Imagine that – In Canada health care costs are soaring, and they can’t figure out what to do.

Pressured by an aging population and the need to rein in budget deficits, Canada’s provinces are taking tough measures to curb healthcare costs, a trend that could erode the principles of the popular state-funded system.

Ontario, Canada’s most populous province, kicked off a fierce battle with drug companies and pharmacies when it said earlier this year it would halve generic drug prices and eliminate “incentive fees” to generic drug manufacturers.

British Columbia is replacing block grants to hospitals with fee-for-procedure payments and Quebec has a new flat health tax and a proposal for payments on each medical visit — an idea that critics say is an illegal user fee.

And a few provinces are also experimenting with private funding for procedures such as hip, knee and cataract surgery.

And here I thought that a single payer system where the government tells drug companies, doctors, and hospitals what they can charge and no one can obtain care except through the government was supposed to solve all problems.

Imagine how much worse off they’d be if their richest people didn’t come to the US for their most expensive health care in our crummy system.