Absolutely. Hell, I live in a major urban center and the healthcare here still sucks. Years of getting the runaround and "Wow, that's so bizarre, you should go

Absolutely. Hell, I live in a major urban center and the healthcare here still sucks. Years of getting the runaround and "Wow, that's so bizarre, you should go to the Mayo Clinic to find out what's wrong with you" only for an answer to emerge from something as banal as a colonoscopy. On that note, I maintain that the opioid epidemic hit the US uniquely hard precisely because of the lack of access you describe. (And I'm always surprised how few conversations re. the opioid crisis ever mention it.) When it's hard to find doctors, when it's expensive and time-consuming to visit them, when tests aren't offered or are too expensive and time-consuming for people to pursue them, when the medication for the condition they finally get diagnosed with is expensive and requires you to jump through a million prior authorization hoops to acquire... of course they turn to cheap, generic painkillers. We're not good at treating the underlying causes of pain, and the treatments that do exist are too often out of reach. We don't have adequate safety nets. People need to work, and it drives them to mask their symptoms.