However, because health care costs have been the largest budget pressure in recent years and because the government appears to be open to innovation, the CTF took a wait and see approach.

Given that taxpayers fork out $35 million a day in health care costs, the $10 million "conversation" is a drop in the proverbial bucket-particularly if it results in meaningful reform to the status quo.

However even before the "conversation" has begun, the government moved to shut down the Urgent Care Centre because it is operating outside the state system.

On the one hand, the government is asking questions like, "Why are we so afraid to look at mixed health care delivery models-" But then turns around and sends in a bunch of government bureaucrats to audit a private company, claiming its services violate the Canada Health Act.

But does it The Urgent Care Centre opened its doors December 1st and offers patients quick access to doctors, state of the art equipment and extended hours. Initially, the boutique clinic had a fee schedule to bill patients directly rather than through the government's medical services premiums. And that's where the conflict starts.

The Canada Health Act sets out several principles of our state run health care system. But many key terms such as "medically necessary" and "reasonable access" are not clearly defined.

The provincial government itself recognizes this as problem to future health care solutions and reforms. In its Throne Speech, as well as on the website for the health care conversation, the government asks: "How should we define concepts like 'reasonable access' to 'medically necessary' services " But then turns around and unilaterally answers that question by claiming the private Urgent Care Centre contravenes the Canada Health Act. It looks like the health care conversation will go something more like this: "Shut up and listen!"

The provincial government didn't just slap the clinic operators on the wrist but issued stern threats. The premier and health minister were prepared to use the fullest extent of the law to shut down the Centre unless it changed its billing practices! Then, the government proclaimed a law that gives the Medical Services Commission the power to audit any private clinic and their billing practices.

Sadly, with the threat of a protracted legal battle, the clinic owners acquiesced to the iron fist of government and will now bill through the Medical Services Plan. In effect, the Urgent Care Centre will operate like every other walk in clinic but with more and better equipment.

The clinic's owner, Dr. Mark Godley, should be commended for his innovation and encouraged to continue challenging the status quo. Patients are way ahead of their politicians on this issue. The demand for Dr. Godley's services will continue to grow; as will the wait lists for public services. The outcome of the health care conversation will depend on the government listening and forgoing knee jerk reactions, like threatening to shut down access to health services like the Urgent Care Centre.