ANDREA HOPKINS: Obama's Prescription For Health Care Is Worth Investigating

Barack Obama easily wowed an enthusiastic, supportive crowd that packed the Virginia High School gymnasium for a midday rally last week.
That he was here, in the flesh, in Bristol was enough. His policy proposals were of secondary importance to a crowd that came to see a piece of history – the first black candidate to carry the presidential mantle of a major political party.
He faces a different, more difficult challenge in the broader world of Southwest Virginia and Northeast Tennessee.
THIS ISN’T Obama country. Living on the spine of the Appalachian Mountains, the region’s voters went for the former first lady, Hillary Clinton, by a significant margin in the Virginia and Tennessee Democratic primaries in February.
Clinton routed Obama in East Tennessee on her way to a statewide victory; Obama found robust support only in the state’s urban areas, including Nashville and Memphis. In Virginia, Clinton was victorious in the Southwest region, but Obama carried the state – largely on the strength of affluent, tech-savy Northern Virginia and black voters in the coastal cities and near the state capital.
For whatever reason (perhaps for a variety of them, including his bitterness and guns crack in Pennsylvania), Obama has failed to connect with rural and small-city voters. His trip to Bristol – the first public event of his general election campaign after becoming the presumptive Democratic nominee – was acknowledgement of what pundits have termed his “rural” or “Appalachia” problem. It was an attempt to make his case to voters who have thus far spurned him.
THAT OBAMA was making a pitch to a wider, regional audience was evident in his stump speech at Virginia High.
“Southwest Virginia is an example of so much that is good about this country,” Obama said. “Washington hasn’t been listening or paying attention. ... I’m here to let you know I’m going to be paying attention.”
Obama used his Bristol appearance to focus on health care, a subject of the utmost importance to the region. The age-adjusted death rate for Southwest Virginians is 18 percent higher than it is for residents of the rest of the state, according to a 2006 report to the Virginia General Assembly.
The disease-specific statistics are even more alarming. Southwest Virginia residents are 25 percent more likely to die of heart disease, 46 percent more likely to die of lung disease, 47 percent more likely to die of pneumonia and other infectious diseases and 34 percent more likely to die of diabetes. The death rates from chronic liver disease, unintentional injuries (like car crashes) and suicide also are much higher here than across the state.
WHAT TO make of these problems? The state report – prepared by a group that trains medical students to become rural primary care doctors – points to a critical lack of access to health care. This scarcity is apparent when thousands line up each year at the Wise County fairgrounds to receive charity medical and dental help from Remote Area Medical – a mission program similar to those that provide aid to the very poor in Third-World countries.
High rates of smoking, lower levels of education and a poor diet that is high in fat, calories and sugar also play a role in this sorry state of affairs.
Obama cannot wave a wand and fix what ails the nation’s health care system. But as he spoke in Bristol, he outlined a plan that will bolster health insurance coverage – bringing more people into the system. This is a good first step, as the most expensive and least effective way to treat the sick is to wait until they arrive at the emergency room in a full-blown crisis. Yet, that is reality for uninsured and under-insured Americans and for those who live in communities, like some of this region’s rural areas, that lack enough doctors and other clinicians to adequately serve the population.
“We must have a health care system and not a disease care system,” Obama said, pledging to cover all Americans by the end of his first term.
Critics were quick to dismiss Obama’s plan as too grand and impractical to make it out of the starting gate in Washington. When did grand ideas go out of style for presidential candidates? Sen. John McCain’s campaign, meanwhile, decried the plan as a government intrusion into Americans’ personal matters. For his part, McCain favors a tax credit program that some critics contend will weaken the employer-based health care system – causing more health care insecurity for Americans, not less.
OBAMA’S HEALTH care proposal has the potential to at least pique the interest of a region where too many people die too young of perfectly preventable causes. Any proposal to fix health care must begin with the concept that all will be brought into the system and no one will be left behind.
Obama gets it. McCain has yet to offer proof that he is of a different Republican mold than the every-man-for-himself variety.

Andrea Hopkins is opinion editor of the Bristol Herald Courier. She may be reached at ahopkins@bristolnews.com or (276) 645-2534.