I grew up in a fairly rural community. Every common service has basically collapsed. The town I lived in had a grocery store, full service station, restaurant

I grew up in a fairly rural community. Every common service has basically collapsed. The town I lived in had a grocery store, full service station, restaurant, hardware store, and even a bowling alley. Those are all completely gone. This was in a town with about 300 people. How the collapse happened is actually pretty simple. As suppliers slowly consolidated they started raising prices for smaller business as somewhat of a "go away, you're annoying to deal with" policy. It's simply far easier to sell 1000 items to walmart than it is to sell 10 items to 100 different stores. That in turn collapsed businesses in the town as you could literally go to the walmart a 45 minute drive away and get things for half the price. Medicine is mostly due to privatization of education and consolidation of medical offices. There are simply limits to how many students medical schools can take and as a result they've simply continued to raise tuition prices to try and limit demand. That has put huge debt burdens on new doctors which makes working in rural locations particularly unappealing (they can't afford the salary a doctor needs to afford the debt they've taken on). 15 minutes from my hometown, there's a medical center that used to employ about 10 doctors when I was a kid. Now it's mostly staffed by 1 or 2 nurses with a doctor that comes in 3 times a week. Where they used to have to tools and equipment to handle most medical needs, now they are effectively just a stabilization location while patients wait for life flight to take them to one of the more major medical locations. I personally blame weak anti-trust enforcement and mass privatization and deregulation for the current state of things in rural America. These communities are dying because they have no capital power. That causes them to be steam rolled by basically everyone. Big business has wrecked that part of america.