In Madrid it's not like this. I've never ridden anywhere in the city where the buses couldn't make it between the stops in good time, and that includes places like Gran Via and Puerta del Sol.
In the US, we really do suffer for our vast wealth. We spent 70 years doing huge horizontal growth, putting tons of the population back to work in the process, and getting huge growth as a result. The problem with this, aside from the car dependency, is that it's not financially viable. When towns first build it, they get a burst of growth. Problem is, their infrastructure costs pretty much go up as a function of area, but the horizontal growth pattern doesn't pay its way. This becomes problematic in second and third life cycles, where the road maintenance is cripplingly expensive, but brings no growth.
We should be building places that converge on hubs of activity. If we did that, we'd be able to put transit to those hubs and it would work because there would be better density nearby, and the potential riders wouldn't be too far to get to stations without cars.
In the US we're going to be building this way, sooner or later. Some towns/cities have taken it upon themselves to move in that direction already. Many others are planning to be too big to fail, I guess. But we can't put off reality forever.