Victorian Premier John Brumby has no real respect for Prime Minister Kevin Rudd or the way that he practices politics.

That is not limited to the handling of the health reform issue. It applies across the board.

So when he told the National Press Club in Canberra today that he won’t be bullied by his Labor colleagues, or anybody else, you had better believe it.

His resolute opposition to the Federal Government’s hospital package is deep-seated and genuine, and cannot be placed in the same category as the usual pre-COAG positioning that has gone on for years.

The media reporting of Brumby’s 3AW interview this week focussed on the Joh Bjelke-Petersen reference; that you would have to go back to the Bjelke-Petersen period to identify another time when the states were held to ransom in this way.

But a transcript of that interview reveals the full extent to which Brumby was prepared to attack Rudd’s jugular.

He said, quoting Rudd: “… if you don’t do things the way I tell you, I am going to take money off you.”

Neil Mitchell: “What are the implications of that? Sick people suffer?”

Brumby: “Well the implications of that is that Victorians won’t be signing up to a deal because it would be bad for our state; and because we haven’t signed up, he would make things even worse.”

Mitchell: “Wouldn’t that mean sick people would suffer?”

Brumby: “Yeah, and I…”

Mitchell: “Sorry, is that yes?”

Brumby: “Yes it would.”

Mitchell: “But that’s obscene.”

Brumby: “Yeah … I would be very surprised if that’s what the PM really meant and there are a lot of things said in the bluster of debate.”

But not any of that. It was calculated and considered. The Victorian Premier was suggesting that Kevin Rudd plays his politics so hard, that he is prepared to make conditions for sick people even worse to get his own way.

A fascinating subtext to all of this is that both Rudd and Brumby have elections this year. They lead separate divisions of the same party. They will need to cooperate and campaign together. Unless there is a circuit breaker, how can they do that with any sincerity?

Furthermore, if Monday’s talks fail, and if Rudd takes the issue to a referendum, they will take opposite sides on that important and divisive debate.

Brumby will have no choice but to run the line that given Rudd’s form on insulation you could not possibly trust him to run the hospitals.

Those around him already argue that Rudd’s devotion to hospital reform is partly a latter-day cover for policy failings in other areas. Poke him with a big enough stick, and Brumby could well say that, or something similar, on the record.

In short, this is developing into a serious rift in an important political relationship. Yet Brumby can manage it and maybe even turn it to his advantage. On the other hand, the downside for Rudd is obvious.

He desperately needs a policy breakthrough – not a fresh debate – not a process – an outcome. The last thing he needs is for health reform to be stacked up against climate change as another unrealised ambition.

Rudd’s position will be strengthened, and Brumby’s weakened, if Victoria stands alone against the reforms.

But Brumby is convinced that won’t happen. He sees the objection of the West Australian Premier, Colin Barnett, to the GST changes as fundamental and non-negotiable. The fact that Barnett is overseas until the eve of the talks partly supports that view.

And even allowing for Rudd’s belated charm offensive with NSW Premier Kristina Keneally, the Victorians judge that the biggest state is no better than a 50-50 chance to sign up.

So Rudd needs a result, and to get that, he will need to deliver a revised and compelling plan. Not merely a concept to “end the blame game”. The plan will have to involve more money, and it will have to allow the states to go away satisfied that more beds will open up, and more patients will be treated … now. Not sometime in the never never.