During the 1990s, the Province of Alberta has undergone unprecedented change in the public sector. Significant downsizing of administrative structures at the provincial level, and regionalization of governance and service delivery at the local level, has characterized this. In the case of health care, the government of Alberta embarked on a plan to reduce expenditures by 19 per cent over a three-year period, as part of a commitment to eliminate a $3.4 billion annual deficit. The elimination of the deficit was to be achieved entirely on the expenditure side, without an increase in taxes. In what followed as a response to this fiscal imperative, the health care sector was restructured through the elimination of most existing local boards and the creation of seventeen regional health authorities with responsibility for most health care services, and two provincial boards.