Public health may not be ready for health system change - but neither is the system ready to integrate public health.

In response to the lead paper, the authors of this commentary propose that there are three fundamental sorts of reform for which Canada's healthcare system would need to provide evidence of progress before public health professionals should get fired up about lumping everything together inside the care system, to help it "transform." These three central changes - the adoption of an integrated data system, the provision of meaningful incentives for prevention, and important structural design changes - would be essential to enabling public health talent (and their skills) to be really useful and effective as staff within the care system. They argue that without clear evidence of this progress, such integration might well lead to the capture of the hearts, minds and energies of many well-intended public health professionals by purely clinical services management work, to the exclusion of proper upstream public health activities to uplift population health status and reduce inequalities more fundamentally.