NA uses 120VAC at most loads - but service is 240V split. So 200A service in NA is the same as 200A in the EU. Of course this is confusing since we often talk a

NA uses 120VAC at most loads - but service is 240V split. So 200A service in NA is the same as 200A in the EU. Of course this is confusing since we often talk about 120V loads, e.g. a 15A electric kettle in the US is pretty lame compared to a 15A electric kettle in the UK. The 120V outlets are approximately equally split between the two legs (which you could view as -120 to 0 and 0 to +120), so one way you could view it is that 200A service in NA allows for about 400A of 120V load. But then larger loads are usually across both legs and you have to account for imbalance so it doesn't work out quite that simply. And then there are "weird load" like dryers, which commonly put the heating element across both legs but the drum and blower motors across only one, resulting in some amps on both legs and some more amps on only one of them. And while we're at it commercial buildings often run the lighting across both legs for wire gauge economy. So there's a lot of nuance on the load side. But on the supply side it's all 240V either way (well, kind of, could be 208V in case of a wye supply, but that's not common).