CleverDonkey.com …Musings, Commentary, Opinions, and Drivel

Sick Profits

The Affordable Care Act (aka Obamacare) is the latest MacGuffin in the decades-long struggle to figure out health care in the United States.  Meaning, in the current debate it appears that the key to solving health care lies in enforcing and/or fixing and/or repealing Obamacare.  However, I think our focus has been misdirected from the true underlying issue, which is that over the last several decades we have moved to a health care infrastructure that is primarily for-profit.

To illustrate, picture if you will a theoretical health care organization, let’s call it Proactive Preventative Health Associates (PPHA).  Now picture that PPHA lives up to their name in that they proactively manage the health of their patients and foster proven preventative measures to significantly reduce the incidence of manageable health issues (cardiovascular problems, diabetes, cancer, etc).

If PPHA is a for-profit organization, their success in creating a healthy customer base will result in a reduction of profits, and the better PPHA does at reducing or preventing recurring, long-term, expensive health care issues the worse they will do as a business entity, until such time that the could conceivably put themselves out of business by being good at what they do.

If PPHA is a non-profit organization, however, the improvement of the health of their patients means they are successful, and frees their resources to focus on more urgent or needy patients and issues, because there are no stockholders or investors watching the bottom line.

So, a for-profit health care organization has two conflicting and irreconcilable motivations.  First, the (assumed) goal of maximizing the health of their patients, and second, the fiduciary goal of maximizing the health care expenses and profitability of their patients.

These two adversarial forces cannot be reconciled – they simply cannot.  Health care and profits do not go together, because if they are combined we are creating a situation where those who we trust to keep us healthy will actually be motivated to maximize our healthcare spending.

These are not theoretical noodlings, fyi.  If you were to read this article, you would find a case of a for-profit hospital that was allegedly sedating patients until they had trouble breathing, and then performing unnecessary tracheotomies at great expense (and profit).  Not only would this constitute fraud, it also may have resulted in the deaths of patients who would have otherwise survived.

Less sinister, but also illustrative, this article discusses (among other things) a study that indicated that for-profit nursing homes appeared to use significantly more sedatives and significantly fewer staff to manage those in their care.  While this might be good news to a profit-motivated investor, it would be disheartening if it were your mother they were keeping sedated because it was cheaper than creating an active and engaging environment for her.

You may find the concept of a completely non-profit health

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The Birth of a New Political World?

Disclaimer: the article below represents the noodlings of a dumbass who is talking about things way over his head, but which he nonetheless found interesting as a mental exercise.

There’s an old saying that ‘politics makes strange bedfellows’, meaning that the alliances and enmities that occur in politics are often highly situational and transient, resulting in kaleidoscopic political theater where it’s difficult to tell the players without a constantly updated program.

When you add money to the mix, it tends to accelerate the wackiness even further.  I think that two recent political theater productions are both ultimately being driven by economics. There’s another old saying that if you want to understand something in the political (or business) world, your best bet is to ‘follow the money’, so here’s my decode based on that precept of two recent omnipresent political issues:

Issue #1: The Sequester
Remember a couple of years ago when the US faced a debt-ceiling crisis, and ultimately the compromise was to extend the debt ceiling, with the proviso that a ‘poison pill’ called the ‘sequester’ would kick in if the Executive and Legislative branches couldn’t come up with a mutually agreeable budget by 2013? Good times.

The sequester was essentially a set of automatic spending cuts that hit at the sacred cows of all the players, meaning the Republicans put the defense budget on the table, while the Democrats put entitlements on the chopping block, etc, and if the two sides couldn’t agree on a more rational budget, these automatic cuts would trigger. The goal was for the cuts to be so painful for both sides that they’d be forced to put aside partisan bickering and actually cooperate for the good of the country.

Well, that didn’t happen, and the sequester has begun to kick in, causing budgetary pain throughout the government. Each side is loudly blaming the other, but nobody seems to be doing anything meaningful to fix things.

But stop for a moment and consider, what if this was the exact goal from the outset? Think about it – we (the United States) needed to drastically reshape our governmental spending, and it needed to cause pain for areas which are staunchly defended by either the Democrats or the Republicans (or both).

If the two sides had cooperated and jointly passed a bipartisan budget that instantiated these sweeping cuts, they could be vilified by challengers in the upcoming elections because they were ‘soft’, and ‘compromised’, and ‘sold out’ the ‘core values’ of their own constituency.

But with the sequester, the cuts are getting made by some mysterious ‘automatic’ process, while both sides get to blame the other for being obstinate. So in the upcoming elections, the incumbents can say, hey, put me back in the ring to go another 15 rounds against those evil other guys who forced the sequester by being big dummies and hating everything that *we* stand for! I’ll show

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Kay’s Cuisine for the Soul

We moved to Brenham from Houston over six years ago, and while we love it out here, one thing we have missed is a selection of fine dining establishments.  Houston is a cornucopia of restaurants, and after a while you get spoiled having multiple fantastic options for anything that you crave.  Not so in Brenham, where the fine dining pickin’s are slim (to say the least).

Enter Kay’s Cuisine for the Soul.  The location opened about six months ago, and tonight was our first visit there.  We had heard good things, but hadn’t been able to make the stars align on getting there until now, and we’re sorry we waited so long.  The restaurant is in an old Victorian house, with high ceilings, multiple rooms (presumably an artifact of the original home’s layout), and tasteful, subdued decor and ambiance.

The menu is short but sweet, with a fusion of Asian and Latin American themed selections.  We started with the pork dumplings and homemade egg rolls, along with soup for Avelynn.  We then moved on to our entrees – I got the tempura shrimp, which came with a cucumber-potato salad and a side of shredded onions and carrots, also tempura style.  Marie got a spicy rice bowl with fresh and pickled veggies, seared sirloin, covered with a fried egg.

It was all *fantastic*.  We gorged ourselves to the point that we passed on the tempting desserts, which Kay assured us were all made in their kitchen as well.

They’re less than half a mile south of the historic heart of Brenham, on Market Street, an easy jaunt if you’re downtown antiquing, and well worth the minute or two drive.  So, if you’re a Brenham-ite looking for an amazing and unique local dining experience, or a visitor from Houston or Austin looking for something with some panache and eclecticism, make sure to keep Kay’s in mind as an option.

You can find more information at their web site and Facebook page.

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Heaven-scented memories…

When I was a kid in the 1960′s in Southern California, we would buy loaves of Van De Kamp’s Salt Rising bread at the grocery store.  The whole family *loved* this bread, it smelled heavenly while it toasted, and tasted even better.  The ultimate was to pair it with Knott’s Berry Farm Boysenberry Preserves…yum!

We then moved to Texas, and found that the same bread was available here, too!  But, alas, after a couple of years all the Van De Kamp’s products disappeared from the shelves, including our beloved salt-rising bread.  This was the early 70′s, and over the next few years we would get our salt-rising fix by bringing home a bunch of loaves any time we traveled to California, which was usually once or twice a year.  We didn’t get to have it all the time, but it turned into a special thing since we only got it once in a while.

But then it disappeared in California as well, as Van De Kamps stopped producing salt-rising bread some time in the mid 70′s, then eventually went out of business completely.  And that was the last of the salt-rising bread for me, for the next 30 years, or so.  Then 5-6 years ago I got a wild hair to figure out how to make it myself, and turned to the internet.

What I found was that the King Arthur Flour Company actually sold a Salt-Rising Bread Yeast, and I ended up buying some and making salt-rising bread at home.  It was good, but it’s a two day process, so I only made it a few times.  Then King Arthur stopped selling the yeast, and as of today the page linked above contains this disclaimer:  ”Sorry, this item is currently unavailable for purchase”.  It has said that for the last few years, so I’m not optimistic they are ever going to bring it back, so I figured I needed to figure out how to make it from scratch.

That led me to find some homemade recipes which turned out to be tricky to master, but after a couple of false starts and failed starters I eventually found a combination of ingredients and steps that work beautifully and predictably, and you can find that recipe below.

Here’s where the story gets a little more interesting.  My grandmother passed away earlier this year, and one of the things that came up as we sorted through memories of her were details I’d never heard before.  In the 1930′s, during the height of the Depression, she moved to Los Angeles seeking employment, and ended up working at the Van De Kamps Bakery store.  It was there that she met my grandfather, who was a regular customer, and they ended up getting married.

So not only does salt-rising bread thread through my earliest childhood memories, but in actuality the connection with Van De Kamp’s goes back even further, which makes it taste

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Vote!

Note: I’m just a dumbass with a blog.  My purpose in writing this post is not to convince anyone to change their opinions, but to (one hopes) maybe have the slight effect of making sure that those who agree with, disagree with, or don’t care about my opinions will be more likely to vote next week.  Having every eligible voter vote is the key to keeping America free and strong, in my opinion, and discourse tends to motivate people.

I’m a 51 year old white male who is mid-to-upper middle class. I got my first job when I was 12 years old (paper route) and have never not worked since then. I’ve never been fired or laid off, some of which is luck and some of which is brains and hard work. I’ve lived on the West and East coasts, but have lived primarily in Texas and consider myself a Texan.

My mother’s family were Texas farmers, and she and her seven siblings picked cotton, tended the animals, and used slop buckets. I did not come from money, but I was raised with a strong work ethic, a strong moral compass, a strong family bond, and an open mind.

Through the decades I have voted for Republican, Democratic, and independent candidates. For most of my life I strove to vote for the person, not the party, with the (perhaps naive) thought that if we always select the best available candidate, that will lead to better government.

However, that only works if the elected parties are willing and able to compromise in the pursuit of (what should be) common goals. However, the American political landscape is at its most divisive in my memory.  Personally, I think the system is broken, and our voting is barely more than political theater, a show that is put on every four years to allow us to retain the illusion that We the People run this country.

Also, my take is that, by definition, any candidate for national political office is a combination of professional liar, megalomaniac, and borderline sociopath, something I talked about several years ago.  I see our choice as being between differing styles of lies and misdirection.

However, even if any of the above were true, we still do have a choice.  Politically I lean towards fiscal conservatism and also towards social liberalism.  Here are my key areas of concern for this country:

Control of the federal deficit
Revamp of health care
Free and fair elections
Maintain a strong defense and leadership of the Free World
Strengthening of civil liberties and civil rights
Return to technological leadership
Improved national and global economy

I am not an expert on all of the above topics (just like 99.9% of all voters), but I do have my opinions (just like 99.999999% of citizens).  As noted in the disclaimer above, I’m just a dumbass with a blog, but my take on these key points is as follows:

Federal Deficit
I think that balancing the budget will be best achieved through both spending

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So long, Astros

Dear Houston Astros,

Through thick and thin for the last 30+ years I have been a fan. Not always fully alert and engaged, but always a fan. Marie and I were at the inaugural game at Enron Field (now Minute Maid Park). My daughter Annalisa fractured her ankle standing on a seat cheering a game. At one point we owned a share of season tickets.

However, the move to the American League is the first time I’ve found myself facing the change from an intermittent fan to a non-fan. I loathe (LOATHE) the designated hitter – 9 men field, 9 men hit, that’s baseball. Going to the AL is almost (but not quite) as if you were switching to playing cricket. Yeah, there’s a bat and a ball, but it’s not the game I have loved (and, for a while, played) all my life.

It’ll certainly be interesting to see the Yankees, Red Sox, and Rangers come to town regularly, so there’s that. But I don’t see myself becoming a fan. I still miss the Oilers and although I like seeing the Texans do well, I have never become a ‘fan’. Hell, in the heat of the moment I still refer to the Colts as ‘Baltimore’, the Rams as ‘L.A’, the Cardinals as ‘St. Louis’, and the Jazz as ‘New Orleans’.

For all of you who love the AL, I respect that, but it’s not for me.  Kind of like New York versus Chicago in pizza, Texas versus North Carolina in barbecue, or East Coast versus West Coast in music, there are no empirically ‘correct’ tastes and I appreciate that different people have different preferences.  But I am not an AL guy, and I don’t see myself becoming one.

So, goodbye to the Astros as I knew and loved you.  Good luck with cricket or whatever you’ll be playing from now on.  There are at least two constants in life…one is baseball and the other is change, and I guess this encapsulates both of those.  Change may be inevitable, but I don’t have to like it, now pardon me while I go yell at a cloud.

Sincerely,

A Long-Time (Former) Fan

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Won Ton Tacos

One of my Facebook friends posted a Pinterest link to a description of little tacos made in won ton wrappers. I took that as inspiration to try it at home, and they were *delicious*!  Here’s how we made them:

Ingredients:

1lb ground beef
1 medium onion
Won ton wrappers
1/2 tsp comino powder
1/2 tsp chipotle powder
2 bay leaves
2 tbsp cooking oil (we use grapeseed)
salt and pepper to taste
shredded cheese (we prefer four mexican blend)

Optional:
1/2 head iceberg lettuce
Miracle Whip or mayonnaise (to taste)

Heat the oil in a large skillet on medium.  Chop the onions and saute until they start to turn brown at the edges.  Add the ground beef, salt, and pepper and cook until the meat is browned, stirring occasionally.  Once the meat is browned, reduce heat to low, add the comino, chipotle, and bay leaves, stir, cover, and let simmer for 20-30 minutes.

A few minutes before the meat is done, preheat the oven to 350 degrees.  Get a muffin pan – if the pan is not non-stick, coat the inside of each cup with oil (Pam, oil spritzer, or wipe with lightly oiled paper towel).  Put a won ton wrapper into each cup, pressing it gently down to the bottom, keeping it roughly centered.

When the meat is done cooking, give it a taste and adjust seasonings if needed to taste one last time.  Scoop a heaping tablespoon full into each won ton wrapper, sprinkle with shredded cheese, and bake in the oven for 12 minutes.

Optional: while the won ton tacos bake, shred the lettuce into a bowl, add some Miracle Whip and gently stir.  We use just enough to put a very light coating on the lettuce.  Note that even the mayonnaise-lovers in the house prefer the use of Miracle Whip for this recipe, due to the nice counterpoint the sweeter taste imparts.

When the won ton tacos are done, serve them with an optional dish of lettuce, and enjoy.  We put a small dollop of lettuce on each taco, then eat it.  Keeping the lettuce in a separate bowl and adding it as you go means the lettuce won’t get soggy sitting on top of the hot tacos.

Note that we usually have a little meat left over, and sometimes put in a second batch of 3-4 more tacos, or sometimes we just use two muffin pans and make them all at once.

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Peace

Mourn the dead, honor the heroes, fight injustice, embrace freedom, celebrate life, and, on today of all days, forget to hate.

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Peace.

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Stop nickel and diming us, start WOW!-ing us

Dear TiVo,

Two years ago I posted an open letter to you and, sadly, I find myself once again compelled to send along some constructive criticism.  Just like last time, there was a specific trigger, and this time the trigger was your announcement of the TiVo Stream add-on.  The Stream is a $130 device that enables TiVo owners to download and/or stream some of their TiVo content to Apple iDevices.

That sounds okay on the face of it, but there are limitations.  First of all, it currently only supports Apple devices, so if you have an Android or Windows or other mobile device, you are currently SOL.  Support may come, but it may not, and given your history of not finishing what you start (see: TiVo HD menus still not finished after 2+ YEARS) I wouldn’t take that bet.  Note that I don’t own or use any iDevices.

Second, the streaming only works if I am using my iDevice on the same local network as my TiVo.  So, if I am traveling and want to watch something from my TiVo, sorry, I can’t do that with the Stream device.  I could theoretically have transferred a previously recorded program to my iDevice before I left the house (assuming I had enough room to hold the recordings) and take it with me, but if I didn’t have that foresight (or the show wasn’t recorded yet) I’ll just have to do without.  Meanwhile, the Slingbox allows me to stream all my TiVo content anywhere, anytime for roughly the same price, without the limitations.

Third, and this is the kicker, is that this is functionality that you should simply have enabled on our existing TiVo boxes, instead of charging us for another device, not to mention forcing us to manage another appliance with all of the power and wiring hassles it causes.

And there’s the rub, and my biggest complaint to you, which is that you continue to try to nickel and dime your already happy and loyal customers, to the point where we are no longer fans of yours.  For example, I currently have four active TiVo devices, and I have to pay a monthly fee for each one.  For that fee I get a) programming information and b) TiVo software updates.  That’s it.

Meanwhile, I pay a monthly fee to Netflix that is less than the monthly service fee on a single TiVo box, and for that fee Netflix provides me with unlimited streamed content.  AND I can watch that content on any of my devices, and I don’t have to pay a per-device fee.  I agree that you should be compensated for programming info and updates, but your current fee structure is simply off the reservation, and as the Netflix’s and Hulu Plus’s of the world come out with much more direct benefit for much less money, you are looking

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Vote!

It may come as a surprise to some of you who know me to hear that I am in favor of Voter ID.  I think that having a standardized method of identifying valid voters, and limiting those voters to a single vote, is a great idea.  I don’t think we have much of an in-person voter fraud problem in the United States, but I’m a big believer in being better safe than sorry.

However, my objection to the current spate of Voter ID laws is that, from my perspective, they have been designed for no purpose other than to disenfranchise Democratic voters in Republican-controlled states during the upcoming 2012 elections.  You can quibble with this if you like, but given that there is not an in-person, voter identity fraud problem in this country, these laws are not designed to fix something that’s broken.  As they stand today, they are designed solely to limit the ability to vote for those who do not currently have a proper photo ID and who would have difficulty in getting one in time to vote, which are primarily poor/Democratic voters.

I currently live a lifestyle such that having a valid, acceptable form of photo identification is not something I ever have to think about.  I have a drivers license and a passport, and although they aren’t always 100% current (because I’m lazy and/or forgetful), I can easily afford the time and costs involved to keep them up to date, and have easy access to all necessary supporting documentation.

However, that has not always been the case for me, and isn’t the case for many, many Americans.  These Americans still have a right to vote, however, even if they have not navigated the myriad processes necessary to obtain an acceptable photo ID and to keep it current.  Again, for those of us of a certain means, it may sound ludicrous to state that having a valid photo ID is a burden, but it is for a large number of people.

As an indicator, current estimates indicate that 6% of Americans don’t have broadband internet access today.  To those of us who are ‘connected’, it’s difficult to conceive of someone living a disconnected lifestyle.  Some of the disconnected simply choose not to connect even though they have the means, but many of them do not have the wherewithal or circumstance that allows for digital connectivity.

Now picture a disconnected person trying to get a photo ID.  How do they even learn the process?  Go down to the DMV? What if they don’t drive and there isn’t mass transportation where they live?  What if they work a job where getting away during municipal office hours is difficult or impossible?  What if they don’t have a copy of their birth certificate?  What if the cost of getting their birth certificate and/or photo ID comes down to a choice between feeding their children or getting an ID?

Consider not only the costs for documents,

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