While I abhor the notion of socialized medicine anywhere, it’s worth noting that New Zealand’s immigration policies (fortified by its ocean-surrounded geography) make a lot of things work there that don’t work in countries that won’t and/or can’t control their borders.
I agree with you: because of the 50-state structure of the US, for example, it would be well-nigh impossible for your country to implement a socialized medicine model. It would be ruinously expensive even to try.
Aside from the abuse that would happen on a grand scale, the fact that it would probably be administered at a state level would make it difficult to keep consistent across the nation.
We have abuse from illegals in our system: mostly from the islands where the population is almost indigent. No medicine at home and no way to repay what they get from us. In that case it becomes an elaborate form of Foreign Aid: I believe it even gets accounted for in that manner.
In the US situation, you would be in the galling situation of providing free medical care to illegals so that they could give birth to their anchor babies.
I do not advocate socialized medicine for the United States: it wouldn’t work, and the necessary infrastructure to make it work would be ruinous.
I am taking issue with the notion, tho’, that socialized medicine is Socialism. It isn’t.