The failure of private long term care insurance in the US and the need for a government subsidized and public program that requires people to carry long term care as in Netherlands and Singapore. Only about 3-4% of people over 51 have long term care insurance, leaving 95% of the population dependent on what Medicare and their savings can provide. The industry is unprofitable making at most $1 billion in one year after losses in three of the last four years when claims for 345,000 persons cost $13 billion.