Whether it's doctors in South Dakota, small business owners in Idaho, or home builders in Washington one word has kept popping up in the closing days of my cross-country trip: uncertainty.
Specifically, people in these states are worried about how the growth of a federal government located more than a 1,000 miles away will impact their own doctor's offices, hotels, and construction projects.
In Mitchell, South Dakota --- located an hour west of Sioux Falls --- I met with a group of health professionals who are anxiously wondering how Obamacare will overhaul their fields.
Numerous doctors I've met during this drive from Washington, D.C. to Washington state confess that they honestly have no idea what really is in the health care law that passed Congress in March. Granted, few people want to sit down and read a legalese-laden treatise that tops 2,300 pages. Yet the doctors acknowledge that the new law will, unlike any other event in their careers, transform what they do. They admit to being simply too busy treating patients to have the time to master the specifics of the changes.
Most agree that the law is not designed for the government to contain health care costs but for the government to control health care costs.
"We are headed toward a much more universal Medicare-type system," worries Carey Buhler, 54, a radiologist. Buhler added that doctors are already reimbursed at lower rates for their current Medicare patients.
Sonja Van Erdewyk, 42, a nurse, fears that more regulations will translate into greater paperwork for a community already burdened by bureaucracy.
"How are you supposed to comply with rules stacked this high?" she asked with her hands spread wide.
Two states further West, in Idaho, Bobby Fuller of Lewiston is already feeling the impact of government regulation in the hospitality industry.
In March, Fuller, 39, decided to leave his job as a parole officer and go into business as a local hotel owner. He yearned for the freedom of owning his own business.
But Fuller was surprised at how difficult it was for him to secure a bank loan. Despite his solid credit and his intention to invest the money to create a business in the community, Fuller fell victim to a post-bailout bank climate. Tighter regulations that have made banks reluctant to make loans are clobbering new and old small businesses like Fuller's.
So Fuller and his wife poured $200,000 of their retirement savings into purchasing Cedars Inn in downtown Lewiston.
Nearly six months later, Fuller has hired a staff of six. But he would like to have more workers. He also has a two-year plan to buy another hotel that would create even more jobs. But those plans will depend on whether federal regulations ease up and allow community banks to issue loans with less fear.
"To be honest, the people it is hurting the most are those looking for jobs," he said about the scarcity of investment dollars. "At least two times a day I have someone coming in looking for work. It is not like I want the money to build a pool in my backyard."
That theme echoed at the last stop on my coast-to-coast journey. Laura Worf, who works with homebuilders in Olympia, Wash., said the credit crisis is forcing the closure of construction companies with as much as 30 years of experience.
"Banks are gun shy because they are having too much trouble jumping through the hoops of regulation," said Worf, who agreed that lax lending practices led to the current housing meltdown. "The joke was your dog could get a mortgage. But now the pendulum has gone too far the other way."
Area builders now pay up to $30,000 in permit fees just to get clearance to start a new home.
With 14 existing home purchases in the area for every one new home construction project, the housing industry is not able to provide the construction work that could help with the ongoing dismal job market.
The problem is not confined just to the Pacific Northwest: In 2008, the five-county homebuilders association that includes Olympia, Washington's state capital, had more than 1,000 members. That made it the 47th largest association in the country.
Today the number of homebuilders in the Olympia association has dropped by more than a fifth. Despite that, the Olympia association still managed to become the 23rd largest in the country, a testament to the pain other associations are suffering as a result of the many homebuilder bankruptcies.
The perspective of this frontline view thousands of miles from Washington, D.C.'s bubble makes one thing clear: The practical implications of current and pending federal regulations are leading to doubts by the very people whose confidence is needed to sustain any kind of economic recovery.
Follow Lee's reports as he travels from Washington, D.C., to Washington state.