Significance: Rural areas across the U.S. suffer from a dramatic gap in healthcare quality when compared to their urban counterparts. The U.S. healthcare system as a whole holds the highest total expenditure on health care in the world as a percentage of GDP (The World Health Report 2000), while affordable rural care is limited, at best. In 2008, each U.S. citizen paid significantly more per capita than any other OECD country in the world-more than double the average of the next highest fourteen countries (OECD Health Data 2010)--while affordable care in rural areas is nearly nonexistent. These issues could be resolved through implementation of a universal health care program similar to Taiwan's National Health Insurance Program (NHIP), which was initiated in 1995. Taiwan's system currently holds a very high approval rating, covers nearly all citizens equally while offering highly-efficient yet affordable care.Methods: This paper explores the effect of the NHIP on the number of insured patients, per capita patient visits, patient per medical center ratios and patient per provider ratios in Yilan County, Taiwan, and Humboldt County, California.Results: I find that if the U.S. policy makers were to implement a single-payer system, using Taiwan's NHIP system as a model, the U.S. system could provide better, more affordable care for a vastly increased percentage of the population--all while closing the rural-urban gap.