Canada, like all industrialised countries, has become concerned over health care costs. Canada has reason to be concerned, with the most expensive system, on a per capita basis, of any country with national health insurance. This paper briefly reviews Canada's health care system, examines the rhetoric being adopted throughout the country at the current time, and discusses the changes which are now occurring. An assessment of whether change will lead to a more cost efficient and appropriate system for an aging society is then presented. It is concluded that there are profound changes taking place in the health care system in all provinces in Canada. Most of the changes to date reflect a restricting of current medical care by making ineligible previously eligible procedures, introducing user fees where there were none before, and in some instances including means testing where there was none before. In addition, hospital budgets are being cut and beds are being closed. However, a corresponding expansion of community programmes, while evident in the rhetoric, is less evident within current actions.