It's also kind of a difference in strategic approach, to pool resources and create cutting edge institutions, or to adopt a more decentralized approach where yes, you might not get as quick of a pace of innovation, but each community is more self-sufficient. So, you might not ever get a fancy cure for cancer or CRISPR technology in this alternate universe, but most communities might have their own local clinics and more local nurses and maybe better overall health outcomes by focusing on common treatable problems, rather than pushing for cutting edge innovation. Similarly, you might have fewer PhD's, but more high school graduates or bachelor's level of education.
Anyways, nothing about this is all that realistic or anything, just some idle world-building in my head.