Reality Check on the NHS: This Won't Hurt?
A third of Holyrood's budget goes on health, so where's the election debate about the future of the health service?
The pledges being made are towards the margins: Lib Dems want more efficient medicine procurement and capped pay, and there would be a small increase in income if Tories re-introduce prescription charges for some.
The biggest difference between Labour and the Scottish National Party on health is between Labour's promise to speed up the maximum wait to see a cancer specialist, while the SNP says the priority is to get Scots with cancer to their GPs at a much earlier stage in the disease's progression.
What they all agree on is protection of the NHS budget against cuts being imposed elsewhere. That makes perfect political sense, as the NHS is hugely popular, and cutting it would be hugely difficult.
It makes a bit less financial sense.
Ring-fencing one part of Holyrood's budget gives an incentive not to make efficiency measures that might be possible or desirable. It allows those within the service to expect continuation of the rapid rise in pay that several groups have seen over recent years.
But look at it another way. While the cash going into NHS Scotland keeps rising, the rise in real terms spending power has come to an abrupt stop.
Spending pressures have not.
With the current financial year barely a month old, I'm reliably told that health boards reckon they face an overspend of around £100m because of ring-fenced money within their budgets and cash that's already allocated.
That may be modest, judging by an interview given by the chief executive of Greater Glasgow and Clyde health board.
Robert Calderwood told The Herald earlier this year that he's getting a 1% increase in spending power this year, but it's quickly wiped out by commitments already in the pipeline, amounting to between £45m and £51m.
Part of that is in the drugs bill going up, by between 6% and 9%. Unlike other sectors, the more you invest in health technology, the more your costs go up, and the more people's expectations rise of having access to it.
Audit Scotland recently reported the VAT bill is adding £23m to NHS Scotland costs, plus an increase in employers national insurance contribution.
It said there are "major challenges to find significant savings", even if the budget is protected from the cuts being felt elsewhere.
The pressure it highlights strongly is the demographic pressure on services.
That comes particularly from the growing number of older people, who use health services more, and the particularly rapid rise in the very old. Scots aged over 85 are due to rise in number by 144% by 2031.
Audit Scotland cites Scottish government analysis showing that the bill for health and social care for those aged 65 and over is around £4,800 this year, and will be up by about 15% by the end of the next parliament, in 2016.
By 2031, it is on track to rise by 62%. Simply keeping pace with general inflation isn't much of an answer to that kind of cost pressure.
Since Professor David Kerr's report into the future shape of NHS services in Scotland, his recommendation of centralising some services to improve their quality has been dumped in favour of protecting local hospital services. That's now common ground for the major parties.
So if hospitals are protected, what about jobs?
The political desire to avoid compulsory redundancies is described by one very senior health manager (they tend not to talk both candidly and publicly) as "completely unrealistic".
So if both hospitals and jobs are protected, then watch out for pressure being brought onto the relatively soft and less politically sensitive options of public health or mental health.
Or there could be a significance to the moves for health and social care to be merged. There are variations on that theme on offer in party manifestos.
In England, one way the government is handling the protection of NHS spending while others suffer is to give it more to do, such as taking on the healthcare elements of immigration and detention.
That might also be what comes out of a merger with social care, forcing the NHS to take more of the squeeze while making it look like a sensible piece of efficient management.
Inside the NHS, and away from the political consensus on protecting the total NHS budget, there's a lot of questions being asked about how sustainable the current model and expectations can be without big and difficult changes and reforms being required.
That's where Campbell Christie's commission on the future of public services, recently set up by the SNP administration, may provide some answers - when it's safer to debate these things, after the election.