Later On

A blog written for those whose interests more or less match mine.

Archive for November 25th, 2013

‘If you don’t like negotiating with Iran what you’re really saying is you want to go to war’

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Let me point out a highly relevant and cogently argued interview on the diplomatic progress with Iran.

Written by LeisureGuy

25 November 2013 at 2:56 pm

Posted in Mideast Conflict

Big Business acting as though it were a government

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And we its subjects. See this report at Democracy Now!:

Spooky Business: U.S. Corporations Enlist Ex-Intelligence Agents to Spy on Nonprofit Groups

The blurb for the program (the video and transcript are at the link):

A new report details how corporations are increasingly spying on nonprofit groups they regard as potential threats. The corporate watchdog organization Essential Information found a diverse groups of nonprofits have been targeted with espionage, including environmental, antiwar, public interest, consumer safety, pesticide reform, gun control, social justice, animal rights and arms control groups. The corporations carrying out the spying include the U.S. Chamber of Commerce, Wal-Mart, Monsanto, Bank of America, Dow Chemical, Kraft, Coca-Cola, Chevron, Burger King, McDonald’s, Shell, BP, and others. According to the report, these corporations employ former CIA, National Security Agency and FBI agents to engage in private surveillance work, which is often illegal in nature but rarely — if ever — prosecuted. We’re joined by Gary Ruskin, author of the report, “Spooky Business: Corporate Espionage Against Nonprofit Organizations,” and director of the Center for Corporate Policy, a project of Essential Information.

Looks like the gloves are going to come off.

Written by LeisureGuy

25 November 2013 at 2:33 pm

Pepper sauce underway

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Recipe this time:

20 habanero peppers, stems removed (pulled off)
12 Serrano peppers, cap cut off
qt of jalapeños, cap cut off
12 dried chipotle peppers
white vinegar almost to cover, less for thicker
good slug of extra virgin oil
1/3 c sea salt
1 Meyer lemon, cut into quarters

I usually include 3 or 4 dried Ancho peppers and 1 large can (or 2 small cans) chipotles in adobo, but discovered I was out of both. I think that may be why this batch is coming out green. I’ll update with photo at some point. Dang! I hate missing those—but change is good, and who knows? this may be the best batch yet. I haven’t tasted it, so I don’t know. (But it is indeed an unappetizing color. Where’s Red Dye 40 when you need it?)

Pepper sauce without chipotles in adobo or dried Ancho chiles

Pepper sauce without chipotles in adobo or dried Ancho chiles

Put that in blender jar (and I had to pack it pretty tight and blend some before I could add the rest) and blend for a while.

Things I thought of adding:

Maple syrup or blackstrap molasses for sweetness (and depth, with molasses) – decided not to because additional sugar might support spoilage — and I don’t really use this as a sweetener
Fish sauce or soy sauce or anchovies — another time, for sure.
a bunch of garlic cloves – meh. I’ve tried it can’t tell in the taste — the heat burns it off, I imagine

After blending, bring to a boil, reduce heat, and simmer for 20 minutes. Best if covered: fumes are fierce.

Let it stand 20 minutes after simmering, then blend again and bottle.

Written by LeisureGuy

25 November 2013 at 2:25 pm

Posted in Daily life, Food, Recipes

Petal Pusher Ciderhouse 5

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I thought I’d summarize my impressions:

SOTD 20 Nov 2013

The first use of the soap I did not glance at the name and tried to identify the fragrance with my somewhat doltish nose. It definitely had a fragrance, but I could not name it. But as soon as I saw the name of the soap, Ciderhouse 5, I immediately connected with the smell of cider: a fragrance of fermented apples with what I detect a tart but subtle hint of vinegar. I like the fragrance, for all that I couldn’t immediately identify it.

The soap lathered well—no problem getting 3 passes, and the lather is good. And the shave went well, too.

SOTD 21 Nov 2013

Today’s lather was somewhat better, though yesterday’s was fine. I’m not sure whether it’s the horsehair brush or loading the brush a bit longer, then adding a driblet of water as I worked up the lather. Good glide, no problems.

SOTD 22 Nov 2013

Final shave of the series and best lather yet. I tried something a little different: I wet the brush thoroughly—sopping wet—then held the puck over the sink and brushed quite briskly and firmly until the bubbles were microscopic and the brush seemed well loaded. Then I added a driblet of hot water to the center of the brush and loaded a little longer. The resulting lather was creamier. This may be one of those soaps that wants a little extra water.

Written by LeisureGuy

25 November 2013 at 12:00 pm

Posted in Shaving

Obamacare supports better health, not just curing illness

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This report by Jenny Gold in the Washington Post gives one hope for US healthcare:

For years, Phil Bretthauer was one of the most expensive patients at Unity Point Health in Fort Dodge, a small town in western Iowa. The 70-year-old was frequently in and out of the hospital with heart attacks, COPD and prostate cancer.

“I always keep thinking, there’s something else coming,” says Bretthauer. “If it’s going to happen, it’s going to happen to me.”

His primary care physician, Dr. Lincoln Wallace, was worried about the same thing.

“It’s a demoralizing position to be in to watch a guy like Phil go out the door and to anticipate that he’ll have some event that will likely either threaten his life or end up in the end of his life, and you have little or no way to stop it from coming,” says Wallace.

But this year, Unity Point – which includes multiple hospitals and doctor practices in Iowa — decided to do something to stop the expensive cycle of illness and readmission for patients like Bretthauer. The hospital signed on to become an accountable care organization, a Medicare program created by the Affordable Care Act that economists say could be a pathway to the holy grail of health care—providing better care at a lower cost.

Here’s how it works: a group of doctors and hospitals get together to form a network responsible for taking care of a group of Medicare patients—in this case, about 9,000 Iowans. If the network can prove it’s keeping those patients healthier and spending less money to do so, it gets to keep some of the savings. The ACO can then use that money to do things Medicare doesn’t usually cover—like reaching out more to patients at home. But if the ACO does not succeed, it may face a financial penalty.

ACOs have become one of the most talked about new ideas in Obamacare, touted as a way to help fix an inefficient payment system that rewards more, not better, care. About 4 million Medicare beneficiaries are now in an ACO, and more than 428 hospitals have signed up for either the Medicare program or a private ACO. An estimated 14 percent of the U.S. population is now being served by an ACO.

‘Now, I Have Some Way To Get Care To Them’

Wallace, who is not only Bretthauer’s physician but is also medical director of Unity Point’s ACO, in charge of managing other doctors in the program, believes the ACO has dramatically changed some patients’ care.“Now, if I have someone with multi-organ system stuff or I know that they’re alone, I have some way to get care to them. And we can only do that because our system is able to figure out a way to make it work financially,” he says.

One of the most important aspects is coordinating care for patients among primary care doctors, specialists and other providers.

Wallace started by identifying the patients, like Bretthauer, who were sickest and costing the most. At the time, Bretthauer had recently spent three weeks in the hospital after a heart attack, followed by another two weeks in a rehab facility. When he finally got home to his apartment, he was sick, alone, and depressed.

“I was just so down. I didn’t have anything to do. I’d get up in the morning and sit in this chair for eight hours,” Bretthauer recalls.

Wallace formed a team to care for Bretthauer, made up of doctors, nurses and home health workers.

At the center is home health nurse Tammy Bennett, who visits Bretthauer at his apartment every week or so to check in on him and go over all 17 of his medications.

“He needs to know why he’s taking it, what he’s taking, and we need to make sure we’re all on the same page. And if there are any changes, I notify the doctor,” explains Bennett. During a recent visit, Bennett discovered that Bretthauer was accidentally double-dosing on one of his medications.

When Bennett can’t be there, a telemonitor at Bretthauer’s apartment collects and transmits his vital signs. This allows Unity Point to know exactly what’s going on at any given moment and make changes, possibly averting an emergency room visit.

And Bretthauer says he is much more engaged in his health now. “I feel protected. If something goes wrong, I call them, they get involved. It makes me feel safe,” he says.

Team Work Throughout The System

Unity Point’s expanded focus on monitoring and data collection extends beyond the home and into the hospital. With the help of an electronic medical record system, the hospital now collects data on each of their physicians to monitor how they’re doing compared to their peers.

“We know what each guys per member per month costs are. I can even drill it down in terms of age, diagnoses, how many people are doing well with their cholesterol control, their diabetes control, their immunization rates,” says Dr. Wallace.

And if a doctor isn’t doing so well, Wallace approaches them with the facts and some potential solutions. Usually they adjust, he says.

But there are some things that can’t be quantified. Earlier this year, Phil was hospitalized for major depression. When he got out, he was worried he’d be back to sitting in that chair, eight hours a day. Nurse Bennett knew she had to do something to keep him from slipping back into a depression.

“Tammy asked me what do you like to do? And I said well I’ve announced at a NASCAR track, and I was involved in baseball,” says Bretthauer. So Bennett helped him get a gig announcing at the Little League games six nights a week.

And when baseball season ended, she helped him volunteer at the rehab facility where he’d been a patient just a year before. Bretthauer visits the facility few times a week now—spending time with residents and his favorite: calling the Bingo games.

Bretthauer says being part of Unity Point’s new efforts has been a lifesaver. And as for the hospital, its care really has gotten better. Patients, including Bretthauer, are healthier and aren’t coming to the hospital as often.

And while the hospital system has not saved enough money to get a bonus just from Medicare yet, they’re hopeful for next year.

Written by LeisureGuy

25 November 2013 at 9:35 am

Minimizing meat in your daily diet

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Minimizing meat

We have cut down our meat consumption considerably, though we will probably never go to zero. But I’m finding vegetarian alternatives tasty and interesting. The above chart is from MeatlessMonday.com, part of an article that begins:

For everyone interested in lowering their consumption of meat, there’s a new food pyramid to tape to your refrigerator. And from the bottom to the top, the advice couldn’t be simpler: Eat these foods every day.

Unlike other recommendations that say eat “50% of this” or “25% of that,” the Oldways Vegetarian & Vegan Diet Pyramid offers an abundance of colorful, delicious, healthy foods you’ll want to eat every Meatless Monday: fruits and vegetables, whole grains, legumes, herbs, spices and, for vegetarians, eggs and dairy.

“The old ways of eating around the world focus on food from plants,” explains Sara Baer-Sinnott, the President of Oldways. “The Mediterranean, Asian, Latin American, and African Heritage diets all have plant foods as the foundation of healthy eating. Therefore, food from plants are at the center of the plate.”

The good news is, this “old way” of eating is new again, reflected by the national trend towards plant-based diets, farmers’ markets, and a reduction in the consumption of meat. “Interest in following a plant-based diet is at an all time high, whether people pack their plates with vegetables once a day, once a week, or all their lives,” says Baer-Sinnott.

The first Vegetarian Diet Pyramid produced by Oldways, a nonprofit food and nutrition education organization, was created in 1997. “Today there is more scientific evidence for the health benefits of plant-based eating,” Baer-Sinnott explained. “And with growing awareness about this lifestyle, we knew it was really important to update the 1997 version.”

To produce the new Vegetarian Pyramid, Oldways gathered a world-renowned scientific committee to review extensive data on plant-based diets and provide recommendations. Complementing the pyramid is a printableVegetarian/Vegan Diet brochure that fully explains all the delicious options available on the pyramid and the proven benefits of switching to a plant-based diet. What can everyone who has taken the Meatless Monday pledge do with this new information? “Cook!,” laughs Baer-Sinnott. . .

Continue reading.

Oldways is, in fact, very much into food pyramids. From the Oldways site:

  • Latino Diet & Pyramid – Oldways created the Latin American Diet Pyramid in 1996 to help Latinos maintain good health through traditional foods, especially those native to Central and South America.  Learn more
  • African Heritage Diet & Pyramid – Incorporating delicious foods from Africa, South America, the Caribbean and the American South, this pyramid shows the wisdom of traditional diets from the African diaspora.  Learn more
  • Asian Diet & Pyramid – This pyramid was developed in conjunction with the Cornell-China-Oxford Project on Nutrition, Health & Environment, and the Harvard School of Public Health.  Learn more

Each of those pyramids is intriguing and helps stimulate meal ideas. Collect ’em all!

Written by LeisureGuy

25 November 2013 at 9:17 am

Posted in Daily life, Food, Health

California shows how the Affordable Care Act can indeed work

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Paul Krugman looks at California in his morning column today:

It goes without saying that the rollout of Obamacare was an epic disaster. But what kind of disaster was it? Was it a failure of management, messing up the initial implementation of a fundamentally sound policy? Or was it a demonstration that the Affordable Care Act is inherently unworkable?

We know what each side of the partisan divide wants you to believe. The Obama administration is telling the public that everything will eventually be fixed, and urging Congressional Democrats to keep their nerve. Republicans, on the other hand, are declaring the program an irredeemable failure, which must be scrapped and replaced with … well, they don’t really want to replace it with anything.

At a time like this, you really want a controlled experiment. What would happen if we unveiled a program that looked like Obamacare, in a place that looked like America, but with competent project management that produced a working website?

Well, your wish is granted. Ladies and gentlemen, I give you California.

Now, California isn’t the only place where Obamacare is looking pretty good. A number of states that are running their own online health exchanges instead of relying on HealthCare.gov are doing well. Kentucky’s Kynect is a huge success; so is Access Health CT in Connecticut. New York is doing O.K. And we shouldn’t forget that Massachusetts has had an Obamacare-like program since 2006, put into effect by a guy named Mitt Romney.

California is, however, an especially useful test case. First of all, it’s huge: if a system can work for 38 million people, it can work for America as a whole. Also, it’s hard to argue that California has had any special advantages other than that of having a government that actually wants to help the uninsured. When Massachusetts put Romneycare into effect, it already had a relatively low number of uninsured residents. California, however, came into health reform with 22 percent of its nonelderly population uninsured, compared with a national average of 18 percent.

Finally, the California authorities have been especially forthcoming with data tracking the progress of enrollment. And the numbers are increasingly encouraging.

For one thing, enrollment is surging. At this point, more than 10,000 applications are being completed per day, putting the state well on track to meet its overall targets for 2014 coverage. Just imagine, by the way, how different press coverage would be right now if Obama officials had produced a comparable success, and around 100,000 people a day were signing up nationwide.

Equally important is the information on who is enrolling. To work as planned, health reform has to produce a balanced risk pool — that is, it must sign up young, healthy Americans as well as their older, less healthy compatriots. And so far, so good: in October, 22.5 percent of California enrollees were between the ages of 18 and 34, slightly above that group’s share of the population.

What we have in California, then, is a proof of concept. Yes, Obamacare is workable — in fact, done right, it works just fine.

The bad news, of course, is that most Americans aren’t lucky enough to live in states in which Obamacare has, in fact, been done right. They’re stuck either with HealthCare.gov or with one of the state exchanges, like Oregon’s, that have similar or worse problems. Will they ever get to experience successful health reform? . . .

Continue reading.

One comment on the column made the somewhat uninformed point that, at the rate of 10,000 per day, California will not complete its enrollments for years, but (obviously, I would have though) the enrollment rate is not static: it increases as the deadline nears. Take a look at how Romneycare enrollments in Massachusetts—basically the same plan as Obamacare, only the GOP likes it because it was done by a Republican:

mass_enrollment_blue

Written by LeisureGuy

25 November 2013 at 8:44 am

Posted in Government, Healthcare

Perfectly smooth, with pleasure

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SOTD 25 Nov 2013

A really superlative removal of two-day stubble. The Omega Pro 48 worked up a terrific lather from Strop Shoppe’s Special Edition (with tallow) Black Tie shaving soap, and the Eros slant, holding an Astra Superior Platinum blade, did a fine 3-pass shave except for one odd nick on upper lip when going XTG—not bad, and staunched immediately with My Nik Is Sealed. I did replace the blade (with another ASP) at the end of the shave. A good splash of TOBS Shaving Shop aftershave, and the week begins.

Tasks include making a new batch of pepper sauce, but it’s pass the season for red Fresno peppers. But we’ll make do.

Written by LeisureGuy

25 November 2013 at 8:31 am

Posted in Shaving

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