A small population in a contained geography does well with the best kind of care -- one on one family, home doctors.  Cultural healers, naturopaths, homecare nurses, health practitioners do well here.  But, a large population spread over a broad continent depends upon clinical, centralized, primary care MDs -- mass productive treatment via clinical diagnosis and specialization.  Furthermore, if high-risk living cultures such as fast foods, soda drinks, processed drugs, etc. applies to a geographically expansive large populated society, that society will inevitably exceed its capacity of centralized clinical care.  This is where the discussion should begin.