In December 2011, the federal government announced predictable cash transfers for health care and set the stage, in accordance with its view of the federation, for devolution to the provinces to help usher in a new era of health care for Canadians. Since then the Harper government has seemed focused on vacating that stage and several announcements have crystalized this approach. Does it matter? To Canadians, the answer is: it should. Very much. It also matters to Canada’s doctors because a majority government such as this one, committed to working with provincial and territorial governments, can truly have a positive impact and transform our health care system for Canadians.  With predictability in funding, all that is left to do is devise a new vision where policies support health and the system works for patients. The Canadian Medical Association has a plan to ensure Canada can have the best health and health care. The time is now to show leadership and action.