Abstract

This commentary responds to Flood and Thomas (2025) by focusing on the often-overlooked principle of portability in the Canada Health Act (1985). It argues that Canada’s healthcare system remains essentially the sum of its parts: provincial and territorial health plans, guided by similar values, adhering to principles that have financial strings attached and bound together by portability and the spirit of reciprocity. To strengthen this sense of shared purpose and responsibility, we need to allow space for the federal government to encourage such reciprocity and to find ways of allowing intergovernmental relationships between the provinces/territories to be enhanced.