Meanwhile they pay a huge portion in premiums only to be denied coverage when they actually need it. Somehow the 'death panels' are a-okay as long as they're the boards of for-profit hospitals or insurance companies. The contradictions are sharpening though (see the doctor shortage) and I think all but the most brainwashed are waking up. You only have to look at the overwhelmingly positive reception Luigi got to see that.
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Rural areas tend to require 4-wheel drive more often, which tends to be offered more often on SUVs and the like (the added clearance doesn't hurt). But cars across the board in the US have been getting larger for the last 30 years, to the point it's even causing problems with road maintenance. The more compact vehicles common in Asian and European cities are often not even sold in the US anymore.