Health care services between the 1800s and 1940s were functionally indistinguishable throughout the country, particularly the rural parts. Indoor plumbing and electrification was rare to non-existent. The most common professions were still agricultural. Plastics were still a novelty. Coal was the primary fuel source. The train and trolley were the primary means of mass transit.

Then we experienced a technological revolution over the subsequent 40 years. Chemistry sciences generated a wealth of new manufactured materials. Nuclear and hydroelectric power flooded the grid with practically free electricity. Industrial agriculture pushed the bulk of the workforce into the manufacturing and professional sectors. Computational sciences radically changed the size and composition of accounting departments. Airlines radically changed both business and recreational travel. Both the demand for and supply of college educated young people surged. The entire composition of the economy was dramatically and inextricably altered.

And then the Soviet Union collapsed in the mid-to-late 80s. All these advancements in technology and industry and global trade just kinda piddled to a halt over the next decade. The globe started balkinizing again. Western powers started rearming themselves. Mass deaths, particularly in regions occupied by western governments, reasserted themselves. The global arms trade boomed. We no longer talk about nuclear power, only nuclear war.

Oh well…