Yes, wouldn't solve the medical care problem in truly rural areas (but let's get brutally real about that: what ever did? you drove 200 miles if you needed a hospital or major treatment; stubborn old people who wouldn't move closer to access were really just chosing to die without treatment)

THAT SAID, that's a fascinating article. Many parts are contrarian, debunking classic tropes. Especially like this part as to policy:

Regional prosperity wasn’t always a zero-sum game. From 1930 through 1980, virtually every geographic section of the United States saw its per capita income trend towards the national average. In 1933, average income in the Southwest was not much over 60 percent of the national average. By 1979, it was nearly on par. New England, once 1.4 times wealthier than the country as a whole, fell to just slightly above average. These gains were visible in the nation’s cities. In 1969, the per capita income of Greater St. Louis was 83 percent as high as New York’s, and it climbed even higher in the subsequent decade. In 1978, metro Detroit’s average income was about the same as that of the New York tri-state area. In the mid-1960s, the twenty-five richest metropolitan areas included Milwaukee, Des Moines, and Cleveland. (Throughout this piece, I’m referring to metro areas as defined by the U.S. Office of Management and Budget, which uses census data to designate “metropolitan statistical areas.”)

This convergence helped the country develop a broad middle class. According to Harvard economists Peter Ganong and Daniel Shoag, approximately 30 percent of the growth in America’s hourly wage equality from 1940 to 1980 was the result of wages across different states increasingly resembling one another. In other words, growing equality between regions helped foster more equality within regions.

But suddenly, these trends reversed, and over the next several decades, regional inequality exploded. In 1980, New York City’s per capita income was 80 percent above the national average. By 2013, it was 172 percent higher. Incomes in Washington, D.C., and San Francisco, respectively, went from being 29 and 50 percent above average to 68 and 88 percent higher. Heartland cities, meanwhile, saw their wealth slip away. Gone from the list of America’s richest cities were Milwaukee, Des Moines, and Cleveland. By 2018, twenty of the top twenty-five were on the East or West Coast. Seven are in California. Minneapolis, which clocks in at number twenty-four, is the only entrant from the entire Midwest.

How did this happen? Some analysts cite the impact of deindustrialization. But while the decline of industrial jobs certainly played a role in the stagnation of the Midwest, other places that once had strong manufacturing industries—like New York and Boston—managed to rebound from manufacturing busts. Seattle provides an especially revealing case. Although it’s now one of America’s most affluent cities, in the 1970s it was one of the country’s most distressed. The local economy was heavily reliant on a sole manufacturer—Boeing—and when a mild recession led to a collapse in the airplane market, the region entered a tailspin. One out of every eight jobs in Greater Seattle was eliminated, and unemployment ticked above 12 percent. But, unlike Detroit, the city had the good luck of rearing Microsoft cofounders Bill Gates and Paul Allen....

We tend to think the whole corporate welfare thing of competing for luring big businesses to set up in a town is bogus and truth be told, there are many fails. But what else is there? The most popular smaller cities right now do have lots of business going on, i.e., Asheville and Charlotte in NC, San Antonio, Phoenix, Nashville...

I sure as hell remember when Seattle was totally dependent on one industry, though, Boeing. Seems like you were always reading about layoffs there! What the hell was that all about actually? Was airplane building really that important to the U.S. economy that the whole country was on alert about it?