L K said:
Big changes need to happen to our nursing home system. The problem is that requires a considerably infrastructure investment and that will come at the cost of other health care expenses unless society as a whole embraces big tax increases.
I don't think there's a real choice there. Because realistically the public has three options:
1) Leave things as they are
2) Embrace some sort of spending increase to fund a public system
3) Maintain a private system but have enough enforceable regulations so as to raise standards to acceptable levels
I guess a fourth would be to divert money away from other aspects of the health care system as you suggest but I think that's a non-starter. Assuming #1 isn't really an option, #3 would almost certainly mean much higher costs at the point of use because higher standards cost money(as does enforcement). So people would be paying for increases regardless, the question is just whether or not you want to socialize those costs and I think our health care system generally tells us it's better to do that than not. At least with the right sort of tax increases, a higher chunk of the burden can fall on the wealthy and corporate profits.