The Gradual Defederalization of Canadian Health Policy

Health policy is an important facet of territorial politics, drawing the contours of the sharing community. Changes in the management of the division of powers in health policy point to shifting understandings of the federal political community. This article adopts this approach in the Canadian case, where observers disagree about whether values of federal diversity remain robust or are eroding. It considers three Commissions (Rowell-Sirois, Hall, and Romanow) reporting over a 60-year time span. The Commissions adopt different understandings of the division of powers and of the proper forms of intergovernmental health governance, moving from a robust understanding of federal diversity and the division of powers in the 1940s, to an afederal emphasis on efficiency and pan-Canadian citizenship in the early 2000s.