The Alberta government has formally endorsed a plan for Medicare reform that will fundamentally alter the way health services are paid for and delivered in the province.

In late January, provincial health Minister Gary Mar announced plans to implement all 43 recommendations put forward by the Premier’s Advisory Council on Health, better know as the "Mazankowski Commission."

On one level the report, authored by Mulroney-era cabinet minister Don Mazankowski, says many things that supporters of public health can agree with.

For example, the Council calls on the Alberta government to explore options to the current fee-for-service model for paying physicians. It also says we should pay more attention to preventing disease and promoting healthy lifestyles. And it says we should invest more in health education and research.

Many observers have pointed to these recommendations as proof that the Mazankowski report is not really that surprising or dangerous. But the truth is that all of report’s talk about "healthy communities and healthy lifestyles" is just a sugar coating that has been applied to sweeten a bitter pill.

Like other Conservative governments, the Klein government in Alberta realizes that Medicare is extremely popular with the public – so they have avoided any direct references to eliminating or replacing the system. Instead, the Mazankowski report opts for vague language that seems deliberately designed to reassure people and blunt the real meaning of what is being proposed.

For example, instead of saying directly that many Medicare services should be de-listed, the report calls on the government to "re-define comprehensiveness." And instead of saying that patients should be made to pay out of their own pockets for health services, the report says that the government should "pursue alternative streams of revenue."

However, once you strip away all the vague language, it’s clear that the Mazankowski report is not just another bland analysis of the problems facing the health care system.

Instead, it is a radical document that presents a relentlessly market-driven blueprint for reform.

And it is a document which, if implemented, poses an enormous threat to the future of Medicare – not just in Alberta, but all across the entire country.