Americans get no drugs covered--at all--unless you're over 65, have insurance through your employer, or pay thousands for insurance yourself (and often thousands more to meet your out-of-pocket deductible each year).
I would take the default of "some" coverage over "no" coverage any day.
To be clear you also need a health insurance plan for medication in Canada generally. The difference is that drug prices are regulated by the provinces, so they cost less. However, this also affects which drugs are available.
Some provinces such as Quebec have a public drug insurance plan as well which you pay into via income tax if you haven't got a private plan.
Of course the overwhelming majority of American do have one of those forms of coverage. You might as well argue American don't have housing or food either since most people need aren't on welfare programs to pay for them.
Over 90 percent of people on ACA plans get subsidies too. Also emergency treatment is guaranteed.
It's certainly a mess of a system, but every time the government does something to "fit" it, the price goes up faster and it becomes a bigger mess.
Over 65, outside drugs delivered in a clinic, hospital or doctors office you don’t get drug coverage UNLESS you pay for it through Part D Medicare, have a Medicare Advantage pan (the privatized version of Medicare that now 50% of the Medicare population has stupidly picked), or a retirement medical policy that acts like a Medicare supplemental policy that many government employees and some company’s offered their retirees.
That said it’s still a good deal and you can switch Part D policies year to year in case there are formulary issues. Plus with the IRA changes the max out of pocket is 2K which before you had no cap on—some new drugs are so crazy expensive that without this even the co-pay would wipe people out. That’s only recent fixed.
In our own case, my wife who 3 years ago our out of pocket for some daily cancer pills went from 15k in 2023, to 8K in 2024, to 2K this year as the IRA fully kicked in.