It is no more confusing to Americans than the fact that Europeans use A4 is to Europeans. Why should it be? Just like you didn’t know standards other than A4 exist, Americans don’t think about the fact that standards other than 8.5x11 inches (I.e. letter) exist. All printers, binders, folders, hole punchers, etc. are made with letter size paper in mind, and most people unless they are involved in business with other countries have never encountered an A4 sheet of paper in their lives and probably have no idea other standards exist.