An American processing bank has the requirements that the businesses that they cater to must reside in the US. This is more of a Fraud prevention thing than anything else, but it also has to do with FCC and FTC regulations. Also American banks allow resellers called ISO's or MSP's. Foreign banks control all of the processing in their areas. Its more or less big banks that don't want to give up any money or power. Also American credit cards use the AVS for address verification which wont work with international credit cards.
If you are in Europe or any other country, you have 2 choices. Process through a local bank that has merchant services, or go through an offshore provider. Either way you are looking at fairly high processing fees, usually 5% - 10% / transaction with a $1 - $2 per transactions fee. You aren't restricted to European only processors.
2Checkout, Paypal,Ikobo and others are called Third Party Processors. They process the transaction for you and then deposit the money in your bank account. Their fees are comparable to your other options, but probably have a much lower startup cost.
It doesn't have anything to do with the patriot act, its more of a financial monopoly held by foreign banks that they don't want to give up.
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