This is a sort of disingenuous way to talk about rural America. Pine Ridge is two hours from Rapid City, not the middle of nowhere, Alaska, and the discussion isn’t about specialty care, but normal primary care, hospital and Ob/Gyn services.

Saying “suck it you stupid rubes, move to a city” is going to make it difficult to get anyone to agree with your version of healthcare reform, assuming it was even going to work.