Canadians don’t tend to think much about the federal Department of Health and its role in Canadian health care. How did the Department of Health come about? What does it do? Why do we have a federal Department of Health but not a federal Department of Education? These types of question are basic elements of public policy, yet few people are posing them.

This brings us to the Trudeau government’s possible foray into pharmacare.

Irrespective of the motivation, a new, national pharmacare scheme would represent a major new policy initiative that would expand Ottawa’s role in Canadian health care in an unprecedented way. Assuming responsibility for expenditures and functions which until now have been carried out by the provinces and territories would be a major departure from historic thinking about federalism and the federal role in health care.

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