Admittedly, once the Tufty Club type medals as displayed by our portly US Marine were added, US servicemen still ended up with rather more fruit salad on their chests than their British and Commonwealth comrades.
All to do with the US capitalist acconomy. (It costs about £10 per medal to get each new medal mounted from RAF tailors - fifth medal equals £50. Add the same cost for miniatures)..... It must have made much profit for this chap's tailor.