What do we mean by effectiveness in health care planning? What and whom does it affect? What methodology should it apply? Such questions refer to methodological (and political) issues that do matter for the purpose of ensuring equal rights to health to everybody. In fact, not only do they "raise the methodological issue", but also they turn the "methodological discourse" into something that has an impact on reality both in terms of governance and in terms of sustainable action. All along the last century we have witnessed: a) a continuous devaluation of territorial knowledge, b) a planning process predominantly targeted to emergency situations, c) a series of processes based upon the dual problem-solution methodology. The immediate involvement of stakeholders in the planning process becomes an ethical principle of planning and governance for health: such method requires the enhancement of knowledge and the continuous exchange of "hands-on" experience among the different groups involved in the planning-acting process, that look at reality from different angles and possess different types of know-how.Only where these two modes and levels of knowledge overlap can we implement health governance as a product of territorial expertise and as a tool for promoting equality.