The Past, Remembered

Today's Saratoga California Rotary Art show, at a nearby public community college was wonderful. All of the usual arts were represented and my wife and I enjoyed our walk through the displays on a warm sunny Spring day. Until we smelled a really foul cigar smoked by a chubby late-middle aged man in a straw hat. We checked with the art show staff, where others were making the same complaint about the same person, and were told that there were many signs indicating that smoking was prohibited anywhere on the public campus. When we later ran into this smoker again and told him what we had learned he waved at us, indicating that we were the ones who should leave.

As one who formerly smoked, I understood the cigar smoker's addiction (and the rudeness which he used to ward off any threats to his denial of addiction). I also remembered seeing acutely sick patients of all ages in hospital emergency rooms, brought there by the toxic effects of alcohol and tobacco. Tobacco and alcohol are major factors in the cost of United States health care and we will not succeed in "health care reform" until we reign-in the use of these dangerous drugs.

A number of years ago  my wife and I attended a conference on the USSR presented by a noted Harvard professor who told us that the USSR was dependent on its revenue from taxing alcohol (primarily Vodka) for many of its national expenditures, including defense.  He should have gone further to indicate that America and its individual states also have an ambivalent approach to smoking and drinking because the nation and its political subdivisions derive substantial revenues from alcohol and tobacco.

If we want health reform, and individual health improvement, we need to resolve our national ambivalence and convince Americans to stop smoking, stop using "chewing" or  "mouth" tobacco, and stop drinking to excess.  If we divert money from our unsuccessful narcotics interdiction programs to high-power campaigns to deglamorize tobacco , alcohol and other controlled substances, maybe we could really cut health care costs and improve results.

That cigar, today, smelled awful.

Fodder For Psychoanalysts

A number of years ago, through a connection I made at a Rotary International meeting at the YMCA in Jerusalem, I spent hours interviewing the medical directors of three of Israel's largest health systems.  When I finished these meetings, I felt as if I had delivered hours of psychotherapy to these individuals who were beseiged by the need to deliver life-saving health care through an irrational system, bounded and constrained by politics and religion rather than by scientific medicine.

 In listening to President Obama's meeting today, I had that feeling again.  It was clear that the parties on both side of the aisle understand the desperate straits that our health care system is in, but prefer to give precedence to irrational political (and personal) considerations in the guise of putting their constituents' needs first, rather than deal honestly with the issues.  My bottom line is that all sides at the meeting were adequately informed as to our health system's prospects for a disasterous future, but that none is willing to abandon political strategy, and personal interest, to meet our country's and its citizens needs.

A good conference, Mr. President.  But perhaps the next one should be led by an experienced psychoanalyst. Call me and I'll give you some names.