Intense variations in local resources and culture heavily impair nationwide consensus on healthcare. Families in rural areas can thrive with a knife, saw and s

Intense variations in local resources and culture heavily impair nationwide consensus on healthcare. Families in rural areas can thrive with a knife, saw and shotgun, drinking from clean lakes, growing food and living healthy, aerobic lifestyles. They see little need for government intervention. They barter and travel on unimproved roads with horses and all-terrain vehicles, even making their own fuel. Even in the event of a fire disaster, they can quickly rebuild on their own vast property. In denser urban areas, housing codes and other cultural laws, like riding horses, drying clothes on a line, noise and land use restrictions and sleeping in public spaces make living close to the land impractical and/or illegal. Collusion with the developed world and its government is mandatory. People in these areas are happy to invest in personal radios transmitting their consumption habits and private conversations in exchange for access to the benefits of mass production, including remedies for their own sacrificed health. In these areas, those with the ability to generate for the system do just fine or excellent. Families with cultural lag, such as the poor, badly educated and immigrants - voluntary and involuntary - have to get up to pace, learning the unintuitive ways of the modern, urban jungle. It's hard work, yet with all the access to information, it remains largely possible. The bottom layers who can't keep up get minimal assistance from the government to figure out how to get back into the system or move out to the rural areas. America is all about navigating the 1,000 shades between these two extremes.