The United States is not healthcare nirvana.

A recent newspaper story introduced a young girl with Ehlers-Danlos syndrome to tens of thousands of readers across Ontario and possibly Canada. The story originated at The London Free Press and was carried by many other papers owned by the same chain. The young teen has found it impossible to get treatment in Ontario and the province is balking at paying the out-of-province treatment costs — costs that can easily surpass the 100 thousand dollar mark.

If you didn't see the story, you must be wondering "What exactly is Ehlers-Danlos syndrome?" Answer: It is a group of inherited disorders affecting connective tissues — mainly skin, joints and blood vessel walls. According to the paper, the disorder "affects one in 5,000, only some of whom suffer the worst symptoms." The paper goes on to claim that this translates into about 100 Ontarians with Ehlers-Danlos with 20 of those having symptoms so severe their lives are consumed seeking help from doctors who don’t know what to do.

A little bit of quick, ballpark math says that a province with population of some 13 million must contain about 2600 people touched by the genetic disorder. It is interesting the reporter only discovered 100 known Ehlers-Danlos patients in Ontario. A little googling reveals why: The condition is under diagnosed. Doctors, both in Canada and the States, lack familiarity with it and there is no consensus regarding diagnostic criteria — this revelation is from the American Journal of Nursing.

But what really troubled me was the claim "there is speedy treatment south of the border." Not true. The wait time to see a specialist is often months and if the doctor does not accept insurance, or the patient is uninsured, the cost of treatment in the States may be prohibitive. One American with the disorder wrote, "I do not have insurance, nor can I get it privately. Testing and surgery will have to wait."

Read a comment taken from the newspaper's own Internet site:

"I'm in the US and recently was diagnosed with EDS after being told for 30+ years, on and off, it was all in my head too. I'm so sorry that you have to endure the ignorance of the medical community and the additional pain that comes with all that. I have been waiting for a list of experts from my insurance company in the US for 2 months now ever since my diagnosis. From what I am told, all the"true experts" in EDS are on the East Coast. I live on the West Coast 3000 miles away...like another country away and my insurance may not cover the referrals. This syndrome is probably not as 'rare' as it has been made out to be, just rarely diagnosed. It's time that doctors become aware and learn how to treat it. Keep fighting and keep having faith."

The treatment for Ehlers-Danlos is expensive. The newspaper got this fact right. And the costs are never ending. This can be a painful, genetic disorder keeping sufferers awake at night while giving medical insurance actuaries nightmares. To further complicate the financial picture, the Stateside specialist the young Canadian is seeing is an out-of-network provider.

About Health has this to say about out-of-network specialists: An out-of-network provider is one which has not contracted with an insurance company for reimbursement at a negotiated rate. Some health plans, like HMOs, do not reimburse out-of-network providers at all, which means patients are responsible for the full amount charged by the doctor. Other health plans offer coverage for out-of-network providers, but the patient responsibility is higher than it would for an in-network provider.

Read the Barbara Calder story in The Wall Street Journal: How U.S. Health System Can Fail Even the Insured. Calder has Ehlers-Danlos Syndrome but despite having health insurance she spent a year battling numerous roadblocks just to see a specialist who could diagnose her condition.

According to The Wall Street Journal:

Mrs. Calder's difficulties mirror those of millions of insured Americans who get lost in the U.S. health-care system's giant maze. For many, the journey is frustrated by coverage limits, denied claims and impersonal service.

When Barbara Calder finally succeeded at getting an appointment with a specialist, she learned the doctor had an eight week waiting list. Unfortunately, her husband had lost his job and their insurance was coming to an end. The couple could not afford the $1,267 a month in premiums.

Ontario has to do better. Our health care system needs improvement. In this, the newspaper position is dead-on. But health care heaven is not to be found just an hour or two down the highway.

Just as Canadians seem to be going to the States for treatment, Barbara Calder has been looking outside her home turf for medical help. According to the journal, Barbara Calder has been lobbying her husband and her children to move to Belgium, where she once lived, arguing that they could get good care there cheaply through the country's universal health-care system. One of the leading researchers of EDS is a Belgian geneticist working at the University of Ghent.

Calder's bright hopes for finding help in Belgium might come as a surprise to EDS patients living in the small, European country:

Every day is a kind of fight against the pain, the fatigue . . . but also against the institutions when you try to obtain support to cope with the disease". — Florence Simonis, president of the Belgian GESED (Groupe d'Entraide des Syndrômes d'Ehlers-Danlos — a support group for Ehlers-Danlos patients). She suffers from Ehlers-Danlos syndrome (EDS) herself.

A must read for those concerned with the state of journalism

The Sad Story of Canadian Geographic

Former employees say the nature magazine became a paid mouthpiece for oil companies and others.

Pizza that adhers to Weight Watchers guidelines

This thick layer of artichokes, sweet peppers, mushrooms and pepperoni is sitting a a pizza.

Dr.Oetker pizzas often go on sale. One can pick up the doctor's four cheese pizza for just under three bucks. My wife and I like to stock-up whenever we get a chance. We use these pizzas for the base on which to build our own Weight Watcher friendly pizzas every Tuesday night: our Pizza night.

One half a pizza, two slices, of our enhanced Dr. Oetker pizza is 14 points. That's a lot of points but not crazy high. We watch our points during the day, taking care to leave some head room, or in this case stomach room, for the pizza.

I add lots of mushrooms - no points, sweet peppers - again, no points, artichokes - no points, pepperoni - one point and hot pickled peppers - no points. Our pizza is filling, healthy (low in cholesterol and saturated fat) and delicious. (I precook the mushrooms, sweet peppers and pepperoni. This cuts down on the fat and removes some of the excess water from the vegetables. The hot peppers and artichokes go straight onto the pizza.)

Can we really afford to have this pizza once a week. I can't afford not to. I weighed about 215 pounds when I started eating Weight Watchers friendly meals with my wife. Today, I weight just under 170 pounds. My waist has dropped from 41-inches to about 37-inches. I may have to buy a new belt. I've tightened my present belt to the point that I'm running out of holes. I don't want to lose too much more. Please, pass the pizza.

Tasty can be healthy

Not a fine photo but it was a fine dinner. Maybe I'll get a better shot next time.

I don't recall how I discovered Elena Paravantes' blog Olive Tomato but as someone who regularly enjoys Mediterranean cooking I have found her blog inspirational. A recent post encouraged readers to quickly fry sliced zucchini and serve it warm with sprinkles of parsley and feta cheese. The picture that Paravantes posted made her zucchini look quite appealing. Inspired, I decided to use a both yellow and green zucchini as a side dish.

My wife and I are trying to adhere to the diet advised by my heart and stroke doctor while also trying to adhere to a Weight Watchers-friendly diet. This dinner met both requirements: low in fat, low in cholesterol as there's neither meat nor eggs but lots of fresh vegetables. This dinner delivered a Weight Watchers low point total.

The star of this dinner was potato gnocchi. At a little over 100gms per portion, the gnocchi contained only four points. It was boiled until it rose to the top of the bubbling water. After a minute it was removed using a slotted spoon.

Meanwhile the small tomatoes were fried in a little olive oil seasoned with finely diced garlic . The zucchini was fried in the same pan at the same time. Two minutes on each side in a very hot fry pan was enough for the zucchini. The tomatoes were removed when the skins began to split. Both vegetables were placed on waiting dinner dishes.

The chopped asparagus was tossed into the hot fry pan with a little more finely diced garlic. After a minute the gnocchi was added to the pan with the asparagus. At this point about 90 gms of Alfredo sauce diluted with an ounce of the gnocchi water was added. The sauce immediately began bubbling, thickened, and coated everything in the pan. A couple of tablespoons of chopped dill were stirred in and the mixture spooned onto the dishes with the zucchini.

While I cooked the gnocchi and asparagus my wife sprinkled parsley and feta cheese on the hot zucchini and tomato. Next, she sprinkled a little grated Parmesan onto the still hot food. With a small glass of wine, this dinner came in at only 15 points. It may have been even less. The only cholesterol was in the small amount of cheese and the light cream used in the sauce.

I have been eating like this for a little more than a year. I had my arteries checked a couple of months ago and the plaque has diminished. Of course, I am also taking some powerful drugs and so it is impossible to say to what extent the Mediterranean diet has been responsible for the improvement.

There is one improvement that I can credit to my new eating habits: My weight. I've lost some 45 pounds.

Treasures

Originally I posted this image on Facebook and Google+ but now I'm sharing it here as well.

There has been about twice the normal amount of rain this June. It has forced me to stay indoors with my youngest granddaughter. Last Friday I had had enough. I decided to take Isla, 2, outside to show her some temporary treasures created by the stormy weather.

Treasures is the term my grandchildren use for beautiful, found objects. In this case, the treasures were the drops of water beaded up on the plants and flowers surrounding our home. Although we could not stuff these treasures into granddad's pocket, we could capture them with his camera.

Wearing her biggest, highest boots and a raincoat with hood, my little 25-month-old granddaughter wandered about the yard seeking treasures that might "make a picture." She would point and I would aim the camera. When she was happy with what she was seeing on the large monitor on the camera back, Isla would snap the picture. She shook with excitement every time she saw the image she wanted appear on the back of the camera. 

We stayed outside until both of us were dripping with water like the foliage and flowers we had been shooting. Oh, how I wish someone had been there to take a picture of us. I think, for me, that picture would have been a treasure.

Can food be art?

Can food be art?

A piece in the New York Times, widely quoted on the Internet, states unequivocally that beautifully prepared and presented food is not art. I beg to differ.

Taking my inspiration from R.G. Collingwood, I have no problem calling some food creations art. For a short summary of Collingwood's work in aesthetics please read the entry in the Stanford Encyclopedia of Philosophy. It will quickly become apparent I play fast and loose with Collingwood's ideas.

For me, I make a quick and easy divide, placing art on one side and craft on the other. Art requires creativity and the results are often unique. Craft, on the other hand, demands skill and the resulting product is cranked out repeatedly.

Most people can appreciate craft (skill) and they like their art (creativity) mixed with craft as well. This is why Jackson Pollock just doesn't cut it with many people. His work may be creative but "a child could do it." Pollock's splatter approach to art, to these viewers, doesn't appear to require a finely honed skill.

The creation of a new food dish is, in the beginning, an act of craft driven by art or creativity. But once an artistic result is achieved, then craft, the skill of being able to duplicate the artistic work, quickly becomes the force pushing the entire endeavor forward. Great chefs are both artists and craftspeople. They develop unique dishes and then prepare them on demand.

I had this at the Blackfriars Bistro.

Take the cold, potato salad I make. The olive oil used is the result of both an art decision and a craft decision. My goal is to delight the sense of taste and I want to do it repeatedly. My personal favourite oil for this salad is one from Provence in the south of France. It has a very light flavour that doesn't mask the flavour of the potatoes. This oil is dependable when it comes to its flavour and thus the resulting potato salad is at once satisfying and yet holds no surprises -- at least, not for those who have enjoyed it before.

I often serve meals that are high quality when it comes to craft but are partial failures on the artistic side. Why? These dinners taste great but fail to impress the eye. A great dish ripples across one senses like a hand playing chords on a piano. A perfect dish delights the eyes, teases the nose and surprises and satisfies the taste buds. Restaurant chefs have perfected the skill of the presentation.

And with this post, I am now ready for my meeting with a lady from the art gallery here in London, Ontario. Apparently the gallery is about to mount a show featuring food and I have been invited to give some input. I believe I can now argue food can be art but, as is true with a lot of art, many people insist on a good smattering of skillful craft with their art.

Pluck must be partnered with a moral compass

According to Larry Cornies, Canadians have become "weak-kneed." We lack "political pluck." Cornies writes:

My, but what weak-kneed nation builders we’ve become.

Forget the formidable challenges that faced our forebears: stitching together a new federation from scattered and diverse colonies, or building a transcontinental railroad, or aspiring to be a nation that would one day stand upright, on its own, on the world stage.

Forget all that. These days, the prospect of merely reforming and renewing the upper chamber of our bicameral parliament is enough to make us cower like frightened turtles.

Cornies tells us, "the nation builders . . . seldom flinched when it came to difficult political negotiations or the job of building a better Canada . . . "

Wow! I thought flinching was in a politician's job description. When I started looking into our Canadian forebears, I found more flinching was the least of their crimes. Our forebears are no better than the folk in power today and possibly quite  a bit worse. I posted something on this -- No saints found despite newspaper's praise.

I learned Sir John A. Macdonald was a shakedown artist. A plucky shakedown artist but still a shakedown artist -- a crook. The following is from a page posted by the Canadian government.

In April 1873, the government of Sir John A. Macdonald was charged with accepting illicit funds from Sir Hugh Allan. In return for these payments, Allan was assured that he would be awarded the lucrative contract to construct the transcontinental Canadian Pacific Railway. When evidence of the agreement was made public by Opposition members of Parliament and published in newspapers across Canada, the episode became known as the "Pacific Scandal."

A telegram from Macdonald to Allan's legal adviser read: "I must have another ten thousand; will be the last time of calling; do not fail me; answer today."

This is not to say Macdonald didn't achieve a lot of good. He did. After all he was one of the Fathers of Confederation. But he also did a lot that was bad. We should not forget this as Larry Cornies appears to have done.

But, when I think of important Canadian forebears, I don't think just of politicians but I also think of all those wielding power outside the political arena. For instance, I think of the chap Sir John A. was shaking down, a fellow by the name of Sir Hugh Allan. Hugh Allan is most certainly a Canadian forebear and a very determined one. Allan had pluck (spirit and resolve). Unfortunately, he didn't have a working moral compass. At the very least, he ignored it.

Richard J. Gwyn in his book, Nation Maker: Sir John A. Macdonald: His Life, Our Times 1867-1891, tells the following story: During a dinner at her home, Lady Macdonald asked Sir Hugh Allan for a donation for her church. "You can't take it with you," she told Allan. From the other side of the table her husband, Sir John A. Macdonald, quietly added, "It would soon melt if he did."

Curious as to who this fellow Allan was and why he enjoyed dinner at Macdonald's home, I began to read biographies on Allan. The words associated with Allan paint a sad picture: scandal, stock manipulation, haphazard bookkeeping, unwarranted dividends, debt, bribery . . . .  Allan called the rumours surrounding him "absurd" and "senseless." I suspect many, including Macdonald, would not agree.

Another term appearing again and again is "political patronage." Sir Hugh Allan controlled Canada's second largest bank. But Allan controlled more than the bank; Allan controlled influential people. For instance, the ex-finance minister John Rose was the bank’s London solicitor, in 1866 the future prime minister of Canada J. J. C. Abbott was kept on a $1,000 annual retainer as the bank’s Montreal lawyer and in 1883 both Sir Charles Tupper and Sir John A. Macdonald were special solicitors for the Winnipeg branch. Well known politicians pop up time and time again on the bank's employment rolls.

And the bank had another way to keep politicians on a tight leash: debt. For instance, Sir John A. Macdonald was probably the bank’s most prominent debtor.

Allan's corrupt ways spilled over to stain the manner in which employees were treated. A Royal Commission revealed the oppressive exploitation of workers by Allan. Many of the longshoremen employed by the Allan Line fleet of ships were compelled to work 30 to 35 hours at a stretch for the wretched wage of 20 cents an hour. Plus, the Allan Line, according to the Commission, retained one per cent of the workers' wages to provide the employees with insurance from Citizens’ Insurance Company. A company that had Sir Hugh Allan coincidentally at the helm.

The commission found that the longshoremen of the Allan Line paid a premium equivalent to an annual premium of $9.12 for protection lasting no more than ten hours a day during 365 days. Better coverage could be obtained elsewhere for $8.75, payable per quarter, and providing coverage for not only accidents happening during the ten hours of the work but all the accidents that could happen during the twenty-four hours of the day.

Sir Hugh Allan: a Canadian forebear. And sadly, he is but one embarrassment among many.
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Some links to other Internet sites dealing with this topic:
Chartered Libertine? A Case Against Sir John Macdonald and Some AnswersA History of Canadian Wealth/Chapter XII
Charles Tupper and his "reputation for parliamentary blather"