In canada, health care is the sole responsibility of the province. The federal government helps with planning and coordination (and maybe funding) You didnt get the insanity because the individial provinces are mostly sane. You still saw individual differences, especially look at ontario's early response.
Very few states maintained their supply of medical equipment properly. Likewise, the federal government hasn't restocked much equipment since the early? Obama administration. Unfortunately, it just wasn't made much of a priority. Of course this failure was made even more devastating due to massive global misinformation leading to late decisions and poor communication by entities that should have been more trustworthy and better equipped.
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With that said, the states rights debate is a tough nut to crack. There's been so many instances of (various) governments doing evil things that I'm not sure I'd want to centralize even more power.
It's an extreme example, but I liken it to letting a Mao or Hitler take complete control for the benefit of a better healthcare system. The cost is just too great.
In the US, the States are very powerful and the Federal government is much weaker comparatively. For anything to be done collectively across the entire US, it requires cooperation from all states, otherwise one of them can screw everything up. That inherently means more talking, more coordination, more meetings, etc.
It's the fundamental difference in how each country was forme and the system that they pursued. In some ways it's better and in some ways its worse. That's why you can have very powerful states like California dictate a lot of their own destiny, but then when it comes time for a national crisis like a pandemic, everything is fucked because the US Federal government doesn't have the same level of control and power as in Canada. In Canada you didn't get the inane policy of each province buying its own PPE like in the States, driving up prices because they are all fighting each other.