Sure in an ideal world single payer is best. But again how do you get the person who lives two hours away from a doctor to agree to pay taxes for healthcare he cant get to or has no access to? We have a lot of things to change first before we can address single payer. We found that out the hard way from the ACA. Getting way more doctors and healthcare professionals out there and offering clinics in rural areas. Hospital consolidation also has gone nuts and now there are fewer hospitals. Its another issue thats going to be urban v rural.
You are totally on point regarding hospital consolidations. In Maryland, now most facilities are part of the Johns Hopkins, the University of Maryland, or MedStar systems.