On the surface, the Mazankowski Report appears highly conventional. The flaws in the current health system that it identifies - lack of service integration, inadequate human resource planning, insufficient information to manage the system appropriately - and the solutions proposed will be familiar to aficionados of health commission reports from the last decade. However, the report does depart from the current Canadian consensus in two important respects: first, it views ensuring access to some types of health services as explicitly an individual, rather than a collective, responsibility; second, it recommends funding access to such services through mechanisms that will likely create financial barriers to care for less healthy or affluent Canadians.