PM me if you want more details, but depending on your needs you can get a decent house between 300-500K, or rent.
I don’t think you have to buy right away.
It’s really fine, I live about 10 minutes from the beach and I have better Internet here than I had in South Carolina. Standard of living in healthcare is certainly subpar to the mainland states, however it’s still pretty good since it is part of US territory and most of the doctors are trained in the US.
A few annoying bureaucratic details can be solved by having an assistant.
It really depends on math, how much are you potentially saving. If you’re saving five figures in taxes, I would say not worth coming down. If you’re saving hundreds of thousands to millions - then it certainly is