So what happens is that as other countries free ride the United State's research, the US would have to not only foot hte bill for research and development (of which it is the biggest contribute in the world), but they would also have the bill for the fruits of that research - ie: the actual healthcare services and machines require to deliver those services. The United States doesn't get to pay a single bill and get great universal health care, it effectively pays twice for care while other countries pay once.