I don’t think any country with single payer national health care covers travel insurance, so this would not put Americans in any different situation than others who are travelling for that gap year, which seems to be the topic here.
It assume it depends on the destination. I suspect most European healthcare systems cover you in most of Europe (maybe Schengen or EU?) while American systems only cover you in America. But yes, I suspect traveling to Africa or Asia puts the American and the European on equal footing.
