Thursday, August 21, 2014

we have lift off!

saying goodbye

My oldest daughter left for college today. She's flying back East to go to school at the University of Massachusetts. That's half-way across the country from us here in San Antonio.
We're so very proud of all she's accomplished and the young woman she has become.

"we have lift off!"

For me, parenting culminates in the moment when you know your kid doesn't need you any more. She's not quite there yet - she's still in our gravitational orbit, but today marks a major departure - we have lift off, as the good folks as NASA say. She is on her way. 

Now, here are my directions to my daughter: take the second star to the right, and head straight on until morning. Just because childhood is ending doesn't mean you have to ever grow up.

Monday, August 11, 2014

we're social animals

Kandie and I often talk about how people need to belong to something and feel noticed and appreciated.

I like this post from Robin Hanson, one of my former professors at GMU about being part of something bigger than yourself - and just exactly what does that mean?

He says:
Here’s my interpretation: We want to be part of a strong group that has our back, and we want to support and promote ideals. But these preferences aren’t independent, to be satisfied separately. We especially want to combine them, and be a valued part of a group that supports good ideals.
So we simultaneously want all these things:
  1. We are associated with an actual group of people.
  2. These people concretely relate to each other.
  3. This group is credibly seen as really supporting some ideals.
  4. We embrace those ideals, and find them worth our sacrifice.
  5. Our help to this group’s ideals would be noticed, appreciated.
  6. If outsiders resist our help, the group will have our back.
  7. The group is strong enough to have substantial help to give.
  8. The group does’t do wrongs that outweigh their ideals support.
  9. Both the group and its ideals are big in the scheme of things.

The whole thing is interesting. And his blog is quite good.

Saturday, August 9, 2014

Why you might work to improve the very thing you’d rather blow up

I find myself thinking this, too! Not about zoos but about being a government employee when its clear the government is the source of so much dysfunction in our society.

Whether or how to engage with an institution (like zoos) or policy area
(like Medicaid or CIA interrogation techniques) that one may find
broadly distasteful or fundamentally, structurally flawed is something
many of us face. In the hopes of speeding its demise, one could protest
and boycott, withholding expertise that might lead to marginal
improvements. A related variant is proposing radically different, yet,
to one’s point of view, far better alternatives. This makes sense to the
extent one’s protest or radical proposals will really change things.
One has to ask oneself: Honestly, will they? That depends on who one is,
perhaps, as well as a host of unknowable factors—the alignment of the
political and cultural stars. What if the most likely outcome is no
effect, maintenance of the status quo? Oops.

Another approach is to engage in an effort to make small, more attainable improvements. 
rest: Why you might work to improve the very thing you’d rather blow up

Walmart enters Primary Care Market

Walmart is entering the primary care market directly with company owned clinics in stores. In the past they've provided space for clinics that were not company owned. But now they are introducing their own clinics.

Cash price is $40 for a primary care visit. That's what the market can bring you.

For employees it will be $4.

This fits neatly with the idea of paying for primary care out of pocket as I discussed yesterday.

As usual, all I can say is I love Walmart because it's done more for poor people than all the charities in the world ever.

Friday, August 8, 2014

paying for primary care

I like the way this blog post expresses the problem of health care cost:

Today insurance purports to pay for all of this when in reality insurance should only be for the major medical and the catastrophic; the last three inches. That’s the whole point of insurance, to deal with the unexpected highly expensive events in life like a car crash or a house fire. Since today’s health insurance covers essentially everything, it is very expensive. A major medical/catastrophic policy on the other hand is not cheap but is much, much less expensive.

Consider a bronze plan with a $6,000 deductible. In Maryland it would cost a 55-year-old $3,660. The platinum plan with no deductible costs $7,728 — more than twice as much. What is the $4,060 difference paying for? Primary care. But primary care never needs to cost that much. It will cost even a lot, lot less than now if the system is turned upside down so that the PCP is paid to deliver high quality in a caring, relationship-based model. When the PCP has enough time with each patient, he or she can give excellent care, avoid unnecessary referrals to specialists and unneeded prescriptions and do so at a reasonable cost.
(rest here:

My reading on concierge medicine so far indicates that in most markets you can get coverage from a concierge practice for about $100/month - $1,200/year. Compare that the $4,060 provided by the ACA's insurance. Some practices charge more, some less. But all concierge practices provide more humane care. No six minute visits with the provider.

As I've said before, you wouldn't add "gas insurance" to your auto insurance. The cost would be absurd. Your auto insurance pays for unexpected costs. Gas is predictable, just like eye exams. And yet this is exactly what the ACA has mandated for everyone.

I like the idea of eliminating primary care from insurance. That seems like a simple way to draw the line between catastrophic and predictable.

This isn't an issue of wealth or poverty. Medicaid could continue to pay for primary care. We just need to recognize that Medicaid isn't really insurance. Medicare, as originally conceived (i.e., Part A) recognized the need for catastrophic coverage. It's Part B where we start to go down the death spiral.

Wednesday, August 6, 2014

bread and fire

It's wicked hot - Texas hot - here in Texas, in August.

So tonight when I decided I wanted to bake bread, I decided to try to honor my Sicilian grandmother and try to bake bread over a fire.

bread on the grill

I started with a dough made with wheat flour and olive oil (and yeast and salt).

bread on the grill

I let it rise out in the sun, covered by an old dish towel.

bread on the grill

Then I put it on my grill, on a pizza stone, with indirect heat for about 45 minutes.

bread on the grill

It came out quite nicely. I wrestled with the temperature some - but eventually I think it was about right.

Food puts us in touch with our past and our future. It's a shame how little we tend to think about it.

Monday, August 4, 2014

and they're off!

I finally got back to Retama Park. I completely missed all of the racing last year and I've been dying to try my new gear (D300S and better lenses).

Retama Park Horse Races

I've only been to the races a few times and still don't know much of anything about them.

Retama Park Horse Races

what I appreciate about the races is the pageantry - the color, the stateliness of the animals

Retama Park Horse Races

Preparing to mount

Retama Park Horse Races

the people in purple help the jockeys guide their horses to the start

Retama Park Horse Races

And they're off!

Retama Park Horse Races

Retama Park Horse Races

Retama Park Horse Races

Retama Park Horse Races

Retama Park Horse Races

It's a messy business

Retama Park Horse Races

the sun is gone, but there is time for one last run.

Retama Park Horse Races

once more into the breach...

Retama Park Horse Races Retama Park Horse Races