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Showing posts from January, 2011

The Tragedy of the Ten-Million Acre Bill

I readily and, I trust, feelingly acknowledge the duty incumbent on us all as men and citizens, and as among the highest and holiest of our duties, to provide for those who, in the mysterious order of Providence, are subject to want and to disease of body or mind; but I can not find any authority in the Constitution for making the Federal Government the great almoner of public charity throughout the United States. To do so would, in my judgment, be contrary to the letter and spirit of the Constitution and subversive of the whole theory upon which the Union of these States is founded.Franklin Pierce, in his veto of the 1854 Bill for the Benefit of the Indigent InsaneThough forgotten today and though issued by a one-term president whose name is synonymous with Oval Office mediocrity, the veto of the Bill for the the Benefit of the Indigent Insane became one of the most long-reaching vetoes in the history of the presidency. With it, Franklin Pierce derailed an early attempt to define a w…


I'm kind of embarrassed to say where I got this recipe from.... okay well you know how some mystery novels have recipes? Yeah. There. Apparently when ones reading about donuts you start to crave it. I guess I could have just gone out to a shop and bought one to settle the craving for them right then and there but when I see a recipe for fast easy donuts? I'm all for it.

Easy Raised Donutsfrom the book Sinister Sprinkles
2 pkg fast raising yeast 2 1/2 tbsp granulated sugar 1 cup water 1 egg beaten 1/3 cup butter, melted 1 tsp vanilla extract 1 tsp cinnamon 1 tsp nutmeg 1/2 tsp salt 3-4 cups flour
In a bowl mix the yeast, sugar and water. Let sit for five minutes for the yeast to activate. Add the egg, butter, cinnamon, nutmeg, vanilla and salt and mix well. Slowly add in the flour until it's not sticky to the touch. Knead the dough for a couple of minutes. Roll out the dough to about 1/4 to 1/2 inch thick and cut out donut shapes and lay them on a baking sheet to raise for 30 minutes.…

Country Profile: Belgium

Population 10,400,000

Government Federal parliamentary democracy

Health Care Model Bismarck

GDP 395B (2010 est.)

%GDP spent on health care 9.5

Per capita income $37,900

Health care expense per capita 3,563 (adj.)

Health care expense per capita normalized to income of 50K 4,700

Life expectancy (m/f) 77/82

Health life expectancy (m/f) 69/73

Goals: Increasing access, ensuring quality of care, sustainability of systemUniversal accessChoice of providerBroad set of benefitsMix of public and private fundingEconomic efficiency of delivery comparable to other European nationsRegulated at national levelPreventive care and health promotion delivered at regional and community levelsStructure
The Belgian health care system is organized around a "principle of solidarity" that recognizes no distinction between rich and poor, healthy and sick, with no selection of risk. Based on the Bismarck concept of social insurance, the system covers more than 99% of the Belgian population with more than 8…

To Live Longer: Don't Smoke, Eat Less, Exercise More

According to a National Research Council report, Explaining Divergent Levels of Longevity in High-Income Countries, life expectancy in the United States continues to increase, but at a slower rate than in the past. The most likely culprits are smoking and obesity; the latter may account from 1/5 to 1/3 of the reduced rate. According to the CIA World Factbook, the United States currently ranks 49th in the world in life expectancy. (Monaco, at nearly 90, is first.)

To learn more about life expectancy, click here.

In another study, Circulation: Journal of the American Heart Association reports that the costs of heart disease are expected to triple over the next twenty years. Combined costs in dollars and lost productivity are expect to rise from $445B today to $1.094T.

Principles of Efficiency

So why is it that other countries deliver health care with greater economic efficiency than the United States?

For starters, it would be hard not to: The United States doesn't really have a health care system. It's a more like a fragmented, uncoordinated apparatus linked by a loose and often contradictory regulatory framework and characterized by both overtreatment and undertreatment. An onerous administrative burden, health care driven by profit and not value, and the absence of several vital traits of an economically efficient system combine to give the United States the most expensive health care in the world, although by no means the best.

What are some of those key traits? Let's look briefly at two systems that are efficient, despite diametrically opposed approaches to universal access. The health care system of Finland (%GDP on health care of 8.5%, HCE of 7.6) is government-owned and -operated -- classic Beveridge Model socialized medicine. Singapore (%GDP on health of…

An Act for the Relief of Sick and Disabled Seaman

In 1798, President John Adams signed the United States' first health care reform law -- An Act for the Relief of Sick and Disabled Seaman. The law authorized the creation of a government operated marine hospital service and mandated that privately employed seamen purchase health care insurance. Attorney and health care journalist Rick Ungar explains the law here. Click here to read it in its entirety (believe it or not, the law is but a little over a page long).

Which Country Has The Most Efficient Health Care System?

This is a raw measure, but useful for comparison purposes. I've taken the Healthy Life Expectancy of 25 countries and divided it by their % of Gross Domestic Product spent on health care. This yields a result equal to the number of healthy years purchased by each per cent of GDP spent on health care. Let's call it the Health Care Efficiency Ratio:

HCE Ratio = Healthy Life Expectancy / % GDP Spent on Healthcare

Healthy Life Expectancy (HALE) is a statistic devised by the World Health Organization, defined as the "average number of years that a person can expect to live in 'full health' by taking into account years lived in less than full health due to disease and/or injury." HALE is always less than full life expectancy, typically by 7-9 years. (To read more about HALE, click here.)

For example, Norway spends 8.4% of its GDP on health care, and Norwegians have a HALE of 73:

HCE = 73/8.4 = 7.8

In Norway, each per cent of GDP spent on health care purchases 7.8 years …

beat the cold

I have to tell you I've made this time and time again. It's just one of those comforting dishes that's doulbly hearty and best eaten on a snowy cold day, (mostly like the days we've been having too much of!) a day where you just want to curl up with a bowl of something hot and let it melt the chill away. No more snow... please?
chunky veg soup recipe adapted from Donna Hay
1 tbsp olive oil 1 onion, chopped 2 cloves of garlic, chopped finely 2 stalks of celery, chopped 3 carrots, chopped 1 tbsp fresh thyme sea salt and fresh ground pepper 2 x cans of chopped tomatoes (14oz) 1 1/2 litres of water or stock 1 cup of pasta (your choice)
In a large sauce pan over medium heat add the oil, onion, carrots, celery, garlic, thyme and salt and pepper and cook until just soft. Add the tomatoes and water and simmer for 15 minutes. Add the pasta and cook for another 8-10 min. Serves 4-6.

Country Profile: Australia

Population 20,000,000 (primarily urban)

Form of Government Parliamentary democracy

Economic System Capitalist

Health Care Model National Health Insurance (Medicare)

GDP $890B

% GDP spent on health care 9.7

Per capita income $38,420 (2006, adj US $)

Health care expense per capita $3,528

Health care expense per capita normalized to income of 50K $4,591

Life expectancy (m/f) 79/84 (as of 2006)

Healthy life expectancy (m/f) 71/74

Goals: Equity, efficiency, and qualityTax fundedReady accessGenerally cost-effective, good outcomesHigh level of public supportConcerns about long-term sustainability due to rising costsDisagreements about funding and accountability between national and state governmentsWaiting lists for elective surgeryDisparities in urban and rural careContinuing poor health of indigenous populationStructure The Australian health care system is a mix of public funding and public and private care. The national government's role is limited to funding and formulating health policy…

handmade cards

Hey guys, just thought I'd give you a little glance of what I've been working on today. I finally had a Sunday off, which doesn't happen quite often, and I spent my time doing a little of this and that catching up on things. Then I got board and decided to make some cards for Valentines. I love how they turned out! If your thinking of making some Valentines cards but have no one to give it out to? I was over at EverSoLovely and she has a fun Valentines Exchange going on over on her blog right now. So fun!

P.S. I do have a awesome rustic chunky veg soup lined up for the next post. Can't wait to share it was so good and pretty healthy which we all know is always a nice plus.

winter granita

Why a frozen dessert in the middle of winter? Clementines. Yes, clementines. I know this is a dessert worthy of ripping out on a hot summer's day but these clementines had to go somewhere and I don't know about you, but I had tons this holiday. I was eating them left right and centre then I think I slowly got sick of them because I was no longer reaching for one. But hey, can't let them go to waste. So why not make something just a little special and frankly I have never made granita before and I figured I'd give it a go.

recipe800g fruit pureed or 800 ml of fruit juice for the base syrup 300 ml of water 100 g sugar Simmer over medium heat until the sugar is dissolved, then allow to cool before adding the fruit juices. Feel free to add other flavors like lemon, lime or even vanilla or lavender, which ever you fancy. Pour the mixture into a shallow baking dish and let set in the freezer for 2-3 hours. Take it out and scrape it around with a fork while it's sti…

The National Health Insurance Model

The National Health Insurance model places a foot in both the Bismarck and Beveridge camps. Like the Bismarck Model, it is insurance-based; like Beveridge, it is single payer. The most familiar application of National Health Insurance to Americans is Medicare: Employer-employee contributions are used by the federal government as an insurance fund. The government in turn pays private providers. That's the essence of the NHI model.

Because the government is the sole payer, it can exert tremendous bargaining influence on the prices of medical services and drugs. That's why Canada -- whose Medicare system is the most well-known version of NHI -- has cheap drug prices that lure Americans north of the border even though it is illegal to purchase prescription medication abroad. NHI countries generally control costs by limiting the services they will pay for and by limiting the availability of certain services, thus creating the lengthy waits for non-acute secondary care.

Therein lies t…

Preventable Deaths

Of the top five countries, France and Japan provide health care via the Bismarck Model, Australia uses National Health Insurance, and Spain and Italy use the Beveridge Model.

Getting Health Reform Right

Peter Berman, William Hsaio, Michael Reich, and Mark Roberts -- authors of Getting Health Care Right: A Guide to Improving Performance and Equity -- have consulted around the world helping countries design health policies and systems. (Hsaio was an instrumental figure in Taiwan's adaptation of National Health Insurance in 1995.) Over the years, the group has developed ten guiding principles for reformers:

Clarify goals and values. A health care systems is a means to a number of ends, and it's vital to articulate precisely what those ends are. Moreover, they must be achievable in a context that is both politically feasible and ethically sound.Diagnose the root problem -- honestly. Work backwards from a problem until you've have identified its source, which might be anything from costs to corruption to apathy to ignorance of public health.Build health systems, not just medical systems. A effective health care infrastructure is horizontal, based on prevention driven by funded …

The Bismarck Model

In 1883, the reactionary German chancellor Otto von Bismarck, a Prussian autocrat through and through, proposed the health care model that came to be adopted by many European nations and that echoes decisively today in the American health care apparatus. Though no social reformer, Bismarck viewed universal health insurance as an effective tactic in his grand design for German unification, which trumped his conservative tendencies. What has come to be known as the Bismarck Model survived the German militarism of World War I, the unstable democracy of the Weimar Republic, Naziism, World War II and its aftermath, and eventual reunification. Its durability cannot be doubted.

Today, the Bismarck Model serves as the predominant means of guaranteeing universal coverage in Europe, used in Germany, France, Switzerland, Belgium, Netherlands, and others. (Japan is also a Bismarck Model country.) The implementation varies, but all mandate insurance in one form or another. In Germany, for example, …

A new year...

Wishing all you lovely people out there all the best in this new year!! And a big thanks to all my readers, you are what keeps me going! So has anybody set resolutions for themselves? So far two resolutions I have this year are to push myself to keep doing the things I love, even when things get rough, and more simply is to post more up on the blog and pictures... take lots of pictures. Okay, maybe that's three, but these are three that I'm sure I can stick to!
Here's to an amazing 2011!