Some input from across the ocean. Here in the UK we have an annual road worthiness check, called the "MOT" (it stands for "Ministry of Transport"). The first one happens when a car reaches 3 years old, then it is every year after that. It includes a variety of mechanical and electrical tests and also rudimentary emissions. It is so ingrained into our society that not having such a testing requirement is truly unbelievable.
It is an offence not to have a valid MOT certificate if your car is being driven on the road. Additionally you have to have an MOT in place before you can buy the (also mandatory) annual vehicle excise duty (aka "road tax").
So, to summarise: to drive on the road you must have:
- valid MOT (if >3 years old)
- valid VED (tax)
- valid insurance
To get the VED you have to have the insurance and MOT in place. If the VED expires you must formally declare that the car is off-the-road and can not drive it on the road until you renew the VED. You must also have continuous insurance cover unless you have formally declared that the car is off the road (and that means, literally, off the road - you can not park it on the road outside your house whilst you wait to get VED or insurance sorted out).
The MOT test costs around £20-£55 ($25-$70) - that is just the cost of having the test done. If you pass then it's all you have to pay. If you fail then you need to fix it and get it retested; there are some allowances for a partial retest within a certain timescale (ie if you get something fixed there and then they only retest the failed thing and the MOT fee is waived). The MOT tests can only be carried out by workshops that are authorised by the Ministry of Transport; many of these are workshops that will also do the remedial work (if needed) but some MOT stations are set up where they only do the testing, not any fixing, so are less inclined to fail a car in order to generate revenue from repairs.
If you're interested in what the MOT covers, it's
here.
Consequently, whilst there are some beaters on the road here, it is nowhere near as bad as in places with no testing requirement. I've seen some real eye-openers in other countries (USA included).