So just ask country X for their data?

Except every country is this bad. This is the problem, it's the medical community in general.

Surly a quick online anonymized form, with a $ kickback/punishment for the hospital, which a lacky could fill in, with patient opt out ability could save lives and $$$ for countries.

So, my hometown in Melbourne has a reasonably well-known children's hospital, the Royal Children's Hospital. A colleague of mine tried to get an appointment for his kid there, and they told him to apply by fax (who even has a fax anymore?). And even after he supplied all the forms by fax, they still asked him to fax them in the correct order. He ended up going somewhere else.

The bureaucracy there comes straight from the consultant doctors. Half a decade ago, an ex-colleague of mine worked in QA there, and there was nothing he could do. Any suggestion he would make would require X or Y department to change procedure or software (some departments couldn't even talk to each other electronically). The departmental heads had their preferred vendors, with their preferred sales reps, with their preferred kickbacks. As soon as you'd float a plan to improve efficiency and intercommunication, the relevant department head would defend their turf with the statement: "If you do this, children will die". Even for something as non-medical as simple appointment software. There is nothing you can say to that, because the department head is the designated expert for X or Y, so they have the final say.

Another meeting he was at showed how insular the place was. A comment was made by one departmental head, and one of the old guard (30 years or so) dismissed him as "we don't do that here. if you'd been here any length of time, you'd know that". The reply was "I've been here for 17 years...".

The RCH is a particularly bad example of this, but it's illustrative of politics. There is so much politics and turf warfare in medicine, some hospitals worse than others, that homogenising a system cannot happen unless it is a specific priority driven from the top, as only the top has the authority to tell the lieutenants to "just fucking do it". It's not paranoia or bureaucracy that creates these silos - it's politics and nest-feathering.