There are two major political issues that could have disastrous consequences for the Pallister government in the next election: the Tories’ health care reform initiative and its proposed carbon tax.

It would take a lot for the Tories, who dominate the legislature with 39 of 57 seats, to become a one-term government. Even if they lost 10 seats in the next election – a highly unlikely outcome – they would still have a razor-thin majority.

One-term governments are rare in Manitoba. It hasn’t happened since former Tory premier Sterling Lyon – who drifted too far to the political right for most Manitobans’ liking – lost government in 1981 after only one term in office.

Even the hard-left government of former NDP premier Howard Pawley managed to stay in office for two terms, although they eventually lost for the same reason the former Selinger government fell to defeat last year – tax hikes and gross financial mismanagement.

In other words, it takes some pretty nasty governing in Manitoba to get punted from office after only one term in office. And there’s nothing indicating that the Pallister government is about to suffer that fate. At least not yet.

But there are two major issues that could change that: health care reform and the proposed carbon tax. Both have the potential to go sideways for the Tories in a very bad way. And if they go sour simultaneously, it could be lethal.

Health care is the biggest one. The Tories’ hospital reorganization begins in October and continues over the next year. It’s the largest revamp of health care in Manitoba in decades and it includes the shutting down of three emergency departments. There will be three acute care hospitals instead of the current six in Winnipeg, supplemented by two urgent care centres. Specialized services are being consolidated and some front-line services are being eliminated.

We won’t know for another year or two whether the proposed changes result in improved patient care, including shorter wait times. If it does, then government will reap the political rewards for their efforts.

But if this revamp doesn’t work, if the planning – or lack thereof – ends up causing even longer wait times and worsening care, these guys are in for a serious political backlash.

And then there’s the carbon tax. The Pallister government still hasn’t shown its hand on this one. All they’ve pledged so far is that they plan to bring in some type of “made-in-Manitoba” carbon pricing scheme. No one knows what that means yet and they seem to be stalling on it, trying to find some way of pinning the blame on Ottawa for whatever they end up implementing. The Trudeau government has said all provinces must have carbon pricing by 2018 or Ottawa will impose it on them.

The smart thing for the Tories to do would be to let Ottawa bring one in and let them suffer the political consequences. The wrong thing to do would be to bring in their own carbon tax, especially without a referendum. Even though the Tories never promised a carbon tax would be subject to a referendum – they only promised one for a hike in the PST, income taxes and the payroll tax – many Manitobans are under the impression it applies to any tax increase.

Nobody likes a new tax. And if the Tories bring in a carbon tax without a referendum, they’ll take a significant political hit for it. That’s especially true since there’s a growing body of evidence that shows carbon taxes have little, if any, impact on reducing greenhouse gas emissions.

All of this would be a worst-case scenario for the Pallister government. They could probably still eke out a slim majority in 2020, mostly because their competition is so weak. But they would almost certainly lose multiple seats and set themselves up for failure in 2024.

By contrast, if the Tories manage the health care file well and avoid imposing a carbon tax, they’re all but guaranteed two terms in office with a very good shot at staying in power much longer.

The decisions they make over the next year 12 -24 months will have a substantial impact on that outcome.