America has very decentralized governance and the states have a lot of power, especially when it comes to the medical system and Medicaid. You need to assess 50

America has very decentralized governance and the states have a lot of power, especially when it comes to the medical system and Medicaid. You need to assess 50 states more like 50 countries when comparing them. Massachusetts has a higher population than Norway. There is a lot of nuance - we also allow millions of illegal immigrants every year, who can themselves get drivers licenses and access state resources, which further makes any discussion very difficult. I find statistics that try to aggregate such a huge and dynamic population very suspicious. I do know that Canadians stream across the border to America when they are told their life saving procedures are months or years in the queue.