American here. Lived the first 30 years of my life in the States, the next 20 in France/UK and have worked (temporarily at least) in most major European cities.

American here. Lived the first 30 years of my life in the States, the next 20 in France/UK and have worked (temporarily at least) in most major European cities. I think you are on to something with you last point. One long-standing joke about Americans is that within 5 minutes of meeting them you'll know more about their bank account, hopes/fears/dreams, and their lower colon than you'll ever know about your best European friend in a lifetime. I'm not judging. We (Americans) are simply open about lots of personal details to everyone. We're a bit like the golden labs of humankind. If someone will listen, we're happy to talk about anything. Europeans on the other hand (this is another BIG generalisation) are definitely much more private especially when it comes to health. I've been in the UK for quite a while now and I struggle to even learn the names of my neighbours two doors down. Good luck borrowing a cup of sugar around here. In the states I actually let someone use my shower! I knew him from passing in the hallway and he had a job interview in an hour but lost his keys. Anyhow...I digress. #4 is my choice. Access to good healthcare is NOT a cause. But I don't want to go there and start a discussion on the pros/cons of socialised medicine. It always ends in shouting. :D