Yes, you did. I was too quick in my writing my response. For that, I apologize. (I live in CA and I have heard the Reagan's fault argument for years which gets on my nerves, so I was reacting to your initial point; forgive my pre-coffee typing.)

As far as a solution, you are right, in that it is not an easy one. I do think institutions of some sort need to be brought back onto play, but rather than turning it over to the state completely, the family needs to have some oversight and 'skin in the game'. In part, because we need to acknowledge and respect that individual families may not have the resources, either financially and/or emotionally to deal with these difficulties, but that does not mean they should surrender their power to advocate on behalf of their loved one. No, they may not hold ABC degree, but the person holding ABC degree doesn't know the person. On the other hand, there are also a number of people who are willing to dump their family member and wipe their hands of responsibility which is wrong.

I read something yesterday that the problem with public health is they tend to view problems and solutions from the lens of populations and overlook the fact that populations are made up of individuals. I think this is where a lot of the problems we currently have stem from. I would like to see a joint partnership where power AND responsibility are shared. Checks and balances, so to speak.

Would this work? I think it would take some tweaking, but I don't see how it can be worse than what we have now. I would also want to see a definition of success. And a willingness to say if success is not met, we revisit; we don't constantly try to put the square peg in the round hole and say the reason it is not working is there just isn't enough funding.