When I lived in Australia. Full sized pickup trucks were very rare. They had to be imported from NA. Then they would have the left hand drive converted to right hand drive.
I'm guessing that bringing a right hand drive into NA is even rarer. So it is eather too expensive to get it converted to left hand drive. Or finding a place that can do it may be difficult as well. It would be a pain in the butt to drive a right hand drive in a left hand drive world.
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