Yeah, this is a real issue. I shouldn’t have to worry about healthcare if I move or travel between provinces. This could be resolved today under the current system, yet it hasn’t. The only realistic reason is the various provinces don’t want to. If the feds could step in and make this go away I would be very happy. This would require a constitutional amendment, so I’m not holding my breath. I’ve heard some rebuttals that the provinces have needs that are too different, but the needs between the north and south of each province are greater than the needs between the provinces and we deal with that (often poorly). Another one I’ve heard is that the feds can’t be trusted to run something like that, but the provinces are doing a pretty poor job in most cases already. All this is besides the redundant administrative costs you mentioned.