My answer would be that if you only have one car, you buy what accommodates the likely maximum use case. So you buy a car that is sufficient when you have out-of-town visitors to chauffeur or buy something bulky. If car rental was more seamless and common outside of travel elsewhere we might be able to shrink cars.
Another factor is feeling safe. I'd love to commute in a single-seater like the Toyota iRoad, but would be terrified between massive pickup trucks.
Just not eye-wateringly expensive would be a start. Though, having met people, I can see why renting cars to people can't be a cheap business to be in.
It just doesn't make any sense, we should be able to come to this conclusion fairly easily.
I also think that this is another corrective action problem. The benefit to everyone from having most carsm in our cities be much smaller would be huge, but the inconvenience from having a smaller car is the thing an individual can control.
Again, there are legitimate use cases for a lot of this. Some people even need a semi ;)
Also, one out six Americans are over 65 years of age, two out of five are obese, so the "extreme vast majority" being neither old nor disabled is really a question of definition.