From a US perspective, these are all markets that depend on expensive skilled US labor. Many things like manufacturing have shifted to labor markets that are cheaper. How much is due to currency differences, cost of living differences, etc. vs. employee safety or anti-pollution regulations ... I don’t know.
To give you an example from construction, a company producing a complex part is "giving away" 3 day training in fancy locations, with all hotel & meals paid by the company. As a government employee who gets a fixed salary no matter the results, would you prefer using a product which gives you to these free trainings (free mini-holiday), or using a cheap part which does the same thing, minus the fancy training sessions?
I think the root cause is having some people in charge of other's people money, without clear responsibilities (vs. evaluations which happen in private companies, with the possibility to getting fired anytime if you have a poor performance on result-oriented KPIs), AND having a monopoly. You can't simply start another healthcare or education system, without complying to all existing complex regulations & processes.