Ontario Health Minister George Smitherman recently stated the election of B.C. doctor Brian Day as president of Canadian Medical Association (CMA) poses a "grave threat" to health care. Dr. Day's sin: Providing health services outside the government Medicare system. He offers sick patients an alternative to the government health monopoly and long hospital waiting lines.

Minister Smitherman's speech - described in the media as "fiery election style" - was mere posturing. Politicians of all stripes have sung the single-tier health care song, including former Ontario Premier Mike Harris and even Prime Minister Stephen Harper, but the reality is this is just rhetoric.

Minister Smitherman has attempted to paint Dr. Day, the CMA, other provinces, and federal Health Minister Tony Clement as antagonists because they have taken steps (in some cases the tiniest of steps) to accept the private sector as a viable alternative to, and a vehicle to improve, the public health monopoly. And yet Ontario's Liberal government has already adopted Mike Harris's public-private hospital partnership plan.

Minister Smitherman and Premier Dalton McGuinty continue to publicly deny that the private sector has any role in the future of Ontario's health care system. Yet their policies tell another story - Since taking power in 2003, the McGuinty government has privatized long-term care facilities and announced 30 public-private partnership hospitals. Furthermore, the Liberal government has privatized routine eye examinations and chiropractic services. This is a promising start.

Simply claiming victory for the public system at photo opportunities will not address Ontario's growing health care demands. Ontarians are in search of quality and affordable health care delivered in an efficient manner. According to the Canadian Institute for Health Information the Ontario government and its citizens spent $19-billion on private sector health services in 2005.

''For years, we have been shadowboxing with often obscure voices agitating for two-tier health care,'' Mr. Smitherman says. This is an absurd statement. The voices for reform are everywhere and include no less an authority than the Supreme Court. Canada's high court kick opened the door last year to expand private sector involvement in our health care system with its Chaoulli ruling.

The CMA has similarly demonstrated it is moving forward trying to improve the ailing Canadian health monopoly under the leadership of Dr. Day. The election of Dr. Day does not pose a threat to the system. He brings hope with new reform ideas and a fresh outlook on how to rebuild the system so that it can focus on patient care instead of political rhetoric and bureaucracy.

The time to move away from rhetoric to reality has come. It is time for Minister Smitherman and Premier McGuinty to publicly accept that privately delivered health care has already contributed to renewing the health care system and will have an even larger role in the future - for they have already done so behind closed doors at the cabinet table