In response, pharmaceutical companies inflate prices of new medications, then negotiate confidential deals that make it difficult to get a realistic comparison for the purpose of setting prices. Because we don't actually have a single payer for pharmaceuticals (there is no national pharmacare program), this program fails at price discovery, since the review board does not go about the actual purchasing of said drugs.

The net result is that Canada has the 3rd-highest per capita drug spend in the world (Switzerland is #2).

In reality, this occurs because the “new” product is junk and no better than the cheaper generic it’s replacing. With these government-sanctioned rebates, the manufacturers save themselves the embarrassment of trying to explain why nobody’s insurance will pay for it (it’s expensive junk).

This is not correct for a variety of reasons, first and foremost that the Canadian healthcare system (systems, really, each province administers its own) do not cover drugs in most cases. There are public programs for low income earners, otherwise it's out of pocket or covered by private insurance.

The real answer is simply that there are legal caps on pricing for most patented medicines, as a condition of being patented.

This simple answer is satisfying to many who otherwise prefer single-payer plans, but doesn't really hold up to scrutiny

I mean, it fails the even more basic scrutiny that Canada simply does not have a single payer for pharmaceuticals, or even a handful of single payer provinces. It's much like the US in structure (out of pocket or private insurance), simply with price controls.

If country X (with single payer plans) does the same thing, the only choice the pharmaceutical company has is to not be covered by insurance, which mean they won't sell their drug. Also the state can just pass laws to make the pharmaceutical company life's miserable. UHC can't do that.

A clarification: Canada does not have a single payer system. Rather it has multiple single payer systems.

Canada is a federation, in that while it has one national government, it also has ten provincial governments (and three territories).

Health care is the responsibility of the provinces, and so there is not "national" health care system (like in France or UK's NHS).

Some groups are a federal responsibility for health care: (aboriginals, military, federal police, federal prisoners and veterans)