Yes the costs would be different. Perhaps 100,000€ instead of $200,000. The fact remains tourists don’t get free healthcare anywhere.
This is a complete nothingburger of a story. The couple got treatment. Their insurance was billed, exactly as it would have been if they’d been in Canada or Portugal.
Their insurance momentarily denied to cover them. Why aren’t we mad at them? Because this clickbait story was created to stoke a pre-existing “America sucks” narrative and get outrage clicks.
And they seem to have played everyone here perfectly.