This is just one snippet: Twenty years from now, the maturation of the baby boom generation will be at flood tide. We will have gone from 40 million Americans over the age of 65 in 2009 to 70 million in 2030. This will put enormous pressure on the health care system, regardless of whether Obama's reform efforts, or even Paul Ryan's, prove successful. The chronic diseases of the elderly will be the front line. Because we cannot cure those diseases at present, nor reasonably hope for cures over the next few decades, the best we will be able to do in many cases, especially those of the elderly and frail, is extend people's lives for a relatively short period of time — at considerable expense and often while causing serious suffering to the person in question.