Certainly. There will always be interdependence and rural communities understand that; that's why they drive modern pickup trucks rather than horse-drawn carriages. Still, they are always looking for ways to reduce their dependence on cities.

Distributism includes the principle of subsidiarity, it doesn't exclude the fact that you need large organisations to produce some technology, just that you should tend towards the smallest organisation that can achieve what you need. Capitalism seems to be tending towards the opposite where the winner takes all.

Well, at least until we reach the science fiction utopian dream of nanoassemblers that can make nanoassemblers. Then rural communities could truly be independent.

Although that independence would be like a group of proto humans that knew about fire and how to use it, but not how to make it, and thus carefully guarded it and kept it fed, lest it go out.

Do you think that we'll be able to escape making this tradeoff in the future? I don't think it's unreasonable to think that sanitation and healthcare technology will advance to the point that they can be implemented in smaller communities at similar levels of quality that could be seen in big cities.

I hope we will have healthcare services that don’t require advanced knowledge or infrastructure to operate, but we’ll still need advanced tech to produce them.

I don’t see a way around this, since you always have to start from the same raw materials.