The American healthcare "system" is dysfunctional because parties who profit from the status quo keep the public bickering about inflammatory issues and distracted from making meaningful change. (My favorite example is "death panels".)

Since the American system doesn't allow people who can't pay for emergency care to die the system ends having a socialist component. Socialism is such a hot-button issue that we can't have mature conversation about funding it. Almost any conversation about it gets caught-up in partisan and "personal responsibility" bickering.

It would be easier if we just let people who can't pay die.

That's repugnant and wrong, but it would certainly make the conversation easier.