Mixed provinces exhibit elements of pragmatism in addition to elements of paternalism. They tend to be more politically open than paternalist provinces but more restrictive than their pragmatist counterparts. This combination produces a policy style in which provincial leaders take a top-down approach to policymaking and standardize new policies across the province yet tend to be relatively frugal in their social policy allocations both in relative and per capita spending. In some cases, mixed provinces are caught in the middle: they do not generate as much revenue as coastal provinces, but they are not poor enough to be eligible for certain fiscal transfers from the central government. As a result, the budget for social policy in these provinces is often among the smallest in the country. This chapter focuses on health policy in mixed provinces, while also discussing the impact of a mixed policy style on education, poverty alleviation, and housing.