Urban vs Rural - 8

[timelets]

Parts of the country are dying out. Services they receive are the worst of both worlds: expensive and low quality:

In the medical desert that has become rural America, nothing is more basic or more essential than access to doctors, but they are increasingly difficult to find. The federal government now designates nearly 80 percent of rural America as “medically underserved.”
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What Van Horn offered was a three-year contract with $300,000 guaranteed for the first year, which was about 50 percent more than Cummings could have earned in a big city. He wanted to practice in a small town where he could get to know his patients. His wife liked the nearby mountains. They would be close enough to drive back to Central Texas to visit family. The federal government would forgive much of his student debt as a reward for his working in a medically underserved area. Van Horn had sealed the deal with a $5,000 signing bonus and a $3,000 monthly stipend during the final year of his residency.
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Even during his residency in tiny Winnemucca, population 7,400, he had worked with a medical team of emergency physicians, hospitalists and general surgeons. Once he started in Van Horn, he would eventually become the only doctor on call.

https://www.news-journal.com/news/in-the-medical-desert-of-rural-america-one-doctor-for/article_cff7ecda-e2f2-11e9-a269-330f202342cd.html

Transportation costs are high, specialization doesn't make business sense, investment into services infrastructure has no chance of paying off. Model-wise, the problem is the same as phone-based customer support.