One essential role of the central government in a federation is to universalize the good – if necessary, against the will of some federated states. This function does not imply superior knowledge or exceptional experience. In fact, it does not presuppose anything but sensitivity to public opinion and a semblance of constitutional authority. The current government of Canada is less inclined than its predecessors to intervene in the health sector; one might even say that federal leadership is lacking. Yet in fact, if innovation is now at a halt in our health system, it could be less because of what the federal government is (not) doing to support national solutions, and more because of intrinsic issues of management and orientation at the level of healthcare organizations and delivery systems.
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