It's a different culture, under different rules, with different philosophies, expectations, and goals. Right or wrong, profit is the driving force for all business in the US, and that will not change no matter how much fun the rest of the world wants to make of it. Short-term profit is the end-all and be-all of the US economy, and short-term profit is not possible if multi-engine, multi-crew aircraft flown only under IFR are required. So get over it, those will never be required, and will seldom be used.
With the greatest respect to our American brothers, there is the problem, right there.
What is the acceptable death rate of pilots, medical personnel and patients before something has to be done to change this?