Hospitals are businesses in developed countries too. Here in Japan, the hospitals and clinics are all private businesses, but the prices are very low, ambulance rides are free, etc. The keys, as far as I can tell, are 1) no consolidation/monopolization and 2) lots of regulation.

Hospitals are also businesses too in Europe. It's the regulations around the system that make the difference.

We were. Then a few decades of legislative capture, private equity, and neoliberal gibberish about "service economies" drained all of the opportunity out of rural and semi-rural America, consolidating what was left in major metro areas.