Even then it’s a pay cut. I know some people who moved to NA, and egotistically it’s a sound decision because engineers there are on the right side of the wealth disparity ravine. Money’s good enough that you don’t need social safety nets. And if push comes to shove, someone making $100k/y can definitely afford health insurance and the occasional trip for medical tourism.
Now personally I believe in income redistribution so I’m happy to pay a lot of taxes in one of the most income-egalitarian countries in the world. But I’d make a shit-ton more if I lived&worked in Luxembourg or Canada.