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SYDNEY — It’s a big gamble, but Australian Prime Minister Kevin Rudd is ready to take it. He will go into an election on the strength of his stance on, of all things, health care.

Never one to avoid a verbal standup, especially when all television cameras have been called in, he is banking on Australia’s world-beating run of economic wins to make stunned voters forget a string of political shocks and return his Labor government for a second term in Canberra.

In picking health system reform for his election winner, he is taking a calculated risk that could blow his comfortable Canberra majority out of office. Already he has upset state governments still smarting over their loss of public face over Rudd reforms in education.

If only fast-moving Rudd had waited a few days he could have benefited from advice from an incoming Washington visitor. President Barack Obama has penciled in a March 22 touch-down in Canberra and an address to both houses of Parliament. If anyone is an expert on the devious ways of getting health care reform past legislature and vested interests, it’s Obama.

Not that the American system of public health care support is comparable to Australia’s. The way doctors and hospitals bring affordable care to lower- income Australians has long been an example to the world — without the angry clashes seen in the United States.

Canberra’s forceful leader is determined to make this issue his rallying call in an election whose date has yet to be announced — despite warnings of unwanted federal intervention from Labor premiers of five states, and despite Rudd’s two years of pushing reforms past angry protests from schoolteachers to house insulation installers.

The installers’ debacle almost cost the job of Environment Minister Peter Garrett. Instead, Rudd stepped in to save Garrett — once the leader of a noisy rock band — from further media bashing by taking the blame himself and appointing Greg Combet to take over most of Garrett’s portfolio. Combet, a former union leader, is one to watch in the never-ending politics of industrial strife.

The incredible row over house insulation — known as pink batts for the color of the material put between a house roof and ceiling to save on air conditioning costs and energy consumption — is a warning to Canberra’s rush to “fix everything.”

Because Australia has come through the global economic crisis in better shape than other countries thanks, say Rudd supporters, to Labor’s injection of cash from the horde saved by former Prime Minister John Howard, there’s no reason to throw money at make-work schemes.

Suddenly someone found that workers were being killed by electric shocks caused by hastily laid foil insulation. It became public that the $2.5 billion household scheme intended to help save the environment would cost billions more to correct.

Radio talkback critics went into overdrive. Alan Jones, the top shock jock at Radio 2GB, where he hosts Sydney’s highest-rating breakfast show, was getting calls from Rudd’s minders. Jones just hung up, but his junior partner took a call and enjoyed 25 minutes of full-on Rudd.

Next, against criticism from teachers, Deputy Prime Minister Julia Gillard has pushed through a computer-based system allowing parents to access the worth of all schools across the country and the progress of students. The comparisons of schools’ performance annoy teachers but not parents. The articulate Gillard is taking credit for updating education. The Melbourne-based deputy should be watched as a likely replacement if Rudd falls.

Enter health care reform, which will usher in an election. Coming ready or not, Rudd will defy the Liberal-National conservative coalition to risk rubbishing overdue reforms.

Australia’s public hospital system is overburdened and underfunded. Hospital costs are rising 7 percent a year — twice the pace of national economic growth. The Rudd case for Canberra control and funding is strong.

Yet, by taking policy control away from state governments, the proposed National Health and Hospitals Network becomes one of the most ambitious changes since the states federated on Canberra in 1901. It is the kind of power transfer that can inflame laid-back Australian voters.

A determined Rudd has gone beyond making this an election issue. If he cannot get his way at the polls, he is promising a national referendum, if necessary, to change the federal constitution. Past referendum polls have savagely divided the community and most have been rejected at the ballot box.

Opposition Leader Tony Abbott was caught napping by the Canberra challenge. The fitness fanatic from Sydney was off in the wilds of the Australian outback, ostensibly surveying the plight of primitive Aboriginal camps — somewhere back of beyond in a place called Fossil Creek.

Abbott is itching to show his spurs after tumbling opposition leader and Liberal Party chief Malcolm Turnbull. Public opinion polls show that move has helped the still-trailing coalition, especially since the Copenhagen debacle when Rudd’s hopes for taxing polluters were quietly shelved.

The health care row will burst forth April 11 when the states tell Rudd whether they accept his taking over 60 percent of hospital funding and 100 percent of funding for doctors. It’s a lot to ask of state premiers who never like to lose power to Canberra.

Only one state, the energy- and mineral-rich Western Australia, has a Liberal government. Premier Colin Barnett will try to curb Canberra’s ambitions. The other states, all held by Labor, begin election season within weeks and will decide on their bargaining tactics for the April deadline.

Already Kristina Keneally, the American-born premier of New South Wales, has rejected the Rudd changes. Keneally claims that her state, the biggest financially, cannot afford the conditions. She says they will soak up most of her state’s budget in two decades.

If there’s one subject that gets Australians off the beaches and on to writing letters to newspapers, it’s health care. This time the prime minister has made it his all-or-nothing stand for re-election. It’s the first big test for a television-loving leader who, until recently, has carried the media with him.

Now the states realize they will lose $90 billion in tax revenue to the Canberra bureaucracy in the first five years from 2011. Even in these good times voters are less than fond of paying higher taxes. The Rudd magic will soon need more than its favored smoke and mirrors.

Alan Goodall is former Tokyo bureau chief for The Australian.

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