So basically, Ronald Reagan set up hospital emergency rooms as socialized healthcare, and then…
…didn’t fund them.
It’s an unfunded mandate.
So it’s illegal to let patients die on your doorstep. A step forward in society (Reagan at the time said it allied with American’s Christian principles and his own). But the Republicans of the time never paid for it. They kicked that particular can down the road.
As a result, hospitals saw emergency room visits drastically increase. Insurance companies, because many of the uninsured used emergency rooms as care (to which they’re legally allowed, it’s how to collect the payment later that’s in issue), try to refuse to pay for the increase. Hospitals got clever at burying costs into healthy patient’s procedures, or anywhere else.
The system gets distorted.
So we already have socialized healthcare, it’s just that the hospitals, the government, and the insurance companies are all putting their fingers on their noses and saying ‘not it!’ due to that single fact: the 1986 bill was an unfunded mandate.