From 1995 to 2006, Canadian trade policy purported to insulate the Canadian health care system from the effects of trade liberalization, largely through reliance upon key general exclusion clauses in the NAFTA and the GATS and other legal strategies. During the Conservative years 2006-2015 the government de-emphasized these strategies, and (more importantly) the international trade agenda increasingly emphasized investment promotion and patent protection. When the Liberal Party returned to government in 2015, personal, structural, and ideological factors all pointed to the retention of the neoliberal trade agenda, but one which was legitimated by more 'progressive' features, such as side-agreements. This paper traces the evolution of 'progressive neoliberalism' in the trade-health interface and argues that we need to recognize the inherent limitations of an approach that preaches harmony and coherence between domestic health care and international trade law.