It is clear both the PC Party and NDP would eliminate Local Health Integration Networks if elected, but just what would take its place is unclear.
LHINs are regional boards that make decisions about how to spend the province's health care dollars, but they've drawn a lot of scrutiny during the provincial election campaign.
During Tuesday's election debate the leaders tried to explain what they are supposed to do and why they should, or should not, continue in that role.
Liberal Leader Dalton McGuinty says "LHINs manage health care in the community. They establish priorities."
But Ontario PC Leader Tim Hudak says "[McGuinty's] created these regional health bureaucracies called the LHINs, basically a bloated layer of middle management that gets between the Ministry of Health, the doctors and nurses, and patients they're trying to care for."
In fact the priority for the PC candidate in Kitchener-Waterloo and former health minister Elizabeth Witmer is getting rid of them.
Witmer says "They're unelected, they're unaccountable…So they've become a shield in some cases for the government accepting responsibility for its own actions."
The Progressive Conservatives say they would close the LHINs and put that money into front line care.
Natalie Mehra with the Ontario Health Coalition says "I don't think the question is so much in the way Tim Hudak has framed it, in that if you took all this money away from the LHINs, boom, things would be better."
That's because while a PC government would save roughly $70 million annually by closing down the LHINs, that's just a drop in the $47 billion annual health care budget.
And at the same time, additional staff would need to be hired at the Ministry of Health, cutting even further into the savings.
But Kitchener Centre Liberal John Milloy says "The simple fact is the LHINs have taken over the role that bureaucrats at Queen's Park used to play, and quite frankly I'd rather have a local group making decisions about my local health care than more bureaucrats at Queen's Park."
CTV News asked the Ontario NDP for an interview on LHINs, preferably with a southwestern Ontario candidate, but received no response.
However, in their platform the NDP has also promised to scrap LHINs, stating they have "forced significant changes...without any meaningful consultation."
Speaking in London, Ont. NDP Leader Andrea Horwath said "There was no transparency in decision-making, and that's not acceptable. I do believe there is a way to bring that accountability into play without shipping decision-making out of local communities."
The New Democrats would give Ontario's ombudsman the power to investigate the entire health care system.
Mehra says "If candidates are hearing anything at the door they're hearing that the public is angry about the lack of accountability."
The Ontario Health Coalition believes the NDP plan could work, but points out they haven't identified a way to pay for it.
In an odd twist, the 60-page Liberal plan doesn't mention Local Health Integration Networks or LHINs at all.
When prompted, the party says LHINs are just getting their footing and should not be eliminated.
Milloy says "Has it taken a few years to develop? Of course it has! It's a new concept, it would totally be stepping backwards to get rid of them."
Liberal platform: http://www.ontarioliberal.ca/OurPlan/Platform.aspx
NDP platform: http://ontariondp.com/en/policy
Progressive Conservative platform: http://www.ontariopc.com/changebook/
