Healthcare Reform

I don't "get" how critics of healthcare reform come up with all the supposed huge new costs related to any healthcare reform legislation--regardless of the specific plan or implementation.

Our current system is so broken that the millions of insured Americans already pay for the healthcare costs and medical bills of the millions of uninsured Americans indirectly. When you are uninsured, you can't afford so you simply don't visit your doctor for routine, preventative care. The delays in providing proper medical care upfront costs everyone much more in the end than if that same person were insured and had sought timely care from the get-go. Uninsured Americans regularly use hospital emergency rooms for routine medical care because they are the only option available to them. This overloads hospital ERs for people with more urgent care needs and runs up huge and unrecoverable costs for the hospitals. Naturally, these costs are passed on to paying, insured customers in the form of higher premiums and other systemic costs.

So in the end, doesn't any healthcare reform that insures more Americans--whether it includes a public option or not--save money in the long run? Where's the extra cost and what's the problem?

Debbie, please don't waste my money to fire Ralph!

With all the uncertainty surrounding Terps football coach Ralph Friedgen heading into today's Boston College finale, I want our Athletic Director Debbie Yow to know that I am one booster strongly in favor of not firing the coach. It has been estimated that the total cost to replace Coach Friedgen now would run close to $10 million and it simply isn't worth it.

The main problem right now is not Ralph Friedgen. The main problem for the University of Maryland is its weak fan base and an overall lack of financial support from alumni and boosters. To be an elite college football (or basketball) program, a school must have enough loyal fans and boosters willing to contribute generously to help the school keep up in the ever-escalating resource "arms race". The funds are needed to build or improve facilities and to buy the best equipment in order to attract and keep recruits. The sad truth is that the University of Maryland never has and never will be competitive in this.

I'm realistic--Maryland is and will always be a second-tier FBS football program. It is simply not realistic or cost-effective for us to try to be an elite FBS program like Florida, Texas, or Virginia Tech as just a few examples. I am grateful for the BCS and five other bowl appearances that Ralph has led us to over the past nine years. Can we do better? Certainly. Could we do worse? Certainly. Overall, I believe that Coach Friedgen's results have been about what we should expect. Personally, I would've preferred to spread the winning around a little more versus 31 wins in his first three seasons, but I'm okay in the end.

The bottom line is that, regardless of who coaches at Maryland, our program cannot, and will not ever, win consistently against the best programs in college football. Coach Friedgen deserves much of the blame for this season's woeful results, but inexperience, injuries and just bad luck were equally responsible for the horrible season. Ralph is otherwise a very good coach who has a good track record of winning and developing young men. Paying $4 million to buy him out after this season just to give Franklin or anyone else an earlier shot is really a huge waste of money. I'm one Terp fan willing to give Coach Friedgen another season because the only question that should be asked is: "Will an expensive coaching change really make a difference?"

Anyone miss Dave Neal yet?

The Terrapin men's basketball team failed its first early season test this week. In losing to two middle-of-their-conference teams, Cincinnati and Wisconsin, the Terps were beaten decisively. While they played adequate defensive, their inability to score created numerous transition opportunities for Cincinnati. Against Wisconsin, they were forced to play Badger ball and again shot the ball poorly. And in both games, they couldn't do the most basic of basketball tasks--make free throws. While it's way too early to worry to sound any alarms and there is still plenty of time to improve, a few questions stood out in my mind.

While the two freshmen bigs, Williams and Padget, clearly improve our interior post play, who will make-up for oft-maligned and now-departed Dave Neal's scoring? While we lacked front-court depth last season, Neal gave opponents a unique match-up problem in his ability to consistently shoot the mid and long-range jumper. Heading into the season, most of us thought surely that, with more practice and another year of development, the rest of the team would easily make up for Neal's scoring with improved team play and pure shooting.

From this week's Maui results, it's clear that the Terps' offense struggled to score against their first significant opposition this season. Sean Mosley's shot has clearly improved, and he is in my opinion, the most improved player. And he hasn't lost any of that hussle! Eric Hayes remains a steady and reliable shooter but opponents know to keep a body on him so he needs to be more aggressive on the dribble or be a better catch and shoot player. Landon Milbourne still has his good mid range jumper and can be aggressive on both ends of the floor, but I don't see that he is better this season.

Other players however have been a clear disappointment so far. Vasquez's productivity has declined markedly as defenses have figured out his game. His shooting is so far off the mark I wonder if he's actually been working on his shots. How can he play in the NBA if he consistently shoots below 30%? You can give any Division I player 20+ shots a game and they will be 20 point per game player. And Adrian Bowie and Cliff Tucker have thus far not shown that they can play consistently or put the ball in the basket.

Of course, Dino Gregory's return sometime next month hopefully should shake things up by taking some of the pressure off of our two frosh players. It will also free up Landon to play more "3". Maybe Dino's return will help get the Terps' mojo back in time for ACC competition in January.

Norfolk Versus Baltimore Cruise Sailings

For next year, Norfolk Virginia will be losing cruise sailings while Baltimore will be adding ships and sailings. The business rationale for this action was very obvious to me however, after a recent post and long thread on CruiseCritic, it became apparent that many people in the tidewater area simply don't understand or can't accept this trend.

In advocating for Norfolk over Baltimore, the following facts were thrown out to support the case for Norfolk:

1. Geographically closer to ocean so ships don't have to waste time and fuel traversing the length of the Chesapeake Bay
2. New or renovated cruise terminal and facility
3. Better and lower-cost dock workers
4. Proximity to great beaches and other tourist attractions

Even if one were to acknowledge these as minor tactical advantages, the argument that Norfolk is a better cruise port and market than Baltimore completely misses or ignores Baltimore’s massive demographic, economic and tourism strategic advantages.

First, this is a business decision that is based on demographics, the laws of supply and demand, overall economic conditions, and business profitability. A cruise line bases a cruise ship in most non-Florida cruise ports for one reason--to expand their market beyond its flying customers to attract customers primarily from that local metropolitan area. In other words, they put their ships within a short drive to their customers. Unlike the major cruise ports, these regional or local ports draw the majority of their customers locally, probably within a couple hours drive. The cruise lines have already put many cruise ships close to major U.S. cities such as like Seattle, San Diego, Galveston/Houston, Boston, New York and Washington D.C./Baltimore. Is Norfolk (like Charleston) in this class?

The demographics case for Washington D.C./Baltimore over Norfolk is both compelling and overwhelming. Based on median household income, the Washington DC/Baltimore metropolitan area is the nation's second most affluent with 7,608,070 people with a median household income of $57,291. Per capita income is fourth at $28,856. The Norfolk/Virginia Beach metropolitan area on the other hand is ranked 84th with 1,569,541 people and a median household income of $42,448. Per capita income is ranked 107th with $20,328. So not only does the Washington DC/Baltimore area have almost 5 times the number of people that Norfolk has, but those same people have almost 42% more money to spend. And these statistics are based on a 2000 Census that doesn't even reflect the reality of a likely wider gap today.

Add to this that Philadelphia and many large suburban Pennsylvania, Delaware and Maryland communities that are all within less than a 90 minute drive of Baltimore's cruise terminal. Except for Richmond, Norfolk doesn't have any other major city within a 2 hour drive to draw customers from. That’s a few million more customers to add to the advantage there.

Now let’s look at their respective tourist attractions and tourism businesses. The Washington D.C./ Baltimore area offers a rich assortment of historical, cultural, entertainment, dining and other tourist options. With over 20 million visitors annually, Washington DC is one of the most visited cities in America. Baltimore is in the top 30 with over 12 million visitors each year--comparable to Fort Lauderdale or Nashville and more than the entire tidewater region. The Norfolk area offers tourist attractions with mostly limited, regional appeal such as Busch Gardens, Williamsburg and Virginia Beach.

So in the end, if you want to put a cruise ship near customers who have the discretionary funds to partake in it on a regular basis, where would you put it? RCI Grandeur (and Enchantment next year), Carnival Price and Celebrity Mercury all sail out of Baltimore because they are conveniently accessible to one of the top five most affluent customer bases in America. If anything, more and more ships will call Baltimore home--not fewer. In fact, I'd bet RCI would consider putting a Voyager-class ship in Baltimore if only it could clear the low-spanning Bay Bridge.

The bottom line is that the Washington DC/Baltimore area is far ahead of the Norfolk region from a basic demographics, overall buying power or tourism perspective. Norfolk cheerleaders have been trying to compare their mid-sized city with an average economy and some regional tourist attractions, to a Top-5 major U.S. metropolitan area with some of the nation’s most affluent customers and attractions with substantial international and national drawing power.

Checklist Tourism

What is your travelling style? I like to research the history and culture of a destination. I like to experience the culture and immerse myself in where I am going. I even try to learn some of the local language in order to fit in better.

There are many people however who seem to go places mostly to say they've been there. I call it "checklist tourism". The objective is solely to check it off a long list of places they say they've always wanted to see. The important verb is "see"--not really visit, not experience, not learn something about, not immerse yourself in, and not understand anything--but rather to "see". Are so many people really that shallow and clueless? They get on a one or two hour city bus tour and actually believe they've seen everything there is to see!

A coworker friend and her family once drove the nearly 16 hours round-trip from San Francisco to Crater Lake, OR and back, and only spent approximately 45 minutes actually at the rim! When pressed as to how a "quick peek" was worth all that driving, she furled her eyebrows at me and said something like "we went and saw it, so what else was there for us to do?". The same family does this type of "drive by" sightseeing all the time. They've certainly "seen" much more of the world than me, but I think they miss so so much.

My dad is the same way. It took almost 48 hours of round-trip travel time to get to and from Hong Kong, but he elected to spend much of the trip in the condo watching the same Chinese TV shows he already watches back home in the US! One city tour was apparently enough touring for the week for him.

This past summer, we spent a couple weeks in Europe with my parents, and whenever I asked them what they'd like to do in a particular port, they'd say, "well, we'll just get off the ship and walk 100 meters to so and so and that's good enough so we can say we've been there". If I dragged them along on one of my extended tours (e.g. in Firenze or Pompeii/Sorrento/Amalfi), they fizzled very fast and looked bored for much of the tour. I was very disappointed, for example, when our day out of Napoli allowed us only about 20-30 minutes in Positano, but it was perfect for my parents!

Next month, my parents are sailing on RCI Independence of the Seas on her trans-Atlantic reposition cruise out of London. I asked my dad how much time he was spending in London pre-cruise, and he responded "We've been there (for a day or two) before and saw everything, so we don't want to waste time there." Another wasted opportunity to experience a wonderful and unique place on our planet...

My Perspective on the 2009 H1N1 Influenza A Virus

Over the past several months, the federal government has thrown resources into tracking, studying and developing a vaccine for the 2009 H1N1 influenza A virus (H1N1/09). The media has reported a drumbeat of stories about the virus, its spread and deaths worldwide. Here in the U.S., the federal government had announced that a vaccine for this virus would be available en masse early in the flu season. Unfortunately, the development and deployment of the vaccine was delayed--a classic situation of overpromising and underdelivering. In the meantime, the steady stream of scary news about the impending H1N1/09 flu pandemic has filled most Americans with worry. Vaccine supplies remain scarce, implementation plans have been uneven, and now people are more scared than informed.

While it is understandable that people are concerned about the H1N1/09 flu virus, I think many Americans are overreacting based on media reports of illnesses and deaths, and not acting rationally on information. The seasonal flu (yeah, that's the flu we are all exposed to every year), infects between 15 million and 60 million, hospitalizes over 200,000 and kills almost 40,000 Americans every year. The H1N1/09 is forecast to infect up to 150 million, hospitalize up to 2 million and cause between 30,000 to 90,000 deaths in the U.S. Based on these numbers, it's reasonable to conclude that the H1N1 is more contagious but has a lower mortality rate than seasonal flu. It is almost a certainty that more people are going to suffer the flu this season, but even with the higher infection rate, it is also possible that same or even fewer people will die from the flu this season.

Yet, in talking with many friends and coworkers, the perception is that the H1N1/09 is like getting small pox or anthrax. Many people are deathly afraid of this pandemic. When told that my kids had it, they try to avoid me at all costs--in case I am a carrier! Most of these same folks however don't get the seasonal flu vaccine and seem to think that the "regular' flu is just like a bad cold.

From everything I've read, the two main differences with H1N1/09 are: (1) it's far more contagious and (2) it negatively affects primarily the young, pregnant women and people with chronic medical conditions. The seasonal flu more negatively affects seniors and people with chronic medical conditions. The H1N1/09 conversely saves its most serious side effects for the young, who have strong, but virgin (to the flu) immune systems.

Parents with children, pregnant women and other high risk people understandably have real concerns. With the flu season well underway already in the U.S., is the long delayed and still scant supply of the H1N1/09 vaccine too late to do much good? Children under 9 years of age, for example, need two doses of vaccine at least four weeks apart, so they wouldn't have immunity for about a month from the start of their vaccination. With many schools in this country already reporting 10%, 15% or higher absentee rates due to the growing H1N1/09 pandemic, is it already too little, too late to vaccinate many of our most at-risk population? In addition, what about safety concerns and other unknowns about a new and "rushed to market" vaccine?

My own kids had the H1N1/09 flu last week. To be quite frank, it wasn't a big deal at all in our case. Our daughter was lethargic with a fever for several days, and had a mild cough. Except for a short fever, small cough and a sore throat, most people wouldn't even know my son was sick by the way he still ran around the house.

Part of me is glad that our kids are already done with the H1N1/09. One of the biggest concerns with any influenza virus is that it can mutate and become potentially more virulent. This is the reason why scientists are constantly battling and reformulating flu vaccines. H1N1/09 could actually become more virulent and lethal as the season progresses.

The treatment for H1N1/09 is the same as for any other flu: rest, fluids and either acetaminophen or ibuprofen to reduce fever. Anti-virals may be leveraged for certain high-risk individuals. As with any flu, you need to be diligent about secondary infections and should seek emergency medical care if you experience respiratory and other complications.

So the H1N1/09 flu is really just another flu for which there is no need for undue concern or panic. For this season, I conclude:
(1) You are far likely to get the flu--most probably the H1N1/09
(2) For most, the symptoms will be milder than the seasonal flu
(3) More children and young people will die due to H1N1/09
(4) Parents with kids and young people must be extra diligent about secondary infections and respiratory complications
(5) It's probably better to get the flu earlier than later
(6) Get your season flu vaccine!

What you should know for your first cruise!

1. Tipping is complicated on cruise ships. Read the cruiseline's specific recommendations for your stateroom attendant, waiter and assistant waiter. Definitely take care of them if you feel they did a good job. Give them extra for going above and beyond. Tipping the head waiter and others is entirely at your discretion. And if you use the children's programs, I recommend a tip for the counselors even though it is optional.
2. Your room is usually ready and the luggage is delivered typically sometime between noon and 3 pm. But just in case you don't have access or your luggage is delayed, be sure to carry on anything you need for that afternoon such as medications, a swimsuit, etc.
3. Ship time may differ from local time so make sure you know the difference if you have excursions planned in port and so you don't miss the ship.
4. If you plan to use many AC-powered devices in your stateroom, bring a multiple outlet plug or power strip because there aren't many places to plug things in!
5. If you are large person and find it difficult to show in the microscopic showers in your stateroom, consider using the more spacious facilities in the spa or gym.
6. Staterooms don't have alarm clocks so bring one if you need it!
7. Your luggage will usually stow nicely under one or both beds
8. On some ships, the stateroom coffee table adjusts up and down!
9. Excursions, and specialty restaurant and spa reservations can usually be reserved on-line prior to boarding.
10. Private companies and tour operators in general offer tours and excursions that are better in quality, more flexible, just as reliable, and far cheaper than the ship tours!
11. On some lines like RCI, motion sickness medicines like meclizine (aka bonine) are complimentary at Guest Relations.
12. You pay for alcoholic beverages and sodas, but the coffee, tea, lemonade and milk are free. Carnival and RCI charge for espresso and cappuccinos but they are complimentary at dinner on HAL.
13. Order as much as you want in the main dining room--you're not limited to one appetizer or one entree!
14. In the main dining room, you can order or ask for things that aren't even on the menu!
15. You pay to eat at the specialty restaurants and there is no unlimited ordering there.
16. Room service is free but remember to tip!
    

Suggestions for Improving Royal Caribbean and Carnival's Web Sites!

Some greatly needed features or functions for RCI, Carnival and other cruise line web sites:

Web site registration and profile
- Allow customers to register and store their profiles with information on family, home address (including state of residence), passport information including ages, specific interests, special needs (physical disabilities, wheelchair needs, dietary restrictions, etc.), and payment options (including registering a credit card or Paypal).
- Upon signing in, use profile information to customize all searches.
- Integrate all past cruises, C&A status and benefits with this main profile.
- Upon booking a cruise, transfer all personal booking information including passport info.

Improvements to search:
- Search by one or more departure ports
- Search by one or more ships or by class of ship(s)
- Search by user-specified cost range and not preset cost ranges
- Search for itineraries to include one or more specific ports and not just "destination" regions
- Search by specific number of dates (e.g. 4-10 days) and not preset date ranges
- Search by date inclusion ranges. For example, I am off from January 5 through January 13 so return cruises that fit entirely within this range
- Search only for available adjoining, connecting, handicapped or other special attribute staterooms
- Exclude obstructed view or handicapped staterooms
- Allow comparison of various cruises (ship, itinerary, costs) that meet one or more search criteria

Search Results
- When returning search results, don't lump all sailings of the same ship and itinerary together. List them separately.
- Handle holds and bookings using pre-populated profile data
- Allow customers to make deposits and one or more incremental payments toward booking
- Allow final payment to automatically be made on final payment due date

Bookings
- Specify stateroom preferences, including bedding arrangement, pillow/bedding preferences, child life preservers, remove balcony partitions, and options such as robes and other amenities
- Ability to make stateroom changes including downgrades and upgrades
- Ability to transfer booking directly to travel agent online

Other
- Show more stateroom details such as virtual 360 views, multiple angle photos