Technology

You would be extremely surprised. Car maintenance is expensive, and lack of inspection very often leads to people driving vehicles that should have been off the road years ago simply because a lot of states that axe it, axe inspections because they're expensive for the driver (a lot of these states are in the former Steel Belt). In better-off areas or places where people have more time/money/equipment/space to wrench on cars, then yes, but here in my city, I definitely have seen cars where the entire frame is basically being held together by Bondo and prayer, cars where they're running on 4 spares, cars where enormous sections of the body paneling are just gone. I've nearly been hit by people who clearly relied on yearly inspections to tell them "hey your brakes are failing" because they drive on autopilot and just adjust how they drive to accommodate failing/failed brakes.

In fact, I suspect maintenance costs are HIGHER in areas without inspection, because shops could rely on that regular-ish influx of cash even if it was only like $50-$100 a vehicle, AND you have the customer in the shop, so it's easier to go "hey you really need brakes, it'll cost you an extra $200 and take an extra hour or two".