No idea how you can end up with such conclusions. How total population is relevant in any way?
That's like saying "USA can't have public school because they are 330 millions" the more people the more teachers, same with doctors.
Cost or efficiency/people ratio stay the same as in a much smaller country.
In fact, it is even better as they make scale saves : in a 330 millions people state they pay for 1 minister of health, same in a 3 million people. Said otherwise, all the central administration expense are divided by a bigger amount of tax payers = cheaper per people.
All that is just basic math, but I guess it is the other that are low IQ according to you.
And instead of blaming IQ of other, just look facts : in a public/private healthcare system like USA has : heal care cost $10,224 per people per year.
In way more public system like Germany : $5,728; in France : $4,902.
Yet the quality of care is better in those countries according to life expectancy and life expectancy in "good health" stats.
And finally, this scale argument, not only is false (if not totally idiotic), but just a non argument in a Federal State like the USA (where the most populated state is California with 40kk way less than big countries with large public healthcare system).