I grew up in rural Missouri. Same thing here just as you described. My town had 300 people in it, but the town close by had around 8,000. Last I heard the hospital there was on the brink of collapse because nobody there can afford to pay after visiting. So most people won’t visit at all and die prematurely. Everyone is panicking because if the hospital closes the nearest one will be 1.5hrs away. A situation entirely preventable with subsidized health care. The hospital would get what they needed that way.