i also want to acknowledge my co-authors, debra, ariela and david gould of the united hospital fund. steve set the stage very well for this. nearly every discussion of long-term care services and support starts with the statement that informal caregivers, families and friends, are the system's bedrock, i think i've said that a lot myself, but like bedrock, family caregivers and by the way, that's a term we prefer to informal, because inform am sounds so casual, so easy, so much fun, which it isn't. but bedrock is underground, bedrock is invisible, and when you start to see it, you get maybe a little nervous. i think that's what's happening in the policy world, we're starting to see these unde undergroundworkers, who are now start to go appear and make some demands. families have always played an important role in caring for people who are sick, or disability, or age willing, but in the past few decades, family caregivers' roles have changed. in addition to providing social support, and assistance with everyday living, many are now taking on demanding medical and managial tasks, and let me