Even counties that have them have issues...
Take my county, please! Multnomah county, Oregon. One of our smaller counties in terms of square miles, but largest in population.
The dots representing cities here aren't necessarily accurate, the boundary for Portland, for example, goes ALLLL the way out to Gresham, but you get the idea.
Back in January, following a medication change, I was having shortness of breath so the doctors told be to pick an ER, any ER.
I picked Mount Hood Hospital in Gresham because a) it was close and b) we were in the middle of a snow and ice storm.
ER determined no, not the medication, I was having a heart attack and they ran an angiogram to determine what the problem was.
BUT - even though they had the ability to do the angiogram, they couldn't do the stent that was required, and that meant taking me by ambulance to Good Samaritan Hospital in downtown Portland, some 19 miles or 25 minutes away (so says Google).
Remember, January? Snow and ice storm? Yeah... Our ambulance service was overwhelmed by slip and fall calls.
So the first night in the hospital, I wake up about 6AM and I'm fooling around on Lemmy such as you do.
Nurse comes in.
"Were you asleep about an hour ago?"
"Yeah, why?"
"Your heart rate dropped to 40."
"Is that... bad? I don't know these things..."
Yeah, apparently bad.
Ambulance still can't get there. So 2nd night in the hospital, same deal, wake up at 6 AM.
"OK, so your heart stopped for 8 seconds."
"Uh... thank you? I'm not sure what I'm supposed to do with that information."
Ambulance got to me a few hours later, got ne to the 2nd hospital in time for my scheduled surgery, all was good.
In the most populated county in my state.
In the largest metro area in my state.
If it had happened out in Harney or Lake county, I would have likely died.
In the 2nd largest town in Oregon, Eugene, they just closed their only hospital(!) People now have to drive to ~~Shelbyville~~ Springfield, the next town over.