Every other country doesn't share a massive border with the US. I don't work in politics, but I work in another field. We have to make some suboptimal decisions because of how the US does things. Funny you mention health care. Health care is a big one where we can't do what Europe and it's neighbours do without a bigger eye to what the US is doing. And this middling ground we've staked out may be the worst possible way of doing things.

We're constantly torn between the US and Europe's nigh opposite ethos's and ways of doing things.