For me my account is American, was created in the US and is backed by an American card. I don't "miss" any software that users outside the US do. Unfortunately, I live in Mexico. So while I have full access to the US market, it shows me prices in pesos, which pisses me off to no end. Not a huge problem, but annoying.
So to note: My A500 was bought in the US, my market account was made inside the US, with all US information, here in Mexico it works just like when I'm in the US only the prices are in pesos. Dunno how hard it would be to setup an account from outside to US to look like it was inside. Use a VPN while you set it up I suppose, look up some random business address and phone number if it asks for such. As far as buying a tablet in the US, well that'd be harder.