Mary Williams Walsh has a great article about the possible future of the world’s long-term care services supply up on the website of The New York Times.

Walsh wasn’t writing about long-term care services. She was writing about what a combination of unrealistic goals, skimpy funding and other problems have done to the medical services supply in Puerto Rico, which is an American territory.

She reports, for example, that, when she was researching her article, Puerto Rico had just two pediatric heart surgeons and one pediatric anesthesiologist.

In other words: Policymakers took a “let’s pretend” approach to designing and overseeing Puerto Rico’s health care system.

The program designers had the generosity of spirit to say, “Yes! Let’s give people in Puerto Rico this, that and the other thing!”

No one had the combination of courage, visibility and political clout to say, “There’s no way we’re going to have the cash to pay for that,” in a way that would stick.

Sounds quite a bit like how the United States and many other countries are planning for future long-term care services and costs. A failure to plan is a plan to have a few terrible, overwhelmed sources of long-term care services.

Related: Venezuela and U.S. long-term care planning

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