Thursday, December 31, 2009

Parent training

Shortly after we adopted Beauty the wonder dog from the Oregon Humane Society we enrolled her in dog school for training. What we learned the first day is that the training really is more for the humans than the dog. She was a pretty well behaved dog to begin with, the training was so we could learn how to properly motivate her to listen to us. Anyway, it occurs to me that potty training is sort of the same. Henry pretty much knows what is expected of him and how to do it but it's my ability to help assist him that success or failure hinges on. If I press too hard, it makes the process too stressful or causes him to become stubborn. If I'm not observant enough, opportunities for victory are missed.

Today is day four of potty training. Since removing the diaper this morning - yes, he's still using them at night - Henry has not had an accident and he has pooped on the potty. Things that have worked include letting Huck run around the condo in the buff, tracking his pees and poops so I can anticipate when he might need to go and get him to the bathroom in time, staying close to home, reading books to help him relax when he's on the pot, and rewards (chocolate or a bit of candy cane and a sticker for his potty chart) for pees and poops done in the potty. And applause, plenty of applause. No negativity or punishment when things go wrong, like yesterday when I heard "oh no," from the living room and found Huck bent over his underwear, which he had been wearing but removed, that were filled with unpleasantness. Oh no, indeed, Bean.

Wednesday, December 30, 2009

We interrupt this blog to bring you live potty news...

Henry has peed standing up. I repeat, Henry has peed standing up.

We now return to our regular, run of the mill blogging.

Tuesday, December 29, 2009

Photography practice: Holiday shooting at night

Well, this exercise illustrates my need for a tripod. Notice the shot with the three second shutter speed. Now count out three seconds and look again. I'm pretty impressed it is as sharp as it is as I'm pretty jittery.
Shutter 0.4 Aperture f/3.8 ISO 400 20mm

Shutter 1/2 Aperture f/3.8 ISO 400 22mm

Shutter 0.77 Aperture f/3.8 ISO 400 22mm

Shutter 1 Aperture f/3.8 ISO 400 20mm

Shutter 2 Aperture f/3.8 ISO 400 22mm

Shutter 3 Aperture f/3.8 ISO 400 20mm

Last night we hit the Oregon Zoo Lights, and spent all of twenty minutes there. It was too dang cold and Henry peed his pants. It was nearly impossible to find a bathroom in the dark with so many people milling about. There was still enough time to take a couple of shots of the lights, and the back of Henry as he walked off into the crowd.
Shutter 1/40 Aperture f/1.4 ISO 1600

Shutter 1/40 Aperture f/1.4 ISO 800

Shutter 1/40 Aperture f/1.4 ISO 1600

Potty training, day two

I nearly broke down and bought more diapers because it was not a good potty training day. Or at least I felt it wasn't progressing fast enough for a bit. Henry is using the potty about 50% of the time. He asked for a diaper and got the lining and cover of a gDiaper, and then proceeded to poop. Henry seems to do better when he's not wearing anything but there was some real resistance on his part to sitting on the potty today. My approach tomorrow will be more laid back so I don't make him anxious about what we're doing.

Sunday, December 27, 2009

Henry 800

Henry - 800 days old
Top Eight Things You Don't Know About Henry
1. He loves playing with Playdoh.
2. He has pooped on the potty.
3. He feeds his raspberries to his dinasongs*.
4. He likes to help his mom make pie.
5. Huck is limping (and if it's not better by morning will be heading to the doc's office).
6. He is starting to say "I do it," whenever he wants to try something on his own.
7. His favorite meat is lamb.
8. When he grows up he wants to be a fire truck.

*Also known as dinosaurs. All dinosaurs are also called T-Rex.

Friday, December 25, 2009

Merry Eatmas!

We've been eating a lot these past few days. I thought the cookie exchange was a great idea until people showed up with really awesome treats. That was just the beginning of Holiday Eat Fest '09. Christmas eve morning we hosted brunch for Brother Nick and his family and our friends from Seattle, Rick and Anya. (With surprise guests Tanya and Stephanie swinging by to drop off gifts and a beautiful bouquet, respectively.) Our menu included bacon, a zucchini and tomato frittata, red potato hashbrowns, Greek honey yogurt and bananas, spiced pumpkin muffins, and mimosas. Fast forward to Christmas dinner where we served country ham (baked in Dr. Pepper), macaroni and cheese, brussel sprouts with bacon, and bread, with roasted apple pie and ice cream for dessert. It should be noted that while Henry did not eat very much at the dinner table with his folks and grandpa Gilroy, he did later consume several helpings of macaroni and cheese and most of the brussel sprout and bacon concoction on his plate. The kid eats brussel sprouts, people! We expect to eat more tomorrow when we hit Darr's sister's place for a Boxing Day celebration. Here's hoping the in-laws aren't too upset when they see what we bought their son, Gavin, for Christmas. (Intrigued? Click here to see how awful we are.)

As for the presents, there were many and all of them were awesome. The handmade count is high this year because my mom now has a room dedicated to doing crafty things. From her famous - at least in our family - slippers to a beautiful cable knit sweater for Henry, everything was gorgeous. (I keep telling her she should open up her own Etsy store. The pumpkin hat alone is a gold mine.) I have a new cookbook - Mastering the Art of French Cooking. While I don't plan on making every recipe in the next 365 days, I am looking forward to working on more challenging dishes. Probably we'll start with desserts. Is there any better place? Because Darr insists he is the very definition of Bah! Humbug!, I opted out of buying him a "big" gift and instead filled a stocking with a few trinket gifts. He has assured me this was the right move. I find myself unable to exclude him entirely from Christmas activities so the stocking stuffers were my attempt at compromising. (Don't like gifts? Okay, I'll only buy you a few small ones.)

Of course there were pictures...

Christmas Eve
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And there were pics of Christmas day, too...
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Wednesday, December 23, 2009

Right to pray in Arabic

The gist, the Ft. Hood guy (Hasan) who allegedly killed 13 people is restricted, pretrial restrictions from his command, from talking in Arabic to anyone unless there is a translator around. He was recently on the phone praying in Arabic with his brother and his conversation was cut short. No translator was present. His attorney is arguing "it's illegal and a violation of his religious rights." The catch, Hasan is currently under military control, not the civil criminal justice system. While I'm not sure I understand why there is a difference, there is. Challenges of this nature in the civilian world usually are typically successful. But based on Hasan's previous actions, the military can label Hasan a threat and limit his actions based on security reasons. When I was talking about this to Darr, his response was "why not just tape him?" That seems a reasonable solution. Odds are they are taping the guy anyway, right? Then, if a translator later determines he's not praying but helping plot another such event, we can restrict his rights with actual proof that by not doing so we're putting others at risk.

Hat tip: Volokh Conspiracy

Cookie Exchange 2009

I'm hosting my first ever cookie exchange today. Because Henry was at school yesterday I had time to bake and so I made peanut butter fudge, Nanaimo bars, and stained glass tree cookies. I bought some boxes and food safe tissue paper so folks have a way to cart the goods home once we divvy up all of the loot. I also picked up cheese, crackers, and cured meats to counter the sugar overload we're sure to experience when we have a nibble here and a taste there. Oh, and what cookie exchange is complete without mimosas? (Answer: None.) The only thing I lack is coffee. Darr drinks it during the week at the office but rarely has it at home and I don't drink coffee so, um, unless folks want the Folgers coffee from my parents' visit two summers ago, they're out of luck. Tea and egg nog are available upon request since I'm not sure everyone is up for drinking at ten in the morning.
UPDATE: 8:50am Stacey has dropped by with the first bit o' happiness. I am tempted to have a taste but will satisfy myself with a snack from the kids' bowl of crackers instead.

UPDATE: 12:46pm Success! Monsieur Henry and Cousin Amels are nearly napping and there is a box on my counter loaded with sweet happy cookie goodness. (I almost forgot to fill a box for myself, a situation I happily corrected by pilfering from the other completed boxes.) The haul included the following:
rocky road fudge
chocolate chip cookies
peanut butter fudge
bratzeli
mexican hot chocolate cookies with dulce de leche
Nanaimo bars
almond roca-type toffee (I'll have to get the official name from the baker.)
stained glass tree cookies

Monday, December 21, 2009

He's still up, dude


He's still up, Dude

The ham is here! The ham is here!

The ham is here! The ham is here!

Sunday dinner with friends, now served with a cheese course!

I am very thankful we have friends without kids who don't bolt at the first sign of trouble when they come to our house for dinner and the little man decides he does not want to sleep. Jen and Craig came for their very first meal - shame on me for not inviting them over sooner - and stayed long enough to work their way through a pretty exhaustive menu, including (a condo first!) a cheese course! WoohoO! Darr was very excited when I agreed to this as I'm not nearly as much of a cheese fan as he is and so it normally is not something we do. I was sent to the store with a list of cheeses but the New Seasons cheese guy saw me perusing the cheese selections and offered up a suggestion. Since Darr had not specifically identified which sharp cheddar cheese he wanted, I went with the cheese guy. Trust me, I know how weird lamb shanks with oranges and olives sound but it is really tasty. On a side note, I need to remember to butter the sides of the ramekins when making the individual molten babycakes. Otherwise the cake sticks to the side of the pan and won't turn out nicely onto a plate.

Antipasti

Prosciutto-wrapped asparagus
Herb roasted zucchini with carrots in a Marsala butter sauce

Primi
Rigatoni with garlic bread crumbs

Secondi
Lamb shanks with oranges and olives

Fromaggio
Cheese sampler including Ossau Iraty, Mimolette, and Fromager D'Affinois

Dolci
Molten chocolate babycakes with homemade vanilla ice cream

Saturday, December 19, 2009

Month Twenty-six

Dear Henry,

I didn't forget, bean. It's just that we're six days away from Christmas and things are a bit hectic. Not to mention your 800th day on earth is just around the corner. We celebrated your turning twenty-six months old by taking you to see The Polar Express at OMSI's Omnimax Theatre. One gigantic screen plus one cartoon containing a train equals one enthralled toddler. You sat in my lap for most of the movie, toward the end turning to me to say, "I love you too, mama." Then you asked for a hug with your arms thrown open wide. Talk about melting my heart, kid.
This was not the first train event of the season. Two weeks ago we rode on the Holiday Express steam locomotive. Whoo whoo! This is where you learned about candy canes. Now you love candy canes. You also choke on candy canes so I'm less inclined to give you one. Yeah, that's me, honing my parenting skills. You are very much into songs. Singing songs like Twinkle, Twinkle, Little Star and Rock-a-baby (also known as Rock-a-papa and Rock-a-mama), and requesting songs. Songs that don't actually exist. Often we're driving around town and you'll pipe up with a song request from the backseat. "Mama, candy cane song." My on-the-fly attempts at writing lyrics are not good but I think it's the effort that you appreciate more than the end result. At least that's what I'm telling myself. Oh, and the candy cane song goes like this: (Set to the music of O Christmas Tree) O candy cane! O candy cane! You are a Christmas treasure. O candy cane! O candy cane! I eat you up with pleasure. You are so sweet when I lick you. I want to have one or two. O candy cane! O candy cane! You are a Christmas treasure. This year Christmas is both more fun and more work. Your tiny toddler hands are busy when it comes to the Christmas tree ornaments. You want to touch them. All the time. And, like many things we try to get you to not do these days, you ignore our pleas to not touch the tree. You touch, then you look at us while touching. Then you laugh when we remove you from the temptation and you return seconds later to continue your reign of touching. It's exhausting. On the flip side, though, you are eager to check out the presents under the tree without opening them and to help in the kitchen with baking. You have learned to plug in the tree lights (helpful). You enjoy ripping the tags off packages (not helpful). We managed to get out for a photo op with Santa. We arrived early enough to see Santa leave the building and make his way to the little faux North Pole house they have set up where the pictures are taken. The minute you saw that big guy in red you shyly shouted "Hi. Santa!" That exuberance faltered once we were inside and it became clear to you that you were expected to sit on Santa's lap. Luckily, it was a very cold morning and no one else was crazy enough to venture out to see Santa so we got to spend a few extra minutes with him just chatting until you were comfortable enough to have the photo taken. The pic turned out good but I am sort of sad I don't get the traditional toddler screaming on Santa's lap photo.
You hate sitting in shopping carts, which means I've had to endure several tantrums at the grocery store this past month. Not fun, Bean. I'm sure other parents see you and remember almost wistfully the days when their kids acted similarly. And I'm certain those without children see you and thank whatever deity they worship that they don't have kids, while simultaneously concluding I'm the worst mom on the planet to make you howl that way. Your pops is trying to help you learn how to go to bed and stay there without the assistance of the gate. It's going well, I think. When given freedom, you tend to push the boundaries further and further. And once the gate goes up, you're so tired from your constant pushing you go to bed.
We worked on table manners. For instance, now you sit at the dining room table for most of the time it takes your pops and I to finish eating. Sometimes you actually make it to the end, and sometimes you actually eat so that's a bonus. Eating is going well. I swear you'll try nearly anything, including bubbles you received from Montana grandma last Easter. Good job on the trying new foods, Huck. The other morning we had to wake up early to take your pops into work and you came stumbling out of our room and ran right into the dining room table. You're sporting a nice bruise underneath your eye as a result. You're always bonking your head. To illustrate how you bonked your head, you'll bonk your head against an object (e.g., the coffee table) again, and say, "I bonked my head." Well, yes, and um, it would have only been once if you hadn't gone for the instant replay. It's easy to love you when you're doing your cute little dance to the hippo Christmas song or when you're super sweet and cuddly. But we love you when you're naughty, too.

Love,
Mama

Miss Avery turns two!

How fast these kids grow up, I tell ya. Monsieur Henry and I attended a party this morning for Avery, who was celebrating her second birthday. She's two! Already! Avery was in super party form, nekkid from the waist down. Serves us right for showing up early. Of course there were pictures...

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When Santa meets Jack Bauer

Thursday, December 17, 2009

Boy outfit #10

Bean's transitioning into his next size of clothing (24 month/2T) so I'm sure there will be a rash of these posts as I dress my boy each morning and realize that I adore each outfit. I particularly enjoy the juxtaposition of the army pants with the anti-war message on the shirt Hen's wearing today. I noticed he was standing still for a millisecond so I quickly threw the camera into automatic, switched on the flash, and snapped a few photos. I think these may be my first shots taken using the automatic setting since the photography class at the beginning of November.
Shopping guide info:
1. pants - Disney Cars, received as a gift from the Johnstons (Darr's Canadian cousins)
2. shirt - Tiny Revolutionary, purchased at tinyrevolutionary.com
3. belt - Miniman, purchased at Spoiled Rotten
4. socks - Mini Boden, purchased at miniboden.com
5. shoes - Columbia, received as a gift from the Bickels

The kinder, gentler SCOTUS

I loves me some SCOTUS blog.

This is a new feature on SCOTUSblog. The Supreme Court deals with a lot of technical legal issues. Our posts tend to be written in the same way, so that if you aren’t a lawyer it can be hard to understand exactly what we’re saying. We try not to go too deep into jargon, but it’s hard. As a result, we don’t connect with all of our readers as well as we could. Many of you aren’t lawyers. It’s important that everyone understand the Supreme Court, and we want to be a comprehensive resource.

So, on a regular basis, we’re going to step back and write about what’s happening at the Court in plain English. We’ll also sneak in some more basic background on how the Court works. That background material will also be incorporated into a “The Supreme Court in Plain English” entry on SCOTUSwiki. When the Court is doing a lot, and we have a lot of content, we may write these posts every day. When things are slower, it may be more like once a week.

Monday, December 14, 2009

Christmas tree at the condo

Mom requested some Christmas tree pics and it just so happens we have some handy. Three things made this year's tree acquisition easy - 1. small stature of tree; 2. tall husband; 3. height-challenged car. For the past several years we have purchased our tree at a lot that supports a local high school, which is good because watching a tree being cut down is a little sad. Not sad enough to keep me from getting a tree but sad nonetheless.
Canon PowerShot SD400

Canon PowerShot SD400

Last year I highlighted some of my ornaments hanging from the tree's branches, the following pics showcase the newest arrivals. The hippo ornament was a gag gift from Monsieur Henry to his pops. When the little button is pushed, it sings this song. If you haven't yet been exposed to the song, you're welcome.
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As shown here, Bean has a bit of a problem keeping his hands off the ornaments. This one had to be placed on the mantel when excessive toddler touching led to the disappearance of the hanging hook.
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To commemorate our first trip to Disneyland I bought this all-characters-on-deck Disney ornament. It survived the plane ride home. Woot! (As an aside, it was totally worth the $73 I paid for it.*)
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I love REI's Santa ornaments. The outdoorsy theme is refreshingly AWESOME. (Bonus that it has a cat.)
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Behold the tree at the condo.
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To Hen's delight, a package arrived from Montana with many presents in it. He has been carting these around the house mumbling things like "Santa" and "Open it!" but has yet to actually dive in. The bet is on as to how long this good behavior will last.
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*It cost a fraction of that. I'm just f--king with Darr. Hi, honey! :*

Friday, December 11, 2009

Good without God

I saw this on a bus today while driving over the Hawthorne Bridge. I probably wouldn't have noticed but traffic was stopped so the bridge could raise the platform to allow a ship to pass and we were in line waiting for about five minutes. When you have one Monsieur Henry in the car with you in this situation, you will hear about the bus's presence about every four seconds. "Bus." <insert 4-second pause here> "Bus. Mama." Repeat. Anyway, it wasn't that long ago when a similar campaign started across the Atlantic. Some days it is nice to know I am not alone.

Pet peeve #229

People who find "clever" ways to spell regular names. For example, Madison becomes <please wait while Crazy Spelling Generator (CSG) processes your request> Madysin.

Madysin.

Really? Really?

I swear, that makes me want to shoot myself in the head. And if I survive that, I'll then go and hunt down those parents and shoot them in the head.* Odds are I'd just be beating poor Madysin to the punch.


*This, of course, is a joke. But because there are people who might come upon this blog, read it, and think me a serious threat I have to add this stupid disclaimer that states it is intended as a joke. Perhaps a bad joke. Maybe a joke that isn't really all that funny, particularly if you are someone who lost your parents when they were both shot in the head, but nonetheless a bad, not funny joke I have every right to make.

Thursday, December 10, 2009

Pics of kids

I had the recent good fortune to be around these cute frickin' kids with my camera handy so pictures were taken.
Miss Avery, while visiting the condo for a play date earlier today.
Shutter 1/60 Aperture f/2.0 ISO 200 Flash
Jackson, the lighting at his parents' house is awesome.
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Lil' Zach, growing up and blowing bubbles!
Shutter 1/125 Aperture f/1.4 ISO 400
I was reading one of Scott Kelby's Digital Photography books earlier, I have the first two and just learned of a third, and he mentions that the sweet aperture spot for portrait shots is f/11. So I tried that today. It didn't work with Henry, who was an unwilling participant in the 'sit still so I can take a portrait shot' game. But it did work with Avery, who actually came close and looked into the lens when I asked if there was a ladybug inside it.
Shutter 1/60 Aperture f/11.0 ISO 200 Flash
For contrast, here's a shot with the aperture opened wide. Note the shorter depth of field, which has her nose in focus but pretty much everything else out of focus. Nice bokeh in the background, though, don't ya think?
Shutter 1/60 Aperture f/2.5 ISO 400

He dances like his father

Ushering in the holidays from Christie Glynn on Vimeo.

Facebook SNAFUs

I find this type of stuff incredibly funny.

Click here.

Health care mandate - unconstitutional or not?

Is it unconstitutional to require people to purchase health care insurance? Folks at the Volokh Conspiracy have been talking about this a lot lately. There is no precedent for such a mandate. Unlike car insurance, which if people don't have, they can just choose not to drive, you'd be breaking the law if the mandate goes into effect and you don't buy coverage. It'll be interesting to see how the lawyers battle this out. It has been suggested that because health care makes up such a large percentage of the national economy, Congress could argue that mandating coverage comes within its power to regulate commerce. Crazy stuff, people.

Tuesday, December 08, 2009

The savings continues...

Last week I implemented a meal plan and did some field testing at a local supermarket to check out prices. This week, the experiment continues.

organic Braeburn apples: NS $1.79 per lb / FM $1.49 per lb
granulated sugar: NS $5.99 / FM $3.99
buttermilk: NS $0.99 / FM $1.19
organic cereal bars: NS $3.29* / FM $2.27*
spaghetti: NS $2.79 / FM $1.34*
penne: NS $2.79 / FM $1.33*
cake flour: NS $3.29 / FM $3.15
bittersweet chocolate baking bar: NS $3.29 / FM $2.00*†

*sale price
†I bought four bars for a savings of $5.16. $5.16! On chocolate!


We've used 'em in the past but I have a new found love for meal plans. This step alone is saving us money as we are no longer making impulsive trips to the store to satisfy whatever craving we're having. Beyond savings, though, it's nice to have a plan in place and not be trying to remember what is in the cupboards to piece together dinner at the last second. The new meal we're trying this week - pasta with butternut squash and sage. Mmmm...

Monday, December 07, 2009

From a retired surgeon's perspective

My friend emailed me the link to this story but I thought I'd share the whole darn piece here because real health care reform, the kind that changes our current mess of a system so that it works for everyone not just those fortunate enough to still have a job that carries health benefits with it, is needed now. It's our shame as a nation that we have yet to find a way to take care of all its citizens.
Forty years as a surgeon in university and community hospitals gives some authenticity for the following reflections regarding the failings of our health care delivery. Partisan rhetoric has led to shouting matches rather than reasoned choices, while the most fundamental issue in health care reform has yet to be stated: should health care be continued as a profit-driven enterprise? If a problem well-stated is a problem half solved, a clear answer will allow for progress. Here are the some of the problems I have observed:

Health care is already rationed and socialized. We have an unacknowledged disparity between insatiable demand for health care and a capability that cannot meet it. We now find health care rationed on the basis of who will receive care, not on what care will be provided.

Rationing does not apply to emergency care. The unemployed laborer severely injured in a car crash or the farmer who collapses will be given the best care possible. No expense will be spared, all needed consultants will be called, all necessary surgery and definitive care completed.

The patient who presents for planned, scheduled health care gets a different reception. Those needing elective heart surgery, or joint repair, for example, are filtered carefully. Care is rationed by ability to pay.

Insurance coverage, pre-approval, deductible, non-covered services, co-pays, will all be scrutinized. If the patient cannot pay, he or she will either not receive the needed care or will be directed to public facilities or programs that depend heavily on outside or tax-supported funding.

What is certain is that the hospital bill for the well-insured will be sufficiently high to cover expenses generated by poorly insured or uinsured patients.

If "spreading the wealth" is socialization, our system is already socialized, with the "haves" paying for the "have-nots" by a tax on the wealthier group. This explains a $15 aspirin, $10,000 to $15,000 antibiotic bills, and bills for heart surgery of $250,000 or more.

We resist "socialized medicine" from the federal government while oblivious that we have embraced socialized medicine delivered -after profits - by the insurance industry.

A crisis is dangerously imminent in which the "haves" will not be able to pay for the increasingly larger segment of "have-nots."

Rationing of medical care in a non-profit system should be based on society defining what services should be provided, not on restricting care on the basis of income, as in a profit based system.

We currently give priority to crisis care rather than preventive or other types of care. For the best care to the greatest number with the least expense, we should to place preventive care first.

There are inequitable and unreasonable variations in the system. The rates of people having surgical removal of atherosclerotic plaques in the carotid artery, coronary artery bypass or joint replacement operations varies so widely across the nation that it appears that factors other than well-defined indications for the operation are responsible. Could the income generated for hospital, clinics, and ancillary services be a major factor in these widely different rates?

Doctors' pay is equally disparate. Despite similar length of training, extreme variations in amounts paid different doctors exist nation-wide. Six- and seven-figure incomes are common among several specialties, while general surgeons, pediatricians, internists, family practitioners and geriatricians whose education was as arduous - and who may put in more hours - earn far less.

Should limitless profit be the motivation to choose medicine as a career? Inequities in earnings have their origin, in large part, because doctors' pay is based on fee for service.

The more tests performed, the more X-rays ordered, every consultant called, every operation done influences income - directly or indirectly.

The solution to these disparities is one that will not sit well with some of my colleagues: Doctors should be paid a base salary commensurate with their time in education and the responsibilities they carry. Increases in pay should be based on such factors as measurements of quality of care, research and teaching. Highly specialized fields requiring extra education and experience, remaining current in new techniques and extra call on nights, weekends and holidays should be compensated.

Fear of litigation, defensive medicine and end-of-life care contribute to costs. Excessive X-rays, unnecessary consultations and inappropriate antibiotic treatments - all contributors to the cost of medical care - are used to ward off malpractice litigation that can be catastrophic for the doctor. The results of these seldom change treatment or give a better outcome.

End-of-life costs constitute the majority of the total health care dollars spent on each individual. The final 90 days often account for 30 percent to 40 percent of lifetime medical costs. CAT scans, repeated blood tests, ventilator support, dialysis, are often done for fear of litigation or demanded by family members who want "everything" done.

Expense of final days can decimate the family finances without bringing benefit or qualify of life. Decisions made before the stress of imminent death, would allow patient dignity without sacrificing financial solvency.

Tort reform, unequivocally needed, is a small wave in the financial tsunami of our dysfunctional health care delivery.

Continuity of care is disappearing. After work hours, emergency rooms often are the only available caregivers. Care within the hospital is increasingly provided by hospitalists whose entire professional work is inside the hospital. Patient and assigned hospitalist may never have seen one another.

Dr. A will send the patient to the emergency room, where Dr. B will decide on admission. Hospitalist Dr. C provides the care, with the patient discharged to Dr. A's partner, Dr. D, in a system fraught with chances for errors and poor outcomes. All four doctors will send separate bills for their disjointed services.

Other issues: profit, payers and an attitude adjustment for Americans. Rejection of payment claims for any reason, is in the best interest of the insurance company, and claims are often returned for minor or nonexistent deficiencies, denied for pre-existing conditions, alleged improper coding and for failure to receive pre-approval. "Beneficiaries" have their policies cancelled for technicalities when the condition is expensive to treat.

In Great Britain several years ago, a perceptive woman afflicted with a bowel disease requiring a great deal of medical attention, offered me her view: "Americans have no sense of community welfare, no willingness to be discomforted in the least for the greater good of the entire population."

She might have been blunt that well-insured Americans say, "I got mine. To hell with you!"

Unless personal selfishness can be refocused to the common good, health care in the United States will remain with irrational rationing and inappropriate and financially unsustainable socialization by insurance, drug and medical supply industries.

Despite professing Christian love for our neighbor, it has fallen to President Obama to call us to the painful truth: "We are ... the only advanced democracy on Earth -- the only wealthy nation -- that allows (health care) hardship for millions of its people."

The fundamental question in the discussion of improved health care deserves repeating: With its widespread and profound problems, do Americans truly want health care to continue as a profit-driven enterprise?
Retired surgeon John Gary Maxwell is former director of the surgical residency program at New Hanover Regional Medical Center and a professor emeritus at the University of North Carolina and the University of Utah medical schools.

Sunday, December 06, 2009

Holiday Express

It didn't look that cold this morning when we left the condo. Henry was wearing a onesie, a long-sleeve shirt, a jacket, pants, leg warmers (pulled up mid-thigh), socks, shoes, and a hat. All of that and he was still freezing by the time we hit the tent to pick up our will-call tickets for the steam locomotive. This prompted the purchase of a Holiday Express hooded sweatshirt, which we threw on over everything else. Then I cuddled with the kid until his teeth stopped chattering. Thankfully, the wait to get on the train wasn't long and the train cars were heated. The train ride was about 40 minutes long, and it came with a visit from Santa Claus, a candy cane, and a monkey tatoo, which seemed oddly out of place but completely acceptable. Of course there were pictures...
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One tragedy at a time

A mill worker in Yamhill, OR
Without insurance, John has been unable to get surgery or even help managing the pain. When he collapses or suffers particularly excruciating headaches, Esther rushes him to the emergency room of one hospital or another, but an E.R. can’t do much for him. One hospital has told them not to come back unless he gets insurance, they say.
Thirty miles away, a hardworking American family is dying. [full story]

Healthcare voters are values voters.

Saturday, December 05, 2009

Recipe Corner: Risotto al Prosciutto e Parmigiano

Does this lady look like she can cook Italian food or what? Tonight we tried Biba's risotto with prosciutto and Parmigiano and it was awesome. Henry not only enjoyed tasting the ingredients, he also partook of the final dish. Each bite was met with the requisite "Mmmmm," which means he likes it. A lot. And who wouldn't? Italian food is generally yummy but add prosciutto and Parmigiano and you can't go wrong. We used Adelsheim Pinot Gris as our dry white and this was a very good decision because it is an excellent drinking wine, too. So, yeah, while I'm typing this I'm having a sip of me wine. Mmmmm...

Ingredients:
6 cups chicken broth
4 tablespoons unsalted butter
1/2 cup finely minced yellow onion
2 cups Arborio rice
1 thick slice prosciutto (about 1/4 lb), diced*
1 cup dry white wine
1/2 cup freshly grated Parmigiano-Reggiano
Salt and pepper to taste

Directions:
Heat the broth in a medium saucepan, keep warm over low heat.

Melt three tablespoons of the butter in a large skillet over medium heat. When the butter begins to foam, add the onions and cook until pale yellow and soft, about five minutes. Add the rice and stir quickly for a minute or two, until the rice is translucent and well coated with the butter. Add the prosciutto and stire for about one minute, then add the wine. Cook, stirring, until almost all the wine has evaporated. Add about 1/2 cup of the hot broth and cook until it has been almost completely absorbed. Continue cooking and stirring the rice in this manner, adding broth 1/2 cup or so at a time, until the rice is tender but still firm to the bite, about 18 minutes.

When almost all of the last addition of broth is incorporated, add the remaining tablespoon of butter and about half of the Parmigiano. Stir quickly until the butter and cheese are melted and the rice has a moist creamy consistency. Taste, adjust the seasoning, and serve immediately, with the remaining Parmigiano.

Serves 4 to 6

*The lady at the deli counter looked at me as if I was nuts when I asked for one thick slice of prosciutto. It's likely you'll get the same thing.

Wednesday, December 02, 2009

Another year, another birthday

Happy birthday you you
Happy birthday you you
Happy birthday, bear papa
Happy birthday you YOU!*

*Happy birthday song as sung by one Monsieur Henry with help from mom

Tuesday, December 01, 2009

Results

We do most of our shopping at the New Seasons up the street. It's quite handy to have a store within walking distance, particularly one that has lots of good foods and quality produce. But I was curious to see how much extra we're paying for regular store items. Today I took my grocery list to Fred Meyer - I drove all the way to Tigard because the Burlingame location sort of freaks me out - and proceeded to load the cart with staple items like butter, milk, and laundry detergent. With New Seasons' shop online option and a sleeping toddler, I was able to do some price comparisons - product equivalents were used when an exact match wasn't possible. Here are the results:

organic whole milk: NS $3.59* / FM $2.99
unsalted butter: NS $2.99 / FM $2.50
laundry detergent: NS $7.99 / FM $7.49
organic cereal: NS $4.99 / FM $2.50*
Glad cling wrap: NS $2.99* / FM $2.50
chocolate chips: NS $3.49 / FM $2.50
organic string cheese: NS $0.79 / FM $0.79
nail clippers: NS $1.79 / FM $1.99
cage-free eggs: NS $2.49 / FM $2.89

*sale price

It's no surprise that, generally speaking, Fred Meyer has cheaper prices. I just didn't realize how much the savings would add up. The prices of most of the items are pretty close but if you are saving a little bit on nearly everything you buy, you are saving real money. I came out with a total around $38 at New Seasons' prices and a total of $29 at Fred Meyer's. The trick will be figuring out which items to purchase at each store to maximize the savings. Costco runs for kitchen must-haves like bacon and bacon will continue as needed.

Cry me a river, United

Espinosa files for bankruptcy because he can't pay his student loan of $13K. He's making around $6 an hour, living frugally (is there any other way to live on $6 an hour). He doesn't have any other debt. His car is worth $1200. His attorney figures out the deal and contacts the lender. The company does not file any objections. Six months later a federal bankruptcy judge approves the payment plan. Espinosa pays off the debt over a period of five years and receives a letter from the bankruptcy court stating the debt is paid in full. And many years later - 11 since the bankruptcy court confirmed the repayment plan - United Student Aids Fund, Inc., the company that lost $4K in interest on the deal, says the court erred in not holding a hearing to determine if Espinosa's circumstances rose to the level of undue hardship necessary to allow the bankruptcy. WTF?

This case has made it all the way to the Supreme Court. You know who's backing United? The U.S. government, 24 states, and the entire student loan industry. If I wasn't rooting for Espinosa before, I sure am now.

For NPR's coverage of the case, click here.

I'm trying to process what this all means if the court finds for United and against Espinosa. So, you file for bankruptcy, the court confirms the payment plan, you pay according to said plan, you even get a court letter that states the debt has been cleared. And years later the company can claim some part of the process was unfair to them and you get stuck for any additional monies they lost out on when the payment plan was constructed. What would be the point of filing for bankruptcy if you can open up a closed deal years later? Is it really necessary to hold a hearing to determine if someone making $6 a hour at his/her job suffers an undue hardship?

Update: Forbes has an awfully written article on the case here. I particularly like this comment to the Forbes' piece:
"...you just had me laughing off of my chair. "Congress, in reflecting the desires of the American people has excluded student loans from discharge in the current version of the Bankruptcy Code." Really?? Do you have anything to back up your statement that the change in bankruptcy law to exclude student loans was based on the "desires of the American people"??

The most recent Gallup poll has Americans' approval rating of Congress at 21%. Do you really think that Congress is "reflecting the desires of the American people" every time they pass a law, when 80% of the country disapproves of their performance?

And it sounds like your embittered professor needs to stay in the make-believe world of academia - because the last time I checked, a majority of Americans DO expect fairness from our judicial and legislative branches.

The Henry Fords and Walt Disneys of the world - had they not been given a second chance through bankruptcy - would never have been able to turn around and build the successful empires that eventually employed hundreds of thousands of people and helped put American business on the map. Many of the products that you take for granted every day come from someone who failed many times before succeeding.

15 million people are unemployed right now. If you are not one of them, then I congratulate you. Many Americans are having a tough time putting food on their tables and paying the most basic bills. Bankruptcy will not help these people if a majority of their debt is in the form of student loans.

The saftey net called "bankruptcy" exists for a reason. It is time that we stop singling out students and treating them like criminals, while giving all other consumers a free pass."