December 18th, 2009


Nation Cruise, Winding Down, Tuesday's Entry

Off San Juan, Puerto Rico Day 4, Tuesday

The seminars and discussions have been stimulating and informative. I’ve purchased books by Stephen Cohen, on Russia, and Howard Dean, on Health Care Reform and had the opportunity to talk to both of them when my books were autographed. I’ve purchased a book on Pat Tillman, written by his mother and Narda Zachino, the former editor of the Orange County Edition of the Los Angeles Times, and wife of Robert Scheer, one of my favorite reporters and commentators. I also bought Scheer’s book, “The Pornography of Power; How Defense Hawks Hijacked 911 and Weakened America.” And, I finished Maggie Mahar’s great book, “Money Driven Medicine.”

Compared to T. R. Reid and Mahar, Dean’s book is more like a primer on his views. Since he briefly referred to both of them, I asked him if he was familiar with William Tsaio, the Harvard medical economist, whom I had met in Boston, and under whom Reid had studied. Tsaio had proposed the “First Question,” namely, that, in constructing a system for health care, one must ask whether health care is a human right, or a commodity to be purchased by those able to buy it. The industrialized world, with the exception of the United States, subscribes to the former, and with our focus on health care as a profit center, we subscribe to the latter. To me, this is where health care reform begins. If our goal is not to get health care to everyone, but to use the health of the nation to redistribute the country’s wealth to entrepreneurs and capitalists through a complex market with multiple middlemen and investors, then we keep putting bandaids on the lacerations that is the health care system.

Dean was not familiar with Tsaio. He said that he decided to emphasize “choice” and that reform without a public option, is not choice, but is a giveaway to the very insurance industry that created much of the current problem, and benefits from the obligation of everyone to purchase health insurance under the current Senate discussion of reform.

The general consensus, here, among Nation attendees is that “reform” without a public option, is not reform. Obama is rightfully criticized as beginning the debate by pulling the rug out from under Single Payer, Medicare for All, by saying that it would be his choice if we were starting from scratch. This immediately moves the debate and compromise to the right, and shores up renegade positions of the Blue Dogs and the Turncoat, Lieberman, who appears to be on a leash pulled by Connecticut insurance companies.

Otherwise, the main dining room food is pretty average. The Tamarind Room at a premium of $15/person is an Asian refuge from overcooked chicken. Holland America is not Crystal Cruises. We did not leave the ship in Grand Turk (Bahamas) but we are going to visit Baccardi’s Distillery in our tour of San Juan. We will take the walker to reassure any fears of falling. No further seminars until Thursday.

Oh, the people on the cruise….fascinating, so many. Love the dinner conversations.