You have done an excellent job with this series, Donald. Here are my thoughts: Just as the paradigm shifted from sail to steam, and from the horse-and-buggy to the horseless carriage, we need to re-direct our entitlement tax monies from that which is no longer effective as measured by outcomes and cost to brand new efficient and productive programs that can be flexible and adapt to the new on-going and changing medical environment. Dividing current entitlement costs, much wasted, unmeasured, unaccounted for and ineffective, by 290 million, we can come up with a unit cost (per capita), that could generously provide for a patient-centered medical home for all citizens (no Alphas in this Brave New World) providing a team approach for cost effective care for 90+% of undifferentiated problems and for meaningful preventative services (i.e., basic healthcare), and with measurable outcomes and savings to boot (no new damaging taxes for anyone). From the patient-centered medical home, that small percentage of cases needing super-specialty or institutional care (less than 10%) could be referred and the receiving group could then be measured and be held accountable for evidence-based care and outcomes. However, as I said previously, the nature of our political beast is self-preservation of the status quo, lying comfortably sideways in the public trough, rather than standing tall, upsetting the apple cart by doing what us professionals have always done, which is to serve our constituent client/patients before all else. That’s it in a nutshell. Even the best of liberal thinkers were hoping for a miracle with Obama's election….But alas, classic politics is the art of the possible, and in the post-election chaos Obama has inherited he has failed to seize the power offered to him in a once in a lifetime opportunity to turn the ship of state in the direction of real change, as has his Congress under the Pelosi/Reid incompetently uninspired (misdirected) leadership. Compromise, after all, is a tool of maintaining the status quo. His speech to the AMA made it clear that he was not going to touch the malpractice issue, nor the other issues of powerful constituent lobbies. Uncompromising duty to country would have upended the status quo to benefit the citizens, of course risking the tenure of those in power under the crush of powerful the lobbies, a worthy and patriotic sacrifice indeed, and not about to happen in the absence of inspired and inspiring Herculean leaders, sadly and obviously absent in this critical time, especially from Obama at the top.