Frugal only goes so far in the US until the healthcare reality sets in.
Most of us Europeans simply don't need to worry about health insurance at all with the likes of the NHS in the UK and equivalent (or often better) free national health services on the continent.
It seems a lot of ring-wingers in the US are vehemently against any form of national health service whereas in Europe, even the right seems to accept the benefit and necessity of national health.
While I appreciate the availability of care in much of the US, the surprise and ever increasing bills are a heavy price to pay. Other family have delayed retirement and had to plan major life choices around health care costs.