The Bad, the Less Bad and the Good

Greetings comrades.  How are you on this glorious road to autocracy and permanent republican rule?  Georgia has purged Black Democrats from its county election boards.  Sunday voting, formerly known as Souls to the Polls, has been banished.  They're ensuring that any election whose results they don't like can be overturned.  You can read more about these awful people here.  It's a knowable thing that what they are doing is wrong, and yet they are doing it anyway.  A not insignificant part of our decision to relocate to a blue state was how awful the republicans are becoming.

The Hill has a horrifying article on a change that is being made to Medicare.  It affects people who sign up for regular Medicare and not Med-Advantage.  Without buy-in from Congress or the old people of America, the Trump administration did this.  I am extensively quoting from the article.

...starting this year, millions of seniors are quietly being enrolled into a program run by third-party middlemen called Medicare Direct Contracting (DC). This is occurring without their full knowledge or consent. If left unchecked, the DC program could radically transform Medicare within a few years, without input from seniors or even a vote by Congress.

Developed late in the Trump administration, the Medicare DC program allows commercial insurers and other for-profit companies to “manage” care for seniors enrolled in Traditional (fee-for-service) Medicare. Instead of paying doctors and hospitals directly for seniors’ care, Medicare gives these middlemen (called Direct Contracting Entities, or DCEs) a monthly payment to cover a defined portion of each seniors’ medical expenses. DCEs are then allowed to keep what they don’t pay for in health services, a dangerous financial incentive to restrict and ration seniors’ care.

A majority of seniors choose Traditional Medicare over Medicare Advantage, the version of Medicare run by commercial insurers, because they value having free choice of providers and the power to manage their own care. But under the Medicare Direct Contracting program, older Americans who actively chose the popular Traditional Medicare program are automatically enrolled into a Direct Contracting Entity without their full knowledge or consent.

Seniors in Traditional Medicare may be “auto-aligned” to a DCE if any primary care physician they’ve visited in the past two years is affiliated with that DCE. That means Medicare automatically searches two years of seniors’ claims history without their full consent to find any visits with a participating DCE provider as the basis for enrollment. It’s no wonder that the current DC pilot phase includes potentially 30 million Traditional Medicare beneficiaries enrolled in 53 DCEs across 38 states.

So, you wonder, who are these people who want to be doing the Direct Contracting?  "Virtually any type of company can apply to be a DCE, including commercial insurers, venture capital investors, and even dialysis centers. In fact, applicants are approved without oversight from Congress. Unlike other care management models, there isn’t even a requirement that DCEs be majority owned by health care providers."  Wall Street investors are falling over themselves trying to get in on this gravy train.  Why this level of interest, you wonder?  "While Traditional Medicare spends an impressive 98 percent of its budget on patient care, Direct Contracting Entities only spend 60 percent of our tax dollars on patient care — keeping up to 40% of revenues for their own profit and overhead."  This is more perfidy and malfeasance emanating from the administration of the orange ectoplasm.

There is another article, referenced by The Hill article, that gets into the weeds of the details.  I'll have to take notes in order to comprehend it all.  Suffice it to say, this is bad.  Call your congress person.

Is anyone else noticing that saves are taking forever in Blogger?  Some fail, and others have the rolling donut for a long time.  It gives me the willies when saves fail.

An Amazon package arrived recently.  This was on the side of the box.  It's sort of cute.  Having had cats in the past, their love for a good sleeping box was always amusing.

It's getting colder.  We bought some Darn Tough wool socks, made in Vermont.  The Smart Wools are way warmer, but they're thick.  They work in my hiking shoes and my Merrell ThermoChill boots, but they make the Hokas a little snug.  The Darn Toughs are better in the Hokas, but then my feet are a little chilly.  Are they not adorable?  Learning to live in cold weather is a process.

Jim has decided he will learn to bake bread.  I can be of no help in this endeavor because I hate baking.  I'm not good at it and no project involving yeast has ever succeeded for me.  Here he is mixing dough for no-knead bread.  It sounded simple enough, but the recipe called for active yeast dumped in with the dry ingredients.  This article clearly states that active yeast must be activated by mixing it in with warm water.   So, I wonder if we used an incorrect type of yeast.  The recipe also said rise for 6 to 8 hours.  You can probably tell by now that things did not go well.

Here is Jim transferring the risen dough onto floured parchment paper.  We would have been better off doing it on the counter because it stuck to the paper.  It did not rise long enough.  Getting it into a small, tight ball for its final rise was not happening, it was more of an amorphous mass.  Our other recipe deviation was not putting my Lodge enameled cast iron dutch oven to preheat to 450 degrees with nothing in it.  Too many internet warnings of cracked enamel, and I just could not do it.

Here is the amorphous mass going into the oven.

Some recipes called for the internal temperature to be 220 degrees when done.  That was not a good temperature, that would be called burned.  Now we know to go with the voices that call for 200 degrees.  We learned a lot.  The Le Creuset website has a recipe that does not require preheating an empty vessel to 450.  They pretty much tell you not to do that.  They also want Instant yeast not Active.

Returning to the article I referenced, there is Instant Yeast, and Rapid Rise Fast Acting Instant Yeast.  All we can find in the store is the Fast Acting, which the article says is not suitable for long rise bread.  The no knead can go 12 to 18 hours.  Of all the things that I thought would be difficult about making bread, it never occurred to me that it would be the dang yeast.

Here is a gratuitous picture of a Christmas tree ornament.

In news of the good, the gas log fireplace is working again.  The gas valve was installed today.  Also we learned that the flame will burn during a power outage.  The fan won't work, but it will radiate heat at us.  That's a good thing.