A while back I suggested that the Libyan intervention was kinda half-baked. CDR Salamander has stuck the proverbial toothpick into the center, and pulled this out.
Highly recommended reading.
Monday, April 25, 2011
Thursday, April 14, 2011
Republicans for Slow Medicine?
As of the last couple of years, biomedical engineering has seen explosive growth. Almost every university in the country now has at least a few faculty and a score of grad students in traditional engineering departments with "bio-" attached to their titles. The needs of an aging population are frequently cited as the impetus behind this effort, as the percent of the US, Europe and Japanese budgets and economies devoted to late-life medicine continues to rise.
This is hardly inevitable. Do-not-resuscitate orders are gaining popularity as people begin to assess the quality, not just length, of their lives. In addition to living longer, there's hints that large parts of the population might be making healthier choices about diet, exercise and entertainment (e.g., not smoking). Medicare is even encouraging doctors to have discussions about this with patients before they enter the painful, and expensive, portion of end-of-life care, so that the decisions are made by the patient, not family members under considerable duress. Slow medicine is a philosophy that incorporates these principles.
The House GOP 2012 budget makes sense in one of two ways. Either, they expect their tax structure to create superlative retirement savings for all seniors, that effectively the stock market's capital gains can displace the $38Trillion unfunded liability, or that seniors will chose to purchase less care than the government would provide for free. In other words, by capping the growth of Medicare spending, it guarantees that there simply will not be funds for both quality of and end of life care for beneficiaries, and lets individuals make the choice. Do they have perfect faith in the private sector to do what the government could not, or did the GOP officially embrace Dr. Dennis McCullough?
At first blush, I thought the primary goal of the new GOP majority was to increase upper middle class consumer purchasing power while maintaining social funding for elderly supporters. I also expected them to quickly move away from fiscal discipline and into social wedge issues that inflame more passionate support than actually cutting spending would do. If this new program provides both fiscal restraint and reballances the economy to invest in productivity instead of retirement, perhaps there is something to like about the new Congress. Not that any of this will matter, as recipients of Medicare today will smell a rat as an excuse to cut their services and see to it that it does not happen. Still, your pie maker was perhaps too cynical in his early assessment, and they do deserve credit for putting their careers on the line for a significant, if inadequate and politically unfeasible, change. (I still haven't read the thing in detail, and will have more to say once I do.)
This is hardly inevitable. Do-not-resuscitate orders are gaining popularity as people begin to assess the quality, not just length, of their lives. In addition to living longer, there's hints that large parts of the population might be making healthier choices about diet, exercise and entertainment (e.g., not smoking). Medicare is even encouraging doctors to have discussions about this with patients before they enter the painful, and expensive, portion of end-of-life care, so that the decisions are made by the patient, not family members under considerable duress. Slow medicine is a philosophy that incorporates these principles.
The House GOP 2012 budget makes sense in one of two ways. Either, they expect their tax structure to create superlative retirement savings for all seniors, that effectively the stock market's capital gains can displace the $38Trillion unfunded liability, or that seniors will chose to purchase less care than the government would provide for free. In other words, by capping the growth of Medicare spending, it guarantees that there simply will not be funds for both quality of and end of life care for beneficiaries, and lets individuals make the choice. Do they have perfect faith in the private sector to do what the government could not, or did the GOP officially embrace Dr. Dennis McCullough?
At first blush, I thought the primary goal of the new GOP majority was to increase upper middle class consumer purchasing power while maintaining social funding for elderly supporters. I also expected them to quickly move away from fiscal discipline and into social wedge issues that inflame more passionate support than actually cutting spending would do. If this new program provides both fiscal restraint and reballances the economy to invest in productivity instead of retirement, perhaps there is something to like about the new Congress. Not that any of this will matter, as recipients of Medicare today will smell a rat as an excuse to cut their services and see to it that it does not happen. Still, your pie maker was perhaps too cynical in his early assessment, and they do deserve credit for putting their careers on the line for a significant, if inadequate and politically unfeasible, change. (I still haven't read the thing in detail, and will have more to say once I do.)
Sunday, April 10, 2011
Voice-Enhancing Chocolate Walnut Pie
Lots of things going on in the world, and your pie-maker has lots of things to say about them. So, to fortify his voice, he concocted the Voice-Enhancing Chocolate Walnut Pie.
Make one double-crust quantity of Louis Pipper's Oil Crust, but use the whole thing for the bottom. Roll it out into a 9.5" deep dish pie plate and prebake at 425F for 10min.
While the crust is pre-cooking, combine:
3/4 Cup light corn syrup
1/2 Cup dark brown sugar
3T butter, cut into small bits
in a small pot (I use a 1qt pot for this). Once the butter is melted, scatter:
2/3 Cup semi-sweet chocolate chips
over the mixture, let sit for a couple minutes to start melting the chocolate, then stir to mix thoroughly. When the pie shell is done, reset the oven to 350F.
In a large mixing bowl combine:
3 eggs
a pinch of salt
and measure, but reserve:
2 overfull cups of untoasted walnuts.
Whisk the eggs until they are just frothy, then pour the sugar/chocolate mix and walnuts in. Stir together just enough to coat the walnuts evenly, and pour the mix into the pie shell. Place in the oven and bake up to 40min or until the center puffs up and the edges solidify.
This pie has also proven to be an effective enhancement for singing voices if eaten with breakfast.
Make one double-crust quantity of Louis Pipper's Oil Crust, but use the whole thing for the bottom. Roll it out into a 9.5" deep dish pie plate and prebake at 425F for 10min.
While the crust is pre-cooking, combine:
3/4 Cup light corn syrup
1/2 Cup dark brown sugar
3T butter, cut into small bits
in a small pot (I use a 1qt pot for this). Once the butter is melted, scatter:
2/3 Cup semi-sweet chocolate chips
over the mixture, let sit for a couple minutes to start melting the chocolate, then stir to mix thoroughly. When the pie shell is done, reset the oven to 350F.
In a large mixing bowl combine:
3 eggs
a pinch of salt
and measure, but reserve:
2 overfull cups of untoasted walnuts.
Whisk the eggs until they are just frothy, then pour the sugar/chocolate mix and walnuts in. Stir together just enough to coat the walnuts evenly, and pour the mix into the pie shell. Place in the oven and bake up to 40min or until the center puffs up and the edges solidify.
This pie has also proven to be an effective enhancement for singing voices if eaten with breakfast.
Tuesday, March 15, 2011
How to Help Libya
A big question floating around the Internet in the western world today is this: How can we help Libya?
This being the season of Lent for most of those in the West, the first and most obvious answer is to pray for them. Beyond that, however, our options are a choice between bad and worse. It would be bad, terrible even, for the rebels to be crushed by an oil-funded autocrat with imported troops. Oh, wait, that's Bahrain. As Mark Mardell and The Conservative Wahoo point out, there is no compelling national interest for the US or any Western country to take the risks associated with, effectively, breaking a country with no transition plan in place, a history (and presumably culture) of involvement in a variety of anti-western groups and
at time when neither the United States nor Europe are in a position militarily or financially to take on rebuilding yet another country.
Instead, we citizens of the US especially can take a somewhat longer view of the Arab Spring and help our fellow humans lead pie-friendlier lives.
Step 1: Ride a bike (or telecommute, carpool, use transit or walk) more and drive less. The resource that pays for most of the autocracy in the world is oil. The less of it we buy, the more governments will have to rely on their own people's productivity which, in turns, means their governments will have to care about their well-being.
Step 2: Tell your Congressman to support domestic drilling for oil and gas. Not because it will do a bit for energy independence, but if our way of life demands that someone bear a resource curse, justice demands that we do so too. If seeing how nasty (link for the pictures more than the text) that is encourages people to consider sustainable alternatives in places where there is also money and incentives to invest, so much the better.
Step 3: Tell your Congressmen to bloody well pass a budget for FY11 and sign on to something like the play approved by the National Commission on Fiscal Responsibility and Reform. The dollar's reserve status has become our own resource curse, and if we want to have a military that can credibly deter threats to peace in the future and respond to natural disasters it is vital.
This being the season of Lent for most of those in the West, the first and most obvious answer is to pray for them. Beyond that, however, our options are a choice between bad and worse. It would be bad, terrible even, for the rebels to be crushed by an oil-funded autocrat with imported troops. Oh, wait, that's Bahrain. As Mark Mardell and The Conservative Wahoo point out, there is no compelling national interest for the US or any Western country to take the risks associated with, effectively, breaking a country with no transition plan in place, a history (and presumably culture) of involvement in a variety of anti-western groups and
at time when neither the United States nor Europe are in a position militarily or financially to take on rebuilding yet another country.
Instead, we citizens of the US especially can take a somewhat longer view of the Arab Spring and help our fellow humans lead pie-friendlier lives.
Step 1: Ride a bike (or telecommute, carpool, use transit or walk) more and drive less. The resource that pays for most of the autocracy in the world is oil. The less of it we buy, the more governments will have to rely on their own people's productivity which, in turns, means their governments will have to care about their well-being.
Step 2: Tell your Congressman to support domestic drilling for oil and gas. Not because it will do a bit for energy independence, but if our way of life demands that someone bear a resource curse, justice demands that we do so too. If seeing how nasty (link for the pictures more than the text) that is encourages people to consider sustainable alternatives in places where there is also money and incentives to invest, so much the better.
Step 3: Tell your Congressmen to bloody well pass a budget for FY11 and sign on to something like the play approved by the National Commission on Fiscal Responsibility and Reform. The dollar's reserve status has become our own resource curse, and if we want to have a military that can credibly deter threats to peace in the future and respond to natural disasters it is vital.
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