The Charter has since become a large part of Canadians' collective sense of self, occupying a space in the national consciousness roughly comparable to that once held by Crown and Empire. As a national symbol, moreover, it has three rare virtues, not evident in, say, Via Rail or the CBC. One, it's a good idea. Two, it is the object of genuine popular approval across the country, rather than the fetish of a few nationalists in Southern Ontario. (And yes, that applies to Quebec: The latest poll, as reported Monday in the National Post, confirms that support for the Charter is even higher in Quebec than elsewhere, contrary to the received wisdom of a generation of constitutionalists.)

And three, it is entirely self-referential: For once, we are not measuring ourselves in opposition to the Americans -- if anything, it has made us more like them -- but rather by the light of our own ideals. In drafting the Charter, in deciding what we stood for, we were also defining who we were.

Now Mr. Romanow has been called upon to draft a new document, one that again will help to define us as a nation. Only this time, he is working from an existing text: the 1984 Canada Health Act. Like the Charter, the Act embodies some of our highest national ideals. Like the Charter, it inspires a certain popular reverence: As Mr. Romanow writes in the preliminary report of his one-man commission on the future of health care, it has acquired "iconic status." And yet the Act, and what it represents, have lately come under considerable strain. It isn't, I would argue, public health care itself that is in jeopardy, or the five principles set out in the Act. Whatever change comes to medicare, my guess is that these will remain essentially intact: because they're good ideas, and because they enjoy broad popular support.

What is at stake, rather, is whether we will continue to define these ideals in national terms -- indeed, our very ability to think and act as a nation. That is what the Act truly represents. That is what is under attack. That is what Mr. Romanow is preparing to defend.

Indeed, his very mandate is at issue. When the provinces tell the Romanow commission, in effect, don't bother, this is our affair, we will proceed with health care reform without you, they are not simply stating that health care is a provincial jurisdiction. They are not just rejecting federal involvement in the issue. They are denying that health care is a national issue: that is, an issue that transcends provincial boundaries, but engages certain national values. They are denying that we are a nation.

I'm sure they don't intend to suggest this, most of them. But the health care debate must be seen in the context of an already attenuated national condition. Against the unifying ideals of the Charter and the Canada Health Act, provincial governments have exerted an ever-greater centrifugal force over the years. They have not succeeded, yet, in breaking the country apart. But they have effectively hamstrung the federal government in the exercise of its powers, at least where these conflict with provincial ambitions.

This is most clearly seen with regard to the economic union. Every federal system in the world assigns responsibility for enforcing the internal common market to the federal government. So, for that matter, does ours -- as a matter of law. Why, then, does Canada, uniquely, suffer from a plague of inter-provincial trade barriers? Why, to compound the offence, does it leave the matter to be negotiated among the provinces, as if between sovereign states? Because the federal government lacks the political legitimacy to do the job. And why is that? Because our sense of nationhood is not yet strong enough. We don't quite see the feds as our government, but as theirs, those others, in the other provinces.

The same is now in danger of happening to the federal role in medicare. At bottom, Mr.

Romanow writes, the debate over health care is framed by certain basic value judgments; it is these that determine the range of policies from which governments can choose. If we cannot agree on what these fundamental values are -- if we cannot even agree that this is something we ought to agree on -- then not only will health care cease to be a national question, but so will much else.

If, on the other hand, Mr. Romanow can succeed in breathing life into the Canada Health Act, if he can convince the provinces to renew their commitment to a national health care system, who knows what we can do together?