http://www.answers.com/topic/health-care
"Low population density and greater travel times and barriers in rural areas affect service availability, the ability of people to get to those services, and the economic viability of the services. Lower population density also means a lower volume of patients and less provider income. Reduced fees and the refusal of insurers to pay for care often destabilize private professional practices in rural areas, leading to greater shortages of personnel.
The lower the population density and the larger the area over which the population is distributed, the fewer the available health services and the longer the travel distances to access these services. Emergency medical services in such areas are scattered over great distances and often staffed with volunteers who have other jobs. Emergency care for severe trauma or major acute illnesses, such as stroke and heart attack, may take longer to arrive than in other areas, causing increased morbidity and mortality. Poor roads or geographic barriers, such as mountains or rivers, magnify the effects of distance. More remote areas with the capacity to pay for the technology, such as western Kansas, are beginning to use telemedicine to improve access for primary care and certain specialty care, such as psychiatry and dermatology."
http://maaw.info/ArticleSummaries/ArtSumBastRueWesbury93.htm
"Geography: The geography and demographics of the U.S. has a lot to do with its delivery of health care services. The U.S. is a very large country with a very ethnically diverse population. It also has a very low population density compared to other nations. Because we are aggressive in receiving health care services, we try to have hospitals and clinics close to patients. Therefore, because our population is dense, we have to provide many facilities in a lot of places, resulting in more facilities than other countries provide. The large size of our country along with a diverse population has lead to “a decentralized and competitive system of financing and delivering health care” (37)."