Book excerpt: In this edition of Canada: State of the Federation, contributors consider whether and to what degree the relationship between the central government and the provincial and territorial governments has changed in the past decade. The authors address three overarching questions. First, is the power base changing in Canada? If so, how are governments responding? Second, what are the implications of the changing environment for the relationships between governments? And third, are there underlying forces – such as economic or technological change, or demands for citizen engagement – that are pushing some provinces and regions to become more assertive in the global environment? The papers are organized into four categories: those that identify and analyze the changing federal environment; those concerned with the implications of the 2011 federal election; those that deal with health policy and economic federalism; and those that explore the growing importance of the North and the changing dynamics among the provinces and the federal government. Among the topics discussed are the impact of a majority government based on a West-Ontario coalition, with Quebec represented primarily by the Opposition, the implications of the trade-off between health care spending and the public financing of other essential public goods, and second-generation trade agreements, such as the Canada-European Union Comprehensive Trade Agreement.