I was unaware you needed medical insurance to download Adobe products.
I am glad I provoked you to display your humorous side
No, you do not need medical insurance to buy Adobe products. But after you pay $12K a year for medical insurance (as I do), there is that much less of your income left at your disposal to buy other stuff, including Adobe software. And my European counterparts have that much more to spend on other stuff, therefore can afford to pay more for Adobe products. Adobe knows that and charges accordingly.
This example of course is extremely simplified, but since this is a photographic forum, I will refrain from going into detailed economic analysis of the multitude of factors that shape pricing in each market. Suffice to say that different markets will always have different size, different supply and demand, different uniformity (e.g., common language), different infrastructure, different price and income elasticity, different spending pattern, different taxation, etc., and, as a result, will always have different pricing even for the same product.
In other words, the pricing differential is quite normal, legitimate, and can not be labeled "outrageous". We do not consider the differential between day and night to be outrageous either, we just take it as it is.
Another reason I used the example with medical insurance is to point out to those complaining about price differentials that they should not cherry pick the object of complaint. They of course always find to complain about things that are more expensive in their markets, and never about things that are more expensive in other markets (like medical care).
On a more personal note, when I was living in Spain, I did not have a medical insurance (nor I needed one). After spending a week in hospital, following a complicated operation, I had to pay the "outrageous" amount of exactly O euros (zero, zilch, nada). I shudder to think how much would the same event cost me here in the States.