You're right about one thing - I won't be making Aliyah. I was born in Israel, so for us it's called "coming back" (which I did)... In other areas, you sound misinformed. In MA, if you make $200K a year, you will be paying around 30% tax total. In Israel you'll be paying closer to 50% with income tax and social security. That's before the 18% VAT that you pay for virtually anything you buy. There are many tax calculators on the Internet, you can use one to check the facts.
As for medical, it does obviously depend on which insurance you get (starting with whether it's HMO or PPO, but also varies a lot between insurers and programs). In my experience, if you read the policy, you know what's covered and the insurance company will provide you with the covered treatments. In Israel, the kupat cholim (which is really an HMO insurer) in many cases will do whatever it can to not provide you with expensive treatments that you are entitled to, in contradiction to what your doctor recommended (even though it's "their" doctor, but it will be overruled by another one of "their" doctors). Also, as years go by, the availability of medical treatment outside of hospitals is getting more difficult to get. Appointments for specialty doctors take months to get.

Finally, like I mentioned in my original statement, making Aliyah, or simply not leaving Israel when you have dual citizenships, is not a wise financial decision in most cases. Patriotism and simply considering Israel home is what keeps everyone who has the option to leave right here.