This chapter describes the governance of Switzerland’s health system and the reform process. Governance in Switzerland is founded on decentralised approaches and consensus seeking. This can often curb the political capacity for reform, but it also provides opportunities for innovative policies at a municipal or cantonal level for sharing knowledge and best practices. In this context, improving governance will depend on the ability of the Swiss authorities and other stakeholders to develop and implement a strategic vision for the future of the Swiss health system. The ongoing discussions over a potential law on prevention and the national health strategy project are important initiatives in this direction. Better governance will also require development of nationwide information systems and generating better evidence to inform policy.