This thesis examines the Royal Commission on the Future of Health Care in Canada (Romanow commission), in particular the ways in which the commission deviates from previous public inquiries. The paper surveys the literature on royal commissions to identify common attributes of commissions and explore the dimensions along which public inquiries vary. By identifying the dimensions of variation, it becomes possible to conduct an assessment of the Romanow commission according to each dimension. The thesis is framed by an assessment of each dimension. The product of this analysis is a clear understanding of the ways in which the Romanow commission differs from its predecessors. The thesis identifies three dimensions in which the Romanow commission is unique: it is the first national commission in nearly forty years with a major social policy as its focus; its emphasis on public consultation exceeds recent commissions: and the long-term advocacy role assumed by its chair.