I'm on the Trillium program and I don't have a catastrophic illness. Anyone can apply to the Trillium program. If your meds cost more than 4% of your income the government will pay anything more than the 4%. You can have a really high income and still qualify for the Trillium program if your meds cost more than 4% of your income.

Not having supplementary insurance in Canada isn't a very big deal because that just means meds, chiropractors, psychologists, glasses and dentist are not covered for the most part. In Canada everyone gets to see doctors for free. (Well they are paid for by taxes, but everyone is covered.)

No one in Canada will go bankrupt for instance because of an unexpected surgery or ER visit.