It's complicated by the fact that Skype itself has issues. It's become so big it's really outstripped the technology they're using. For almost two weeks recently performance world-wide was very poor, and the quick fixes they've put in place won't last. It's a victim of its own popularity.
There are several VPNs available, some free, some pay. You can also set up your own without too much difficulty, in which case you can choose your virtual location. There are times when you want to appear to be in the US, and other times when eg. you might be better off appearing to be in Europe. For example, if your VPN server is in the EU and you buy something from a dealer anywhere in the EU, you will not be able to avoid paying VAT (it's a universal EU tax, though the rate varies from country to country).