It's not about the Canada Health Act.

Pieces of paper do not a health care system make - especially when their contents have been so wildly exaggerated that perceptions of them are generally false. For the record, the legislation that Ralph Klein allegedly intends to violate does not explicitly forbid private delivery, private insurance or doctors working both within and outside the public system. To violate the act as it's written, Alberta would have to delist or fail to deliver public services, privatize the public insurance system, impose user fees, deny public health insurance to residents or turn away patients from other provinces. None of those measures are included in the 10-point proposal unveiled by provincial Health Minister Iris Evans earlier this week.

But even if popular interpretations of the act lead you to believe that it implicitly forbids what Klein is trying to do, that's still not much of a basis to reject his reforms out of hand. This isn't our constitution we're talking about. It's a simple piece of legislation, albeit a hugely important one, and legislation is challenged and amended all the time.

None of this makes Alberta's health care plan any less disturbing. It just means those who actually believe in universal care need to stop being so intellectually lazy about defending it.

There are two separate ways to go about introducing what the Post's editorial board typically refers to as "flexibility" into the public system. One is to allow greater private delivery of publicly funded services; the other is to make it easier for patients to go outside the public system and pay for private care. Both get medicare loyalists up in arms, but only one really should. Unfortunately, that's the one Klein seems more interested in.

In theory, at least, there is no good reason to oppose an increase in public-private partnerships, of the sort B.C. Premier Gordon Campbell has spent the week examining in Europe. There's no guarantee that it'll actually make the system more efficient; for all we know, it could actually prove more costly. But provided certain standards are maintained, and that services are still covered by public insurance, it's perfectly reasonable to experiment. At the end of the day, the basic aim of our system - that all Canadians have access to the same level of care, regardless of their ability to pay - won't be compromised.

The same, however, can't be said for what Klein has in mind. By encouraging doctors to work both publicly and privately, and allowing patients to pay for faster access to certain treatments - with more, presumably, to follow - his plan would strike a blow to the universality at the core of our medicare system.

Yes, every patient would still have access to services, regardless of their ability to pay. But with the gradual implementation of a parallel private system, it would no longer be the case that all Canadians had access to the same services. In the end, those who could afford to shell out for expensive insurance plans or individual procedures would wind up receiving quicker (and probably more effective) service than the rest of us.

The "socialist" tag is often applied to our current system, usually derisively. And in a narrow sense, it's probably accurate. But when it comes to medicare, universality is about equality of opportunity -- an aim you don't have to be a socialist to share.

There is no way to ensure that every Canadian has exactly the same opportunity to succeed, regardless of socio-economic background, geography and all other factors. But the least we can do is ensure that everyone has the opportunity to grow up healthy and to live as long as possible. To date, we haven't done a perfect job of that: Quality of medicare varies by region, and there are already ways for affluent patients to receive better care than everyone else. But the fact that we've come reasonably close is to be celebrated, not scorned.

The challenge should now be to ensure a higher quality of care for all of us. Waiting list guarantees of the sort that Quebec is planning suit that aim. So, too, might greater private sector involvement. But Klein's plan will do the opposite. The more that influential high-income patients go outside the public system, the less impetus there will be to improve it.

We don't need the Canada Health Act to tell us this. And we can't expect it to serve as a shield against unpalatable reforms. It's up to those who believe in the universal system both to defend it and to modernize it. Hopefully, Klein's alternative will lead us to do a much better job of both.