Canadian healthcare is not universal. Nowhere is this lack of universality more evident than in the payment for drugs in Canada. Canadians without the financial wherewithal cannot access orphan drugs for rare diseases and take-at-home oral cancer drugs and many other pharmaceuticals. In addition to the physical and emotional tolls experienced, patients and survivors and their families and caregivers bear the brunt of an ever-growing financial burden. This article outlines how this happened and what to do about it.