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       Conservative Leader Erin O'Toole speaks to the media on Aug. 24, 2021 in Ottawa.

       Ryan Remiorz/The Canadian Press

       Conservative Leader Erin O’Toole promised to give Canadians “choice” in health care on Tuesday as he pledged not to intervene with provinces that allow people to pay for faster access to health care, after the Liberals said they would claw back cash linked to privatized care.

       The debate over health care delivery drew a premier into the fray for the first time during this federal election campaign. Saskatchewan’s Scott Moe released a statement Tuesday condemning the Liberals for their Monday pledge to penalize the province if it continues to allow people to pay out-of-pocket for faster access to MRIs. And Liberal Leader Justin Trudeau was pressed on Tuesday to explain whether he would apply the same policy to Quebec if re-elected.

       At the same time, Mr. O’Toole sought to clarify his position on privately financed services within a public health care system after the Liberals surfaced a 2020 video in which the then Conservative leadership candidate praised Saskatchewan’s two-for-one MRI program as a “brilliant move” and an example of how to “find public-private synergies and make sure that universal access remains paramount.”

       The Saskatchewan program allows for-profit clinics to charge individuals for MRI scans if they provide an equal number of free scans to people on the public waiting list. One clinic lists a base fee of $950 for the first MRI.

       “I support universal access in our system, public and free. And I also support provinces making sure that they can offer more choice, faster service and less waits for their citizens,” Mr. O’Toole said when asked to explain his endorsement of the program at an announcement in Ottawa on Tuesday.

       The Liberal government raised concerns about privately funded services offered in Saskatchewan and Quebec in 2016 and 2018. In both cases it threatened to claw back federal health funding because the Canada Health Act is supposed to ensure Canadians do not have to pay for medically-necessary care.

       In 2020 the Liberals brought in a new diagnostic services policy under the act. It confirms Ottawa’s right to penalize provinces that offer queue-jumping for people who are willing to pay for the services. But the new policy gives provinces a long runway, only taking effect in December 2022, and is based on self-reporting.

       On Monday, the Liberals for the first time said they would use the clawback on Saskatchewan — if the province doesn’t change its policy. In response Mr. Moe accused the Liberals of singling out Saskatchewan while turning a blind eye to others.

       “Other provinces including Quebec and Ontario have long had private MRI clinics operating within their jurisdictions, yet the Liberal leader has not threatened cuts to health funding in these provinces. This includes private MRI clinics that operate within the Liberal leader’s hometown of Montreal,” Mr. Moe said in a statement.

       Asked on Tuesday whether he would also apply the same claw back policy to provinces such as Quebec, Mr. Trudeau said his government has in the past “made adjustments” to health care transfers. “There are penalties for private delivery of services that we have brought in,” he said.

       “We will continue to stand up for a public, universal health care system, unlike Erin O’Toole. In the depths of a pandemic, he actually shared his perspective that he believes in a for-profit, private health care system, and he will not tell people what exactly he wants to do with that.”

       The Conservative Leader on Tuesday sought to highlight the differences between the Liberal and Conservative positions on Ottawa’s role in health policy.

       “If Saskatchewan, Alberta, Ontario or Quebec want to innovate to provide better health care, I support that. Why? Because it gives Canadians more choice, the more choices Canadians have in health care the better. It reduces wait times and it frees up more money to reinvest in health care,” Mr. O’Toole said.

       In a statement, NDP Leader Jagmeet Singh questioned Mr. Trudeau’s sincerity in preventing privatization within the health care system and accused the Liberals of not doing enough to address privatization in long-term care.

       “If he’s really against private health care, why has he let provinces privatize healthcare services and why does he think it’s good enough for our seniors?” Mr. Singh said.