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Publius: The Journal of Federalism Advance Access originally published online on October 30, 2008
Publius: The Journal of Federalism 2009 39(1):187-209; doi:10.1093/publius/pjn029
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© The Author 2008. Published by Oxford University Press on behalf of CSF Associates: Publius, Inc. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org.

This article appears in the following Publius: The Journal of Federalism issue: Federalism and Health Policy [View the issue table of contents]

The Gradual Defederalization of Canadian Health Policy

Peter Graefe* and Andrew Bourns{dagger}
*McMaster University; graefep{at}mcmaster.ca
{dagger}Osgoode Hall Law School

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.


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