I lived in Europe a couple of times and you realize just how 'close' everything really is. The infrastructure for sewer, roads, electric, etc... has been laid for generations. For the most part, Europe is densely packed and everyone has equal access to home internet and cellular service.
There are still US States that may have 1 to 2 people in a 100 square kilometre area. States like North and South Dakota, Wyoming, Idaho, Nebraska, and so forth. The cost to bring internet to these sparsely populated areas just isn't worth it for most telecoms.
So there are a couple million people in the US alone, that are basically screwed by Apples policy. Doesn't seem fair when all Apple has to do is add a feature in settings that allows people to download large apps. It could be off by default and request users consent every time. This would prevent Apple from responsibility.