Borders between states are hardly the same as borders between countries, and Portugal is not representative of Europe. Europe is a region with multiple cultures, languages, countries, and governments.
Trying to insinuate that the degree of differentiation between states is the same as between Europe countries is utter absurdity. Clearly, trying to track healthcare across different governments with different languages and different cultures is much harder than trying to track healthcare across different states with the same language, the same national government, and a very similar culture.