Medicare caused a LOT of rural hospitals to close.
I remember growing up in the 60's. Small town at the time 2300 people. We had a 30-40 room hospital where most people
in a 30 mile range were born. When medicare came along, the hospital would have been forced to make a TON of "mandated"
upgrades to qualify to be able to take medicare patients. They closed the hospital, the doctors stuck around for a few years then
they left too.
After that happened, if there was an emergency, instead of being a couple minutes from an ER, you were sent in an ambulance
25 miles away.
Not only that, once medical insurance, medicare/medicaid came along, RATES for doctors visits, hospital stays went through the
roof! Companies started buying hospitals, doctors offices and what not. Now, in most towns & cities, there is ONE hospital and all
of the doctors are "owned" by the hospital. So you can't really shop for a less expensive doctor. Other than the urgent care places
you are really screwed.