Most Canadians would likely agree that those who need potentially life-saving prescription medications should have ready access to them. Yet prescription drug coverage in Canada varies widely depending on where you live, your health status, your income and your age.

Canadians don't like to hear this, but when it comes to pharmaceuticals, our health-insurance system has plenty in common with the United States. In fact, the U.S. is marginally ahead of us where prescription medication is concerned.

Provinces usually cover medications for the very poor, but so does the U.S. system. Provinces also tend to cover seniors, although not as generously as in the U.S. -- since many provinces have, or are in the process of, de-insuring so-called "wealthy" seniors because of budget constraints. Limited provincial drug plans are also riddled with deductibles and co-payments, meaning financial barriers still deter many from getting the drugs they need.

This U.S.-style approach to prescription medications leaves us with U.S.-style results (that's not a good thing). Many Canadians have no drug insurance whatsoever, and one in five Canadians now report that someone in their household is not taking their prescription medicine due to concerns about costs.

The results are devastating for Canadian health.

Despite not covering everyone, we still manage to spend more on drugs than most other countries.

For example, in Ontario we insure bunion removal and IVF services, but not insulin for young and middle-aged diabetics. As a result, an estimated 830 diabetic patients are dying in Ontario every year from want of something as basic as insulin.

Here's something else we have in common with the U.S.: despite not covering everyone, we still manage to spend more on drugs than most other countries.

Consider England and New Zealand, where everyone is covered for a broad range of prescription drugs, there are minimal co-payments and for poor or frequent users, many drugs are completely free. All this and they still spend much less on prescription medicines than Canada or the U.S.

Why?

Universal drug plans mean national bodies negotiate fairer prices for prescription drugs. The results are dramatic. In 2009, the cholesterol-lowering drug, simvastatin (20mg), cost New Zealand 2.4 cents compared to a whopping 62.5 cents in Ontario.

So, while some critics claim that universal prescription drug insurance is a nice idea, but not affordable -- it's very clear that universal prescription drug insurance is actually the key to affordability.

So how can we make universal pharmacare happen?