The new Minister of National Health and Welfare, Judy LaMarsh, was a Niagara Falls lawyer who knew from personal and professional experience about the high costs of health care. She was pleased to discover that her senior staff had been analyzing possible approaches to medicare while waiting for the Royal Commission’s report. In July 1964, LaMarsh and her provincial colleagues began the initial discussions of the commission’s recommendations and almost immediately identified lack of personnel and lack of training facilities as key problems in the adoption of a national medicare plan. However, since the Department of Finance was in the process of undertaking a major overhaul of the taxation system, the addition of an expensive new shared-cost program would have to wait until the new transfer and equalization system was in operation. But medicare had become a political issue, and Prime Minister Pearson held a federal–provincial conference in July 1965 to spell out his government’s proposals to the provincial leaders. He did not have as many allies in his quest for support as his predecessor had had at the 1955 conference. Rising deficits were making all politicians wary of large new programs, and the expansion of provincial bureaucracies meant that these governments were now prepared to develop their own approaches to medical care insurance.