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Currently I'm a high tech professional working in Seattle, one of the "latte urban intellectual" crowd. I grew up though in a blue chip blue collar home in Kentucky. So I know a little bit about rural white Americans who started voting Republican because they felt the Democrats no longer represented them. I don't deny that Sen. Obama spoke a hard truth, but speaking the truth is not enough to win an election. His first order of business will be to convince rural voters that he does not view them with contempt or pity. Sorry, but rural voters tend to be a proud group. They will not vote for you if they think you hate or fear them, no matter how much you offer to improve their daily lives. And Obama's comments did come off as elitist and out-of-touch, no matter how the underlying truth.
But even more importantly, rural voters I know tend to be quite a bit more pragmatic than some of your idealistic urban voters. They want results - and Obama will have to prove that he can deliver those results.
As the old cowboy proverb goes, "a dude who speaks the truth should keep one foot in the saddle."