No, but you won’t hit a 42% marginal rate in CA until you make over $207,000 as an individual.

No, but it is much easier for a US citizen to move from California to a state with no income tax than it is for a German citizen to emigrate.

and they also dont owe an arm and a foot everytime they go to hospital

Anyone who makes $100k+ in US, has health insurance with a few thousand dollars annual maximum out of pocket.

More importantly, while in the US, healthcare insurance is typically a benefit offered on top of the cash salary, in Germany, health care tax is deducted from the salary. So, if you’re American household making $100k, you’ll spend $3k on Medicare tax, and then you’ll spend up to your out of pocket max, typically less than $5k/year (and you’ll hit the max only in years in which you heavily use healthcare). In contrast, if you’re German making 100k EUR, you’ll be paying 8k EUR healthcare tax every single year.