We continuously read about the "forgotten Americans" who live in rural America. They are sicker and receive poorer care. This issue of the Journal focuses on what can be done regarding rural health care. This issue is focused on options to improve health care in American's "heartland" or rural America. Fuller and Goldfield lead off with an introduction to the topic, with specific proposals largely focused on telehealth, population health, and moving away from the current hospital-centric focus of care. In response, Noah Nesin and Lori Dwyer from Penobscot Community Health Care in Bangor, Maine, and then Harold Miller of the Center for Healthcare Quality and Payment Reform in Pittsburgh, Pennsylvania, provide responses to this article. We welcome additional commentaries throughout this year, as we all attempt to deal with the challenges we face with a sicker, widely dispersed population with fewer economic resources.

Other original research articles in this issue continue our interest in community health workers (Njeru et al) and patient-centered medical homes for diabetes care (Gill et al). Eden et al link community health workers and patient-centered medical homes in their examination of practice transformation for family practitioners. Bruen extends our understanding of medical expenditures of children in community health centers.

Finally, John Wasson, an Associate Editor of the Journal, takes the ludicrous nature of our political discussion in the United States to new heights with his important commentary, titled "Insights From Organized Crime for Disorganized Health Care." Enough said-read this well-referenced article and you will "become enlightened."

-Norbert I. Goldfield, MD

Editor