In the U.S. many important functions are handled by the individual states. For example, most legal matters, including for example murder trials, are handled in "state court". Also, the organizations most involved in taking licenses away from bad doctors, dentists and lawyers are state-based rather than Federal-based (and heavily intertwined with state politics). Of course the effectiveness of these organizations has a big effect on a resident's quality of life.

So, in addition to the question of whether it is a good idea to exit the U.S., another relevant political question for U.S. residents is whether it is time to exit his or her state of residence. At least one highly-rational person I know has decided to end a long residence in California. (He moved to Florida.)