Health System Leadership and the Federal Role in Canada

While provincial governments constitute the primary locus for healthcare system decision-making and provision, the federal government retains an important funding and "steering" role in directing health system performance. This commentary explores three possible redeployments of the federal spending power to elevate health system performance; improve access; increase individual, provincial and regional equity; and achieve better health outcomes for present and future Canadians. The proposals include amending the Canada Health Transfer to better support its original policy purpose, improving and expanding an informational and analytical infrastructure and the eventual implementation of single pharmacare program by the Government of Canada. These changes are aimed at accelerating evidence-based health reforms to improve access, quality and responsiveness of healthcare and, ultimately, health outcomes.