I think one issue that doesn't get talked a lot is that rural areas make it hard to offer a modern standard of living.

Ok, a place wants high speed internet, but the company is going to have to lay 500-1,000 feet of wiring per home instead of 20-50 feet. That's going to cost a lot more, but people think it's unfair for things to cost more. Trash pickup: in a rural area, it's going to mean a lot more miles driven per resident which increases time and fuel usage. Someone to call about issues: if the town has only 1,000 people, how many staffers can they have to take your calls? If you want a staff of 5 people, that's basically $500,000/year including benefits and office space, possibly more. Assuming around 300-400 households, that would be $1,250-$1,667 per household in taxes needed.

The US already subsidizes fuel which makes driving $3,000/year cheaper. The US puts a universal service fee (it'll likely be around 9% of your wireless bill) on telecommunications to pour billions into rural phone and internet service - a 9% tax to fund rural telecom. We mandate that the postal service deliver to all addresses for the same price - so urban people pay much higher postal rates and higher prices for goods shipped to them since the USPS needs to charge extra for their shipping to subsidize rural delivery.

I agree that the needs of rural people often aren't being met, but it's often due to the fact that rural life is expensive and the more advanced we get as a society, the more heavily we'll need to subsidize rural life to keep it up to a modern standard.

150 years ago, rural life wasn't missing out on much. You couldn't have a cathedral or a theater, but there wasn't electricity or internet or trash pickup. Today, there's so much stuff that just costs a lot more to offer rural (and suburban) areas.

Part of this might be solved by reconstituting counties or creating regional authorities. Instead of having each town deal with tax collection, maybe the county should do that. That way, they can hire people who know what they're doing and spread that cost among hundreds of thousands of people instead of between a few thousand people. I know that Massachusetts has a big history of independent towns with self-rule and this doesn't need to throw that away, but it probably makes sense to start sharing certain administrative costs. Each town trying to run its own website, tax collection, etc. seems a bit much in many cases. If you're Mount Washington, you have 36 families in your town and 5 people for emergency services (police/fire/etc.). You have an animal inspector, building inspector, Board of Assessors, Board of Health, Tax Collector, Town Clerk, Town Office Manager, Treasurer, Tree Warden, Webmaster, Electrical Inspector, etc. I'd have to guess that most of these are part-time jobs that they do on the side of another job. It probably makes a lot more sense to have a larger body (like a county) handle a lot of that. You're not going to be able to offer a full-time person to call about tax stuff in a place with 36 families.

Other things are harder to overcome. It's simply going to cost more money to provide trash pickup in rural areas. It's going to be harder to convince doctors to want to live/work in rural areas where there might not be enough patients to keep them busy enough - and lead to lower earnings.

Rural life is going to have trade-offs and some of those are going to get worse over time. A lot of infrastructure just becomes really expensive when supporting rural areas and we don't just want to subside off the land anymore - we want all the advancements of the past 150 years of human progress.