OK, but the state of California is the fifth largest economy in the entire world ($3.4T USD) and has less than half the population of Germany.

Arguments like this are pointless.

U.S. productivity is higher than Germany (outputs / inputs), so it appears Germany hasn’t quite figured out how to worker smarter than people in the U.S.

Yeah, but how much of the value that this is based on is artificially inflated, either by outright bullshit such as HFT and other forms of "wealth" that are solely created out of numbers or to account for indirect bullshit such as absurd healthcare and rent costs that drive up wages and, indirectly, product prices?

  > artificially inflated

a huge chunk of that is excessive healthcare costs

https://www.statista.com/statistics/184968/us-health-expendi...

Yup. My back-of-envelope from past looks at this is that 5-10% of US GDP is purely drag from excess healthcare costs, i.e. we'd collectively be better off and our economy (entrepreneurship, especially) healthier if that amount of our GDP simply vanished, even though it would mean lower GDP per capita.

There's a quote from Obama in an article from The Nation years ago, that basically says we can't fix our healthcare system properly because it would put too many (white-collar make-work jobs program participants, essentially, under our current system) people out of work.