Your comments illustrate that you have bad information when it comes to the current state of healthcare and how it is delivered.  Healthcare providers (i.e. nurses, doctors, therapists, etc.) aren't being laid off (at least in my city/state).  Indeed, healthcare providers such as nurses are in high demand.  Have you seen those Johnson & Johnson "be a nurse" commercials?  Administrators; i.e. office people, those who's work can be done using an electronic transaction, maybe.  Coincidentally, regarding the case managers you refer to - there's an EDI transaction called a ANSI ASC X12 278 that contains the information case managers write up or call in.  So maybe that's why you've seen them getting laid off.  They're still needed, but as hospitals and docs move to these transactions, their need becomes diminished - this is an example of the admin overhead I referred to in my prior post.  Healthcare is actually one of the few industries you can get a job in right now provided you have the right skill set.  

You say,

But I guess that whole hospital based management scheme where CEOs stole tens of millions of dollars might have demonstrated that there was big money to be had and no Republican was going to turn up that option.

You also state

I just don't agree with the concept that the delivery of health care services should be outsourced to for-profit companies, competition amonsgt whom is supposed to create an environment where costs are reduced and passed on to "consumers".  What happens is that those running the business just think of ways to pay their executives higher salaries. With such large government subsidies, why would efficiency lead to reduced costs for consumers? It doesn't. It just leads to fewer companies who won't completely walk away from the "market".