While I know that there is excellent medical care available in many communities, and our local area with hospital, clinic, assisted and full nursing home at Philip, SD with satellite clinic at Kadoka along with their own nursing home are excellent. BUT they also began as local endeavors built with donations and great support in the area. I was born at Kadoka in 1940 and it was about 40 miles from our ranch. There may have been a hospital in Midland at the time, but, I think no doc. Or maybe it was because my mom could stay with a favorite aunt who lived nearer Kadoka for the last days before my arrival. In any case, that was in the day of dirt trails for most of the rural roads, not even gravel on them, so travel in any but dry weather was difficult, to say the least!
Other 'local' hospitals still are few and far between in West River SD. We feel pretty blessed to live within 30 miles of such a good facility, with, I believe currently there are two or three MD's and one or two Physician Assistants. Great Lab Techs and volunteer staffed Ambulances with EMT's on call in each of the small towns without hospitals. It isn't easy for those volunteers, but they do a great job. My family has needed the ambulance a few times in our nearly 60 years of marriage, and each trip ended well, tho I doubt I've ever been more scared of the speed of a ride than when I had a mild heart attack in the Philip Hosp. and was QUICKLY hauled off to Rapid City Regional Hosp. 90 miles away, a few years ago.
Point: WHY was/is there no systematic method of learning needs and the communities AND the medical professionals, Insurance companies and virtually everyone involved with and/or concerned about medical service, costs, access to insurance, and the 'whole ball of wax' in regard to health care in each state? We who have gone about building our own know that it can be done on a practical, but effective basis. Why does that seem not to be important to our politicians and 'powers that be'????
mrj