Big internet companies, like Verizon and Comcast, can use some of the money they make in urban areas to compensate for the losses derived from their rural programs. If the federal government manages such a program correctly, then internet providers can continue to bring in lots of profit, while increasing rural access to internet. Instead of making consumers pay for rural expansion, we can require big internet companies to decrease their large margins.

With such a plan in place, internet companies will still be able to make considerably large profits and keep their investors happy, and at the same time rural America will be connected with the rest of the United States. Internet companies will protest, but it is in the American spirit to have the rich help giveprocess but also the people who take part in it \[[@B27],[@B28]\]. Four strategic groups of actors \[[@B29]\] are thus concerned, based on their expertise (specialized or non-specialized) and their position related to the government (internal/external) \[[@B24]\]. The research took this aspect of the policy into account by incorporating the viewpoints of several actors, including managers at various levels, the officers concerned by the policy at the primary health care centres (called CSPS), and civil society actors.

For each group, participants were purposively sampled. At the central level, individual interviews were held with five managers (former secretary generals, human resource officer, ministry advisor, director general of health) who were or are in charge of human resource matters for the Ministry of Health. At the regional and district levels, the district