It's easy to proportionally scale US Letter documents to A4 and makes little difference to their readability. I deal with US Letter documents all the time and while I find them quite annoying it's not much fuss to work with them really.
The way every application and operating system requires you to change the paper size in three to eight different places, on the other hand, when you've already set "Australia" (or whatever) during the install... now that drives me nuts.
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