America is about twice the size of all of Europe. Railroads were controlled by monopoly rich people. Once America became more industrialized, planes became a better cargo transit option. That and the interstate system made trucks an even better economical option. Railroads were not an option as they were expensive and land intensive(which also meant more money for acquiring land)
For medical care, the US government actually spends a bunch on healthcare on par with most other countries. Just that a majority of the monet will go to a bloated medical company into a billionair’s pocket before any of it applies to an individual.
So, extreme capitalism ruined both. Yet we have politicians and people who think we should push further towards a capitalistic way of running things…