Trudeau can afford to be picky, he doesn't have to stand up to the  powerful health care unions and doctors lobbies. He doesn't have to take on any political heat whatever he does in health care because he isn't responsible for its delivery. Lecturing the provinces on what is best for them is condescending and childish, using his financial lever to move is dangerous.

The only governments that can take on these lobbies are the ones that deal with them daily.