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In light of all the hospital talk I wanted to get a few perspectives on all of this. I sent messages out to about eight different folks who either are in important positions in the eUS government or who would have unique knowledge and/or perspective on the whole debate. Five of them replied and I thank them for their thoughtful responses. I'm not trying to push a stance, one way or another, this is simply to present some different ideas side by side. Also, everyone had the same questions to reply to. Some questions didn't quite apply to their realm of experience. Their responses will be presented after each question in alphabetical order.
It's a little lengthy. I was going to cut down the responses as possible but really they've already provided very concise answers, so you'll just have to deal with it. 😃

Weighing in we have:

Aeros ~ Author of the great newspaper, Defense Intel Review
Astra Kat G ~ Congresswoman
Colin Lantrip ~ The Great Ape Himself
Jewitt ~ POTUS
Max McFarland 2 ~ of McFarland Constructions

What would be the best way to further develop infrastructure, if at all?
Aeros ~ Obviously the first Hospitals should be dropped in regions that have a high real life population. It’s a common misconception that supporters of this strategy want it done all at once. A more realistic expectation is a gradual building up of our infrastructure.

Astra ~ The best way to further develop infrastructure at this time is to concentrate on building Q5 Hospitals and Defense Systems that can be held in reserve storage or given to our allies as measures of gratitude. Plans for anything less than a Q5 is a waste of time and resources, especially given the upcoming V2 update. We shouldn't try to push beyond three fortresses at this time.

Colin ~ For the most part I support the current "Fortresses" strategy. I oppose the placement of anything that is not Q5, but I might support the addition of Q5 states at a slightly quicker pace than what we're doing now. (more below)

Jewitt ~ Right now, I feel continuing our practice of constructing Q5 hospitals to be most cost efficient given how the war module and economics modules play out. Of course, once the game changes, this will need to be reassessed.

Max ~ No comment. I defer to executive/military opinion.
~ Whatever infrastructure they want, I shall build.

How much would such efforts cost?
Aeros ~ Depends on what Quality level we opt for. Each quality level of a hospital is 2,000 wood plus labor. So, for a Q2, that’s 4,000 wood per hospital plus working expenses. Normally even this would not be cheap, but McFarland industries has offered to do the work for free, so expense to the Government is not an issue. We must also remember that it’s a one time expense, whereas the current strategy of procuring moving tickets is a constant drain on our Governments coffers.

Astra ~ *Editor's Note* I'm not sure if I lost this response or what. I think her other responses are very clear and I'll check my PMs again, but I don't think there was one here.

Colin ~ Is it $1 or $.01 that Max is proving them for?

Jewitt ~ As it stands, the U.S. Government is grateful to have an ultra-nationalist patriot named Max McFarland 2, whom is the embodiment of selflessness. He pretty much fronts the raw materials and wages, while the U.S. Armed Forces (primarily Marines and Airborne) supply the labor. In all, the construction of a Q5 hospital is cheaper in the U.S. than in any other country.

Max ~ There are no primary costs.
~ Whatever infrastructure the President wants, I shall build and donate.
There are secondary costs.
~ My volunteers work for minimum wage; this reduces their economic consumption.
~ Constructions offers far less economic benefit then manufacturing or land; products are "permanent". As such, volunteers building skill in constructions are proportionally diminishing their long-term economic contributions, both in production and consumption, in the more valuable economic sectors.

Would it undermine the fortress strategy, and in what ways?
People leaving fortresses, not coming to fortresses, etc.
Aeros ~ As it stands, no. The people that already make up our fortresses are not going to up and leave for Q2 hospitals. Florida is already one of the largest fortresses in the game and that is not liable to change anytime soon. Opponents claim that putting a low quality hospital in a state will cause the people in that state to stay there and not be productive, which is absurd. Money and experience points inevitably talk and people will be able to do better in the Q5 regions instead of the Q2. There will be some hold outs, even I will admit it. But I am not calling for these hospitals for those individuals. I’m calling for them for the vast majority of new citizens who will be retained by this project and inevitably make their way to the Fortress regions, thus making them bigger.

Astra ~ Well, I think I worded my answer very carefully so that it wouldn't undermine the fortress strategy; that's certainly not my goal, in any case.

Colin ~ "Undermine"? It would change it for sure. We are not the country that PEACE invaded. We are much more organized and able to react. I'm not sure it is necessary for us to have 1 million point walls sitting around at every Q5. Is Florida under any immediate threat? Can you even see a threat to Florida at this time?

Jewitt ~ What would undermine the fortress strategy is the implementation of the Q2 hospital concept. The key to the fortress strategy is taking advantage of our 51+ region "shield," which allows us to pick and decide where to fight our battles and at what time. Placing non-fortress qualities across the nation not only would hamper this tactic and make it more costly, but would also cause citizens to instead move to California, Karnataka, to stay home and write their congressman for an upgrade. Many from California, when it had Q4, even attest to staying at home because it was "just one fight," when about 800 active citizens were there. Assuming they just did a conservative 100 damage each, that's 80,000 damage. Wars have turned and been won by that much.

Max ~ Yes.
~ Some folks who do not care about the military game will move to non-fortress states with hospitals.
~ Some folks who are emotional about their regions will make emotional residency decisions.
~ The more fortress states we have, the less of a fortress each one becomes.
~ To spread beyond what we have now and one high wood region would no longer be a fortress state strategy.
~ If lower quality hospitals are included, those folks who reside there are not good fighters.

Would it weaken us militarily by reducing the number of times people can fight?
Aeros ~ No, because the vast majority of our military strength is already in place at the Q5 regions. The only people who will use these hospitals would be brand new citizens, and their damage barely registers in a battle. This is something that the Commander of the Army himself has pointed out, but to no avail. The opposition is very much set in their ways.

Astra ~ Nope. It's Q5 Or Bust, Baby, as far as I'm concerned.

Colin ~ I am opposed to anything less than a Q5, so no.

Jewitt ~ Our military is nothing without the citizen wall, and to have it concentrated on getting their congressman to "upgrade" their state's hospital (if it exists) instead of moving to a Q5 region would be a stunning blow.

Max ~ Perhaps. The argument here is for quantity or quality.
~ Our current approach is for quality. We want folks to become active players, move based on rationality, enlist in the military, follow daily orders, etc, etc. Many nations shoot for quantity; retaining people where they want to live because we cannot make them move. Accepting what level of contribution they want to offer, and working with that. this will retain more people. Perhaps only marginally more. Ultimately, it will weaken our top-down command structure for the military, sure, but it might be worth it. I don't know. I defer to executive/military opinion. Perhaps you should talk to them to get their opinion? What you find might surprise you. *Editor's Note😘 I contacted two military leaders but received no reply. I honestly assume the PMs were simply lost in the mess they must get every day.

Aren't the fights we have now plus two new fights better than the fights we have now alone?
As in, if we bring in new players, even if they can only fight twice, that's still more than if we lose that new player.
Aeros ~ Absolutely, and to quote General NXNW again, if we gained 5,000 new citizens in the major states from this project, they would become Fortress regions in their own right. I think our Government leadership is still stuck in the Beta era. They forget that a States like Texas and New York have populations larger then Serbia and Hungary. Leaving these regions out in the cold is bad strategy, and counter productive to retention. I can understand the immediate military concerns, but thinking about the present at the expense of the future is a serious mistake.

Astra ~ Two new fights... Oh, are you talking about adding Q2 hospitals for the couple dozen or so people who refuse to accept moving tickets from Meals on Wheels in order to move to a fortress state? In that case, no, it would not be better. It's just more cost efficient to take the gold that would've gone towards building that Q2 hospital for the small number of people who refuse to do the patriotic thing and go to a state where they can fight five times and instead give it to our tanks, who can do far more damage with it.

Colin ~ You're assuming the Q2's would actually work. I clean the bodies out of my skill 0 org every sunday. Most of what I throw out is level 6 and 7 multis and level 1-3 players that signed up and never came back. A Q2 would not in any way change that.
*Responding to the statement/example😘 I don't think a Q2 in "Texas" would have any measurable effect. (or NY, PA...)

Jewitt ~ I think you are meaning if someone was in a Wasteland state and would be granted a Q2 hospital. The fact is: No. If they are gung-ho about staying in their state then they are more of a liability to the nation (militarily, at least) and should be in a higher quality state.
*Responding to the statement/example😘 This is true, but why spend the money when for around 10 USD we can move them to California, where they can fight five times a day?

Max ~ Yes.
~ But, to be fair, this is an oversimplification. This use of the term "fights" is purely offensive in intent. The fortress strategy i primarily a defensive strategy. It is an assumption that this defense if of primary importance, and that the risk of losing new players is easier to accept then the risk of dispersing our defense. It also assumes everyone will be rational and move to a fortress state; just as it dismisses anyone who cannot see reason and move.

During the NA Invasion we moved citizens to Florida while being overrun.
Why couldn't or shouldn't we be okay with possibly needing to do that again?
Aeros ~ The fear is to invest the money involved only to see it go up in smoke and watch our ability to defend ourselves and do tactical retreats be compromised. Again though, this relies on past and present military calculations that fail to consider the possibility of future growth. Getting a baby boom just in Texas and New York would increase our population exponentially, and have long term ramifications that will last much longer then the the few days that New York lost a hospital because the eUK blew it up.

Astra ~ Obviously, the economic impact of needing to use our fortress states would be dramatic, but hopefully not as dramatic as Florida given the fact that many companies now exist in our fortress states, partially as the result of our previous exodus to Florida, and the fact that California has double High resources. However, it's better to have fortress states and not need them than to need them and not have them. The fortress strategy was devised as forward-thinking to minimize the impact on our society, in terms of people's individual lives and our economy, should we be reduced to one state again.

Colin ~ We likely will at some point. We have come a long way towards having a mobile population. We are always going to have some people that sit on their Q5 and never move, but there are enough of us active to rapidly move and fortify any location if there were an organized, official request to do so.

Jewitt ~ Well, if we're under invasion, we saw that the massive wall in Florida deterred the enemy. Now that California is at that level and Florida still holds the high ground, I feel confident in our ability to wage a respectable war once more. The threat of invasion is ever present, and will for as long as we have hostile borders.

Max ~ Because it is just too expensive and time-intensive.
~ Nonetheless, the risk-reward considerations might make this an acceptable risk.

How do current education and retention efforts work?
I've heard not all new citizens get contacted, some never get replies, and generally more are lost than need be.
Aeros ~ The Government assures us they message all new citizens and give them moving tickets, but I have yet to see compelling evidence for its success. Not one person has come forward in any of the debates saying they were helped by the Welcoming committee, though many have come forward to say that they received no help at all, or are helping noobs on their own with their own money.

Astra ~ National education begins with the New Citizen message, which has useful URLs in it, and continues in places such as the Welcoming Committee forum on our official eUnited States forums. Several players have written guides to help newbies and others yet are reaching out as mentors as part of official government programs in order to increase national retention. ligtreb, Max McFarland 2, and Colin Lantrip all message new employees at their Skill 0 companies in order to impart important beginner information to them. Of those three, only ligtreb's is government-funded; the other two are private citizen volunteer efforts. The Salvation Army, among others, are working to contact every new citizen, but a lack of manpower is their primary shortcoming. If you'd like to volunteer, let them know.

Colin ~ This is where the solution to this debate lies.. Sometimes they do, sometimes they don't. At this point we don't contact every new player. Most that we contact don't take the time to read and reply, so really this is a numbers game. We have to contact EVERY new player, put some resources in their hands and then focus our efforts on those that show some interest in participating. This is what we do at Ft Harlot, McFarlands and Great Ape and it must be done at every place that hires skill 0 employees. I'm not sure how they enforce it, but go post a skill 0 offer in Hungary. You'll get a msg telling you to "get the hell out, we hire and educated all skill 0's". ?? (paraphrased)

Jewitt ~ In the past, we had a "you come to us" policy of filling out forms. Now, with IT work done by Vice President PigInZen and others such as LiveFreeorDie, Killing Time, etc., we have a "we come to you" policy. We have databases where we send mentors and educators to talk to the new players, engagement them and make the nation give off what it really is: A positive and social environment. By giving this off, we hope to retain the interests of more citizens.
*Responding to the statement/example😘 This is a sad fact, and it comes from the fact that this is game. We have amazing mentors, educators, and philanthropists. Unfortunately, the game comes second when real-life is concerned and human error is ever present no matter what we are talking about it. Sometimes a PM will be lost, manpower will be low, or a name will be accidentally skipped on a roster. It is a sad but true reality that cannot be fix short of automation.

Max ~ No comment. Speak with the government program managers and major party leaders.

How do you think programs like the Welcoming Committee do?
Aeros ~ I am sure they work very hard, but again they are the product of Beta era thinking when the eUSA was much smaller and citizen birth rates lower. I find it hard to believe a half dozen people are able to follow up on 300 new people every day. I am sure they have lives outside of eRepublik.

Astra ~ How do I think programs like the Welcoming Committee do what? Or how well do I think they're doing? I think they're doing the very best they can and provide an invaluable service to our new players.

Colin ~ See above and I love the USA Welcoming Committee and Meals on Wheels, they are essential in making my efforts affordable. They also require a player to make some effort on another msg, which reduces the amount of resources we waste on players wouldn't move if we just sent them a tkt right away.

Jewitt ~ I think they're doing a great job and help in our retention. I myself know of many occasions where newer players thanked us for having the WC and programs such as Meals on Wheels because it made the game much more easier to play starting off.

Max ~ Something is better then nothing.
~ They do great on there own merits. Could they do better? Sure. Can we expect them to? Maybe not. When our expectations of these people rise too much, we cannot expect them to continue their work; this is only a game.

Can we rely on the efforts of people like Max McFarland and Colin Lantrip to insure new players are retained?
Aeros ~ Absolutely... to a point. Again back to the original complaint. There are simply too many new citizens, and not enough workers and time in the day to follow them all up.

Astra ~ In short, yes, but more volunteers are needed and always welcome; these men do their best at a very tiring job, answering questions and trying to keep new players interested in the game.

Colin ~ No... We only reach the players we hire.

Jewitt ~ We should not rely on them specifically, but their efforts are symbolic of the eAmerican Dream - to create a fun and enjoying experience. To Mr. McFarland, it is all about helping others and his nation. The same applies to Mr. Lantrip and countless others in the U.S. Government. We are not paid real dollars, we are not given real awards. What we are given are friends, and a fun community. It is the effort of those who want to continue making this community great that we as a nation need to rely on - otherwise we stagnate and the country gets boring.

Max ~ No. Any plan dependent on individuals is doomed to failure. Retention programs must be developed in such a way that they survive beyond any individual. Much of what Colin and I do today will collapse if we lose interest and leave. Contrast this with the USA Welcoming Committee. Chocolate McSkittles was the life behind it; he left and it was barely noticed, as ligtreb and Jude Connors picked up the slack. Nobody is truly successful at retention unless they are making themselves expendable by training others to succeed them.

Would new infrastructure of some sort help retain players? How and why (or why not)?
Aeros ~ Infrastructure prevents wellness loss and death. It also provides a safety net for noobish mistakes like fighting in a region that does not have a hospital. All of these things could lead a new player to quit the game, which is what we do not want to have happen. Infrastructure also provides a stable location for the new citizen to be able to wait and save up enough resources to move to a Fortress region on their own without having to rely on a Government hand out or charity that may or may not be forthcoming.

Astra ~ I think it's very newbish to say that new infrastructure will help retain players. That's all right, though, we were all newbies once. In fact, I remember being angry at Congress for not placing a Q5 in New York, when I was a new player! However, I didn't leave the game over it. Since then, I came to understand what was going on here. I firmly believe, therefore, that any player can put his or her nose to the grindstone and educate themselves on why new infrastructure is not only unnecessary, but actually a harm to our overall productivity and military prowess as a team -- that's what we are, after all. This is a game and USA is a team. We've all got to work together to do maximum damage and work our hardest, for the mutual benefit of all. You can do that a lot better in California than Nebraska. If people are going to leave the game, it's because no one is helping them and they feel lost, alone, or bored, not because their state doesn't have a hospital.

Colin ~ Not likely.

Jewitt ~ I am far from convinced. I have been an adviser to every President since Benn Dover (wow I am old >.> ) and I have always heard their complaints of citizens asking them to upgrade and buy higher quality constructions for their states, when we had a mass of Q1, Q2, and some Q3 hospitals across the country. I never did hear much from Gaius Julius, nor from Mr. Frost. I have not gotten a single inquiry except "Why do we not have more hospitals?" I then gave them a brief explanation and showed them the forums - I was thanked and he is now an active citizen in Karnataka. Also, our engaged and participating citizen base in battles have increased by the triple digits percentage wise and it all comes from California, Florida, and now Karnataka.

Max ~ No comment. Speak with executive/military leaders. Specifically, the CP, VP, CJCS, Deputy CJCC, and JCS x4.

Think back to when you were new. Did you join in a fortress or even just a state with a hospital? Did you use it? If it wasn’t a fortress, why and when did you move to a fortress? Did someone assist you in this (either just advising it or donating a ticket or anything)?
Aeros ~ I was eBorn in Virginia, which had a Q4 hospital at the time. I used it quite a bit until I had enough resources and knowledge of the game to move on my own.

Astra ~ If you'd like to know what it was like when I was new... I started in my home state of New Jersey, which was a fortress state at the time, yes, and once I became high enough level, I used it. Once New Jersey was clearly going to be lost in battle, I evacuated along with the rest of the financially-able population to our last stand, Florida. I had received much assistance in my early days, but it was money from my own job that provided me the means to move to a fortress state.

Colin ~ No, i joined in Arkansas. There may have been some sort of hospital, but I read up my first few days and got to NJ as quick as I could. WWIII was just about to start and Chris Stanwick was giving out tkts at that time.

Jewitt ~ I was e-born in Turkish-occupied Israel, so I had no hospitals to use. I quickly learned and moved to a Q5, as I saw it as part of excelling my character in the game. I saved up my hard earned TRY, and bought a moving ticket and used it immediately. I did ask the congressman from that specific region exactly how to use it, though. That's when I found out I did not know how to speak Turkish 😉

Max ~ Did you join in a fortress?: No.
Did you use it?: N/A.
Why and when did you move to a fortress?: In order to fight, as soon as I was eligible to fight.
Did someone assist you in this?: No.

Colin also offered some closing comments I feel obliged to publish: In my mind this whole discussion of Hospitals is a distraction from the things we need to be focusing on. Player recruitment and player retention. If someone feels we have to try a Q2 just to see... ok, but it's a waste of time and resources. I don't know how we go about recruiting more players, but the solution to retaining more of them is simply putting them in Q1 jobs and contacting every single one of them. These are just my thoughts, I'm sure I've missed a point somewhere and as I read more peoples ideas they will likely change a little.

Again, thank you to the respondents and I hope whoever my readers are enjoyed this. Also, if there's one thing we can gather from this that isn't worth debating it is that the Welcome Committee and other such efforts need volunteers.