title: Transforming the System with One Small Change? An Idea for Debate.
abstract: Gardner, Levy and Fierlbeck offer a thought-provoking plan for turning Canada's currently unproductive and obstructive model of fiscal federalism into an effective tool for leveraging substantive change in the country's healthcare systems and enhancing their ability to provide effective care at acceptable cost. However, what is presented as a straightforward solution actually requires a complicated and highly demanding set of interlocking transformations. The author of this commentary is not convinced that these can all be achieved within a politically realistic timeframe and without significant new resources.
authors.affiliation: Director for the Centre of Applied Health Research, Memorial University, St. John's, NL.
authors.forename: Stephen
authors.initials: S
authors.lastname: Bornstein
mesh_terms: D002170:Canada; D003695:Delivery of Health Care; D006295:Health Resources; D006801:Humans; D011057:Politics