"Congress' efforts to overhaul the nation's health care system are plagued by an age-old urban-rural, east and west coast vs. the heartland schism in the Democratic Party," write McClatchy Newspapers reporters David Lightman and William Douglas. The reporters point to a remark from California Democrat Rep. Pete Stark, the urban chair of the House Ways and Means health Subcommittee as evidence of the "tension" between city and country. "Well, the only co-op I know about is when I used to milk cows and we sold the milk to Golden Guernsey. And I think there's only one co-op left," said Stark, who considers the co-op idea a non-starter. "There aren't many of you listening who remember the co-ops of the '30s, which was a — just kind of a Roosevelt outgrowth of rural electric co-ops, phone co-ops."

Meanwhile, Democrat Rep Charlie Melancon of Louisiana announced he would run for the U.S. Senate as a "pro-life, pro-gun Southern Democrat." "The two sides don't understand each other. They're reading from different scripts," said Steven Schier, professor of political science at Carleton College in Northfield, Minn.

The health care fight has centered on whether there should be a public option for health insurance, or whether co-ops should be created as a competitor to the for-profit health insurance industry. Republicans have not shown an inclination to endorse either model.

Medicare was an idea that took time, decades, in fact. Maybe health care reform will take as long. Good ideas often come slowly.

Both rural and urban America are facing a shortage of doctors. There are 26,000 new docs entering practice very year. However, there are nearly just as many retiring. In 2017, for instance, 24,000 physicians will turn 63, according to a report given as a recent meeting of the Health Resources and Services Administration. The population rises, still, and so most of the country will experience a declining number of doctors per person. Meanwhile, most health care reform proposals envision increasing the number of primary care doctors — all of which is why the HRSA held a conference on "The Health Care Workforce Crisis: A Summit on the Future of Primary Care in Rural and Urban America."

Among the solutions talked about at the conference was a 15-year-old program at the http://www.nwpaahec.org/ ">Northwest Pennsylvania Area Health Education Center in Erie. The center approaches rural students as early as elementary school about becoming doctors, recognizing that "if you come from a rural are, you will practice in a rural area," said a director at the center. Middle and high school students work with doctors or other medical professionals.(Photo above.) The kids conduct research programs. Over the last eight years, the program has produced 103 physicians.

Last week, people went to Whole Foods because the food was largely organic, fresh and, often, local. Whole Foods fulfilled the desires of people who had strong ideas about the politics of food. This week, however, the same people who shopped Whole Foods for aesthetic and political reasons are avoiding the place — again for political reasons. The president and founder of Whole Foods, John Mackey, wrote an op-ed piece in the Wall Street Journal opposing President Obama's health care reforms. (He began his piece with a quote from Margaret Thatcher.) Mackey warns of "government bureaucrats" and "socialized medicine." 

The leafy lefties who shopped at Whole Foods because the food there was "better" are now boycotting the place. The Washington Post this morning describes a beginning boycott as consumers are now looking at Whole Foods the way some shoppers once considered Wal-Mart. (Wal-Mart, we should note, announced this summer that it supported universal health care.) Whole Foods shoppers say they feel "betrayed." 

Conservative columnist Kathleen Parker, meanwhile, announces that "Now is the time for all good capitalists to shop at Whole Foods." (We'll wait to see if good capitalists will pay Whole Foods prices.) Parker picks up Mackey's argument that obesity could be reduced if Americans ate decent foods (the kind of foods sold at you know where). Parker writes: "Mackey's ideas aren't necessarily the only route, but they offer a path that is pro-market, pro-individual and pro-choice -- all concepts that are organic to America and, like spinach, good for you."