Of course there are institutions in the midwest. Some of the best universities are in the midwest. But practically if you lived in, say Lodi, it would take you over an hour to drive to the cleveland clinic main campus to see a specialist. That might be fine while you are 35 but untenable when you are 85.
The services are there but the density is low and the sprawl is wide in the midwest, and your only option is the car or to be entirely dependent on a relative to shuttle you to your appointments as public transit is anemic to non existent outside of chicago.
