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The constitution of Canada specifies the powers of the territorial, provincial, and federal governments. The provinces under the Constitution Act of 1867 were responsible for managing, maintaining, and establishing asylums, hospitals, and charitable institutions; the federal government was in control of quarantine and marine hospitals and was empowered to borrow, tax, and spend such funds as long as this did not undermine the provincial powers. In 1919, a federal department of health was established.

The first ministers (the prime ministers of Canada’s federal, provincial, and territorial governments) adopted the Accord on Health Care Renewal in 2003 in an effort to provide structural modifications to the health care system in order to improve access, long-term sustainability, and quality. The accord committed the governments to adopt specific reforms ...

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