I invite you to visit Northern Michigan! This world exists only 7 hours, by car, north of Chicago, a metro area with something like 9.5 million people. Hardly 'pretty far out' in my opinion. Growing up I had to call EMS a few times for various things, if you're not directly in town or on a tourist road, one can expect some seriously long waits. Washed out 2 track during a light rain isn't exactly something an ambulance move quickly on.

People adapt to their environments, if you have to fix your car in the country, you learn to fix your car. If you have to fix your car in the city, you learn to schmooze the repair guy into giving you a better deal.