That's a very, very complicated question. When I first started consulting, almost all of it was done here in this country. I was invited to evaluate facilities where people cared deeply about transferring care from hospitals to the community and giving improved services. But as issues of funding began to supersede issues of service delivery, most of my consulting was done in other countries, where interest in providing good care has continued. Toward the end of my active career, almost all of my consulting was done in Europe and Australia, where there is a cultural attitude that supports giving help to those who have difficulty helping themselves. I think we lack that attitude here, in large part.