In the US, most highly-skilled senior engineers will be multi-millionaires in their 40s which means that they can immediately retire and pay out of pocket for private health insurance covering the entire family without even making a dent on their principal. Even if that wasn't an option, one can get health insurance via one's spouse or work a few hours part-time for an employer that provides it.
I retired in my 40s and spent the last 10 years living in both the US and multiple European countries (with a lot of time spent in Germany as I have family there). While I've so far enjoyed living in Europe, the worsening downward slope in quality of life is more obvious here than in the US. Unrestrained immigration is a big problem that's going to get a lot worse in the next decades and is already rapidly eroding the much praised European social safety nets.
Ultimately, US offers optionality which means that one isn't chained like a slave to a grossly inefficient disintegrating socialist state for the rest of one's life.