You are forgetting the huge problems with the old system. I had great insurance through my employer and money if I lost my job and coverage. My fear was if I had a preexisting condition I might not be able to get coverage and everything I saver for in my life could disappear in one crises. Trump promised better and cheaper coverage, not possible unless the rule changes to no coverage no treatment. The point you are missing is, once someone goes into a hosipital, someone in North America is paying that bill and I'll give you this hint, it's Canada or Mexico.