Acknowledging rural challenges to healthcare delivery and reform

In her story on the two sides seeking to influence the views of the U.S. Senators from Maine on healthcare reform, Abby Goodnough explains her focus on this New England state which, in spite of its smallish population (1.3 million), has proven particularly challenging in terms of health care coverage and delivery.

The state has large rural, poor and elderly populations with significant health needs. It has many small businesses and seasonal workers, and few employers large enough to voluntarily offer employees insurance. Meanwhile, most insurers no longer find it profitable to sell individual coverage here, leaving a few companies to dominate the market. (emphasis mine)

The dateline is Presque Isle, Maine, population 9,511. Presque Isle is the largest city in Aroostook County, a sprawling county along the Canadian border. Aroostook County's population is 71,676 (down from 73,938 in 2000), but its population density is just 11/square mile.