Because Health Minister Tony Ryall is likely to back the proposal, the only remaining major issue is the speed of approval and whether the Southern Board will be in place early enough for this year's local body elections in October.
The merger will then, in due course, act as a blueprint for similar moves in other parts of the country.
As Otago, and perhaps even more so Southland, scrambles and scraps for every dollar in the battles against funding deficits, no miraculous cures should be expected.
The merger should encourage some efficiencies and promote the already advanced sharing of staff, systems and services.
In so doing the merger supports the best possible health for the people of the South.
But it should be recognised this is just one part of the effort and it will not produce large savings.
Remember that Otago already faces a deficit of $10.9 million this year and Southland $11.1 million.
Given the considerably smaller size of its budget, Southland faced a particularly tortuous future going it alone.
As it is, health news will continue to be dominated by struggles to squeeze out every health dollar and to battle the deficits.
Otago chairman Errol Millar was, therefore, not overstating the case when he said the merger was only the end of the beginning rather than the beginning of the end.
Much work needs to be undertaken in many areas as efforts continue to amalgamate systems, cultures and work practices.
Continuous endeavour, too, is required to ensure the promises of services as close as possible to patients are fulfilled.
The natural tendency is for clinicians and administrators to favour centralisation, in this case in Dunedin. That must be resisted and the strength of Invercargill maintained.
At any hint of northern smugness from Dunedin, the prospect of Otago and Canterbury Health Boards combining should be raised. The people of Dunedin would be fearful of having to trek more and more to Christchurch, and the city would shudder at the blow from the loss of medical professionals and other staff.
Over the years, Otago and Southland have seen services, for example control centres for fire and ambulance, first pulled together for the South in Dunedin and then, several years later, ending up in Christchurch with the loss of local knowledge and local jobs.
Already, one South Island board is being talked about.
The Queenstown Lakes division underlines the wisdom of the merger, with the Wakatipu in Southland and Wanaka in Otago. Queenstown interests have, largely, been disgruntled by what Southland provided and backed a combined board.
But, like the residents of the wider region, they would be well advised to limit their expectations.
Indications are that community rather than hospital services will be the focus.
For the sake of the people of Otago and Southland, communities and staff - both clinical and administrative - have to make the most of a joint future.
They have to ensure, for the long term and not just as a temporary expedient, that Southland Hospital retains its health.
They need, also, as they continue to set up combined operations, to build on the best attitudes and systems from either of the primary centres.
There was a certain inevitability to the merger when Otago and Southland began working more closely together during the past few years.
The sceptics might argue that one board was the behind-the-scenes long-term end game all along.
And they might well be right.
The fears from Southland of an Otago takeover were not confronted at first and, as was said at the time, the "horses were not scared".
Now, they have been sufficiently corralled and a clear majority of the Southland board was willing to back the merger.
What a relief that must be to Mr Ryall.
With unanimous support from Otago and an anti vote in Southland, he would have faced making a most unpopular call.
All he has to do now is get on and approve the merger.
