Are other countries able to have universal healthcare because the USA doesn’t?

So healthcare is like the third or fourth largest industry in the United States after, finance, energy, defense, etc. and a major reason for that is pharmaceutical companies. Are the medical breakthroughs that pharmaceutical companies are able to achieve (for example, COVID-19 vaccines) due in part that they can make record profits and continue to fund R&D without a care in the world? Would they not be able to do that if the USA had different healthcare laws, or the healthcare system was nationalized? And then obviously countries with universal healthcare are able to use medicine developed in the USA in their healthcare system, but their citizens don’t have to pay for it like Americans do. So by that logic, are Americans also paying for the rest of the developed world’s healthcare as well?

submitted by /u/bballin1204
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So healthcare is like the third or fourth largest industry in the United States after, finance, energy, defense, etc. and a major reason for that is pharmaceutical companies. Are the medical breakthroughs that pharmaceutical companies are able to achieve (for example, COVID-19 vaccines) due in part that they can make record profits and continue to fund R&D without a care in the world? Would they not be able to do that if the USA had different healthcare laws, or the healthcare system was nationalized? And then obviously countries with universal healthcare are able to use medicine developed in the USA in their healthcare system, but their citizens don’t have to pay for it like Americans do. So by that logic, are Americans also paying for the rest of the developed world’s healthcare as well?
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