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1) I would only consider Visage if I'm vlad or mundo, or if I have strong healing on my team. Get Abbysal Scepter instead, you're getting so much out of that for Galio, AP, MR, and MR reduction aura! Yes.
2) Aegis of the Legion and Banshees seem to suffice for me, if not get some HP Quints.
3) This is where Frozen Heart/Omen comes in. But overall yeah this is a good point.
4) True. But I've actually managed well enough with little CDR.
1) The reason I go Visage is because it's just.. It's just straight-out great because of how it affects Bulwark and synchronizes with Force of Nature. Bulwark healing for 20% more makes a big difference, as... Say your Bulwark is healing you for 100 on the first hit. With Spirit Visage, that's 120. Then the second hit is 96 healing instead of 80. Then it's 77 instead of 64, and so on. It's a big difference for those first two hits when it matters most, and with Thornmail I've been able to heal off of turrets as Galio, as well as tank the enemy team a lot better.
2) I'm not too fond of Aegis because I feel that slot could be fit with better items, but only if someone else is getting an Aegis, otherwise it's a great idea, and if you don't eventually get Banshee's on Galio, you shouldn't play him.
3) I have to agree with you there, I always run HP Quints on Galio of course, but having a bit more health doesn't hurt because, again, Force of Nature is percentage healing and Spirit Visage..
4) Yeah, CDR isn't the biggest worry, but it can lead your allies to force more teamfights early on, and on a team with Galio, unless you're super-derp solo queuing, your team should be geared to go right in and wreck face in teamfights with you.
Different strokes for different folks.
Slinger O Guns:
Best build for Galio I've found (I've been playing him since release as my main tank)
Chalice of Harmony
Randuins Omen (If they're a heavy magic team then Force of Nature)
Might I convince you to try out Archangel's Staff instead of Chalice? If you have the right runes you won't have mana problems, and by the time you'd get a Chalice, Archangel's can fill that need for Galio just as well, as well as adding a good boost of straight AP, moreso than Chalice, even if Chalice adds some of the ever-nice MR for him, I think it helps him a lot better to have that Archangel's just to boost his damage, especially since his AP ratios have been scaled back just a bit lately.
Also I don't see a Thornmail in there, while it may not be the end-all-be-all-you-must-get-this, I find it really helps both with Galio's ult and for if one of those pesky carries starts plinking at you. It's especially funny to watch Twitch and Tryndamere kill themselves on you.