I completely agree that we need more centralization of policy in Canada, but at the same time provinces should still exist, just don't put them in charge of major policy.
In the case of healthcare, we should centralize the core portions of it while leaving the general specifics down to the individual provinces.
My ideal way, would be if you were to liken it to a division within a company. You have the Federal Head which has a key set of stuff only they handle, such as administrating the handing out of Health Cards, the billing , negotiations to get stuff for cheaper and the core set of requrements. Then from the provinces (divisions) perspectives, they are in charge of administering the actual program within the province and can choose to add onto the base coverage should they want to. Then slap a fancy label on it that says "Canada Health Insurance Plan" with a new logo and away you go.
Basically, its the same degree of seperation that exists with the Student Loan Program where you have the NSLSC being the main entity behind it all, and each province which has signed onto it acts as administration divisions to modify as they see fit. For provinces, there is a very key set of ideas in the program that they don't have to manage, while they still have the power to do some more off the wall ideas like Ontario's Free Tuition simply via the province paying more money into the program and saying "this is what the money is for"
We need to get this done.