You touched on all the big issues that the American expats I know here in Germany feel strongly about: healthcare, gun violence, extreme partisanship, the rich/poor divide (that keeps getting worse), lack of governmental support for economically disadvantaged people and little support for new mothers, lack of constructive political discourse, and more. Most people in the U.S. are unaware of how poorly their country stacks up to most European countries - because of another topic that you did not mention, namely the insular news reporting (not to mention the right-wing news outlets that exacerbate the situation) and an exaggerated, misplaced patriotism that does not allow constructive criticism or discussion.

It is indeed very sad to observe this downward spiral. A very divisive dynamic is gathering force in the U.S. and has now begun turning violent - witness the January 6th riots. Once a certain momentum has been reached, it will be impossible to reverse. This is something Germans are keenly aware of; scars of this tragic chapter in German history are in every family (and in many families living elsewhere). I hope such a destiny does not befall my beloved home country.