> I live in Germany and I pay almost 50% of my income in income tax and social tax.

I live in the US and pay less raw tax than that, for sure.

But I reported $49k in medical expenses (premiums, deductible, copays, stuff they won't cover) last year on my taxes, and I've got two kids going to college in a year, which may cost $10-40k/year for each.

I'd rather your trade-off.