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> For example, in the US the plumber pays for health care. In Europe he mostly does not.

More like in the US he pays for private health insurance (and/or he is covered by Medicare/Medicaid). In Europe he pays for public health system, something like 5% of his earnings, and he may choose to buy private health insurance on top of that (as many do) because the public health system is in shambles.

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The point being that the health amount is already removed from the net salary. So when comparing net salaries it's important to understand what has already been paid for.

Yes, some people top up with private health. That is a discretionary spend. And while areas in Europe may vary, public health services are typically good.

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