They are saying that, like many governments, healthcare requires the use of the PDF/A-1a standard.

That is it.

You mean, like many (non-US) governments, (the US) healthcare requires the use of the PDF/A-1a? It's just a somewhat bizarre contraposition: "Like many animals, Helianthus annuus needs water to survive". Wait, but it's a plant, right? "Yes, and it needs water, just like animals".

I just assumed that they meant that there are many healthcare orgs that require this standard.