States in the US =/= Countries within the EU. Europe is really not a cohesive entity. Different languages, different history (stretching back a thousand+ years), completely different value systems, cultures, etc.
Trying to insinuate that the degree of differentiation between states is the same as between Europe countries is utter absurdity. Clearly, trying to track healthcare across different governments with different languages and different cultures is much harder than trying to track healthcare across different states with the same language, the same national government, and a very similar culture.
Culture and that other stuff you mention are important, but so is size and distance. In the same way that someone who moved from Austria to Scotland would be tolerant of differences in official services, so is someone who moves from Seattle to Orlando.
Trying to insinuate that the degree of differentiation between states is the same as between Europe countries is utter absurdity. Clearly, trying to track healthcare across different governments with different languages and different cultures is much harder than trying to track healthcare across different states with the same language, the same national government, and a very similar culture.