The LA Times published an interesting analysis of the health reform paradox: rural states (South and West) would be the biggest "winners" if health care reform makes care more accessible, but residents in these areas are most likely to oppose change of any kind [http://www.latimes.com/news/nationworld/nation/healthcare/la-na-uninsured-rural2-2009sep02,0,1307203.story]. If it is difficult to bring change in good times, it may be even more challenging to effect change in bad times.
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