Reforming Governance: Careful Advice

Looking at the feedback received on my paper on governance reforms in Canada, I was struck by the diversity of viewpoints. Some commentators were more optimistic than others and saw the importance of and the possibility of fixing governance for a better health system. Others were more skeptical, and they were certainly not alone, considering the limitations of past reforms. Being aware of the complexity of achieving beneficial governance, reforms should not deter us from efforts to better align governance with health system improvement. Indeed, critical awareness and perseverance appear through these commentaries' essential ingredients of real governance reforms.