It depends on how uniform the country is demographically.
The United States doesn't have any large ethnic minority majority regions. It doesn't have any large regions that are third world in terms of income and infrastructure.
So there aren't many problems.
Conservatives love that trope about how socialized medicine can only work in Sweden because Sweden is small but it would never work in America because we're big. That's just a load of nonsense. As long as the population increase is matched by a tax base increase (and of course it always will be because of two things are the same thing), it could work fine.
It's a different matter when you're like Russia where you have separatists and Asian regions where people still live in tribal situations.
You can take this line of reasoning too far, as the US right does rearding healthcare, but it still has some merit. Its just easier to govern small countries efficiently (not talking microstates here, units can get too small).
Besides the US is not exactly homogenous