I'll preface this by saying that I don't think I have any way of analyzing who has what, or how many of everything there is.

There's some pretty decent gear out there, still. And if you compare some (Noteworthy) gear to some (Famous) or even (Legendary), you'll see that the differences in most cases are pretty minor.

That 50 hp coat might not be in, but there are NUMEROUS 30 hp on-body options, some of which aren't even limited at all. Can't get your hands on a super-rare 40-50 hp ring? You can make do with unlimited or fairly common 20-25 hp rings, some with added stats or saves.

Bracelets of Longevity, long seen as the holy grail of mage wristwear, offers only 15 hp more than exceedingly common alternatives. Can't find a granite ring? UNLIMITED OPAL RINGS have only 1 less dam a piece.

Sure, multiply these relatively minor differences by ~18 gear slots and that can make a substantial difference. But we're talking about ceilings at that point.

Once you learn how to regear at hero, the floor really isn't all that low. It's certainly high enough to exploit mistakes by players using higher-end gear so you can take it for yourself. Also, from what I've seen, most players in the hero range have a couple of pieces of really nice gear, and then a bunch of OK gear.

(Obviously, a few stand out as just plain old stacked with gear that I've never even seen, but I can tell you that none of that crazy gear makes them unkillable.)

In sum: Gear up the best you can, get creative, murder, and loot. And once you're stacked, enjoy the 1400 hp or 80 dam or whatever you have - but don't get too attached to it. You're going to have to remember how to be deadly with far less, because you're gonna lose it all, sucka!