The vast majority of people (over 90%) in pre-Revolution France belonged neither to a clergy (1st) nor nobility (2nd), had less privileges and were unrepresented in government; this imbalance led to their Revolution.
With that in mind, Politico has an article making it clear that rural Americans are tiny in number and spread out, which leads worse healthcare than in the worst in the world.
“We have a residency program at Guyana, on the coast of South America,” Russ said. “These are the types of things that [I see] when I go down and work in Guyana. We see this for the Amerindian population that are coming out of the villages and need a canoe to get, you know, to a hospital. This isn’t the type of thing that we’re used to seeing in the United States.”
Tennessee lost over 1,200 staffed hospital beds between 2010 and 2020 despite a population that grew by over half a million, according to the American Hospital Directory and census data. Mississippi, with the most Covid-19 deaths per capita, lost over 1,100 beds over that decade. Alabama, second only to Mississippi in per-capita deaths from the virus, lost over 800.
Apparently living in rural America with a need for healthcare is like having a canoe without a paddle.
Or, as Dolly Parton famously sang, life on a mountain in Tennessee is hard.
Didja know corn don’t grow at all on Rocky Top?
The dirt’s too rocky by far
And that’s why all the folks on Rocky Top
Get their corn from a jar
Apparently nobody thought to put dirt in a jar and grow fresh corn. Yee haw.
But seriously those lyrics are about the rural community suspicion of federal government (e.g. prohibition and the history of bourbon, which is basically alcohol encoded as corn in a jar).
They come right after lyrics about killing the federal agents who visited.
Once two strangers climbed ol’ Rocky Top
Lookin’ for a moonshine still
Strangers ain’t come down from Rocky Top
Reckon they never will
As much as scarcity of services may seem like news, also I remember experiencing it myself in rural America for decades. A trip to a hospital was considered a minimum 30 minute drive. Even that was to what felt like an outpost where chance of meeting someone with any clue about science was marginal at best.
More recently when I tried to setup a primary care physician — a step required to use health insurance — I was told there was no availability. Doctors would not accept any new patients because healthcare crisis (COVID19) meant they had zero capacity. At one point the American healthcare “system” advised I try to find the rare Muslim woman doctor because they estimated (without explaining why) she would be most likely to have availability and take new patients.