Rural communities will fight tooth and nail to hold on to their hospitals, primarily for that reason. Even if the strip malls are vacant, and the downtown shopping district is boarded up, as long as there is a hospital, money will be circulating in the community.
Of course if we still made our shoes, sheets, blankets, shirts, pants, machinery, and electronics here in America, this wouldn't be an issue would it?
That is interesting-there isn’t a big tourist industry in your area-I’m asking because I’m used to rural Texas ranch country, having been born and raised here-
The rural area I live in depends mostly on the guest ranches, winter cabin rentals RV parks and other small businesses that cater to the tourist industry-our busiest season begins in late November, when the snowbirds arrive to spend the Winter-they stay until around Easter buying from our stores, leasing our cabins and RV spaces-and patronizing the clinic, physical therapy center or chiropractor in case of injury/illness those are all in the biggest town-less than 900 people-they do employ a few people, but not as many as restaurants, grocery and feed stores, ranch store, lumber yard and the gift shops known as tourist traps.
The nearest hospital is in the next county, some 40 miles away in a town of around 20,000-but that town is also pretty much a snowbird/tourist trap, too. Sounds like a whole different place from what you describe.