You Guys in the USA don't know you are alive.
In the UK we have an annual test that really goes through the car.
Takes up to 45 Minutes to do properly.

It checks a very detailed list of items covering -
Lights
Steering
Suspension
Brakes
Wheels and Tyres
Seat Belts
Wipers and Washers
Exhaust System
Exhaust Emissions
Catalyst Emissions
Other Items

Car is First put on Ramp so that they can see everything - rust, rubber gaiters etc.
Then after that it is put on a type of rolling road that can sense the braking on each individual wheel very accurately PLUS the parking brake.
Then finally the emission check - tougher than anywhere except CA.

If you want a flavour of why we Dread the annual MoT Test take a look at this site -

List of UK MoT Checks

As you can imagine it provides a lot of garages with a Huge amount of work at a very good price.

Mike