As a physician practicing 44 years in rural North Dakota, I would like to voice my approval of the president's plan, but Iunderstand he cannot be always winning, and even Lincoln compromised before war broke out.

The small-town doctor is almost a thing of the past. Rural hospitals are struggling to stay solvent. Nursing homes rely heavily on the support of local boosters.

In short, it is not profitable to practice medicine in the boondocks.

But who said it must be profitable?

When profits are the motivation of the health care provider, good medicine flies out the door.

That is one of the reasons private medicine is not working in sparsely populated areas.

Acting together with the things that work should be the battle cry of those who have health care interests of the poor and suddenly disadvantaged at heart.

Interestingly, the State Insurance Department with their CHAT plans will be following the ideas of working together with the people setting their own plans. All of those of you who have been fighting to keep your rural doctors in town to keep your 20-30 bed hospitals open all of you should be assisting the Obama forces with a very necessary type of reform we all can live with.