How to cover the tab?

Very simple.  Single payer medical system (which would get medical costs in line); tort reform (which would get defensive medicine under control); and tax reform - getting rid of the idiotic tax system that shields corporations and wealthy from paying high, and accounts for the expense of universal healthcare.

Somewhere, somehow, at some point, the system became, "I get mine, and you don't".  "Eat what you kill, and kill all you can, whether you need to eat it or not."

That simply needs to be dialed back.  Some will suffer (or actually, have less than outrageously more than they could ever need) as a result.  But, profit motives will still exist, and therefore business will continue to operate.  "Freedom" will still exist, it will just exist in a way that doesn't mean "Let me get away with whatever I can at others' substantial expense."  National Security will be enhanced - make the nation something EVERYONE has a high interest in protecting.

That's how.