Very astute observation.
Of all the northeastern states, Pennsylvania was the last to get its highways out of the mud. And that was the work of Gov. Gifford Pinchot, who was elected in 1926. By that time, states like New Jersey were far ahead of their neighbors.
Pennsylvania is probably one of the most difficult jurisdictions for managing/operating a system of roads. In addition to the weather-related issues I mentioned above, it's also a state that has a lot of roadway miles in sparsely-populated areas where the level of economic activity simply doesn't support that kind of roadway infrastructure.
I understand you have a similar problem with medical facilities in rural areas, don't you?