Talk About a Big F-ing Deal Mr. Biden

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"For all of these Americans, the failure to have their wishes respected concerning who may visit them or make medical decisions on their behalf has real consequences. It means that doctors and nurses do not always have the best information about patients’ medications and medical histories and that friends and certain family members are unable to serve as intermediaries to help communicate patients’ needs. It means that a stressful and at times terrifying experience for patients is senselessly compounded by indignity and unfairness. And it means that all too often, people are made to suffer or even to pass away alone, denied the comfort of companionship in their final moments while a loved one is left worrying and pacing down the hall."

I Liked It Better When Noone Else Knew

Forbes magazine just published its 12th annual ranking of the Best Places for Business and Careers. Their advice? Move to Middle America. Leading the way at Number 1 is Des Moines, Iowa, which grabbed their top spot after ranking seventh last year. Iowa's capital has 562,000 people in the metro area and features business costs 15% below the national average (living costs are 10% below the national average). It has an educated labor supply as 33% of adults have college degrees (ranking 46th among the 200 largest metros) and 92% possess high school diplomas (ranks 19th).

"Des Moines' favorable regulatory environment and well-educated workforce makes it an attractive destination for high-value-added, well-paying industries," says Sunayana Mehra, an economist at Moody's Economy.com. The financial industry has set up shop in Des Moines, with Wells Fargo ( WFC - news - people ) and Principal Financial being the largest employers in the area with 19,000 employees between them. Other big employers include insurers Nationwide Insurance and Marsh & McLennan.

The economic outlook is bright in Des Moines as well. Employment is expected to increase at a 2.7% annual clip over the next three years, 10th best in the country. Meanwhile, household incomes are projected to rise 2.9%, which ranks 11th.

Des Moines city manager Richard Clark points to the area's quality of life as a big draw for corporations. Housing is affordable with a median home price of just $149,000, one-quarter the price of a home in the San Francisco area. Commute times, according to the Census Bureau, average 19.8 minutes, one of the fastest in the U.S. Getting outside is easy, too. Des Moines designed a system of more than 300 miles of trails in and around the city for running, walking, biking or in-line skating. A 4.4-acre public park and sculpture garden opened downtown in September. Local venture capitalist John Pappajohn and his wife Mary donated $40 million of sculptures to the project from their personal collection. The park is surrounded by the offices of Wellmark Blue Cross Blue Shield, Nationwide and ING