We spend a lot of money on health care and yet our system is not always able to provide the care that people expect. Waits are long, access uneven and inefficiencies abound. Health system performance draws on the professionals, administrators, technologies, organizational structures and incentive systems that shape the activities of both providers and users. The articles in this section include case studies,  papers and reports from discussion groups on measures that have been taken, in Québec, Canada and elsewhere to improve health system performance.