Saturday, March 9, 2013

Better preparation for a bitter pill

About two weeks ago, TIME magazine published a seminal article titled "Bitter Pill:  Why Medical Bills Are Killing Us", which was authored by Steven Brill.   
Low-res screengrab from this site
Plenty of recent commentaries have described the state of America's medical system, but this one is different because the author successfully avoided the pitfall that dooms most such digests: a resigned ambivalence regarding the status quo.  Most commentators acknowledge that the current systems sucks, but that doesn't stop them from drinking the benzo-laced Koolaid and concluding that our collective situation represents a necessary evil that we all just have to shut up and live with.  This unimaginitive conclusion effectively nullifies any valid criticism those authors may have generated in their initial analyses. 

Brill does it differently, by focusing on the numbers rather than on the philosophy behind those numbers, and by asking the obvious resultant question: why aren't the market efficiencies of supply and demand working normally in this economic sector?  Let's not get mired in the bottomless pit of debate about whether American medicine should be a for-profit industry - let's just accept that it is (even when it is ostensibly termed "non-profit"), and evaluate the results accordingly. 

What falls out of the resulting analysis is nothing short of shocking.  It was so unsettling that I was only comfortable reading Brill's eleven-page article in small bites.  This was my pattern:
  1. Read the first two pages.
  2. Set the article down and go for a 2.5 mile jog around Centerpointe.
  3. The following day, read the next two pages.
  4. Set the article down and go for a one-hour yoga class.
  5. The following day, read the next two pages.
  6. Set the article down and cook a large quantity of a healthy one-pot beans and rice dish for my family (recipe to follow).
  7. The following day, read the next two pages.
  8. Set the article down and begin writing a blog post about it. 
Rather than focusing on the absolute nightmare that Brill's research describes or on the far-reaching implications for all of us (including for everyone who does have health insurance), I thought I'd focus a couple of posts on my responses to that absolute nightmare. 

In other words, why dwell on steps 1, 3, 5, and 7 which I can't do anything about, when instead I could use step 8 to talk about steps 2, 4, and 6 which are all under my direct control? 
  • The best way to cope with any unfair burden that life thrusts upon you is to simply side-step that burden. 
  • The best way to cope with America's failing medical system is to side-step the system by minimizing the extent to which you need to avail yourself of that system.
  • The best way to minimize your use of the American medical system is to remain maximally healthy.
  • The best way for most people to remain maximally healthy is by engaging in a lifestyle that helps to prevent disease by optimizing health, a lifestyle of which diet and exercise are enormous components.
Short version:  If you want the recipe for the tasty beans and rice dish I mentioned above, you have to slog through all this preachy preamble. 

When life hands you lemons in the form of a medical system that destroys the financial lives of many of the same people whose physical lives it paradoxically saves, make lemonade.  Make a really rich and healthy beans and rice dish that you can store in your freezer without significant loss of quality.  It might not sound like much of a push-back, but generally in life, we just have to do the best we can.  If we focus on doing our best, many problems will either resolve themselves or they will fail to manifest in the first place. 

So here's the recipe and yes, I intentionally chose a bright and colorful dish to counterbalance the gloomy truth that TIME magazine documented so thoroughly.  And this'll be fun because I bet you've never seen a beans and rice dish cooked in a wok before. 
I need to be efficient when I cook, so I make dishes in huge amounts and then engage in that highly-underrated American art form - freezing.  Assemble about this much celery, red pepper, oregano (fresh pictured here but dried also works), and onions (I used both green and bulb because both were available, but I usually use just bulb onions).

In this case, the green onion and celery are from Froberg's Farm in Alvin because I buy locally whenever possible.   
Chop everything and add to a large cooking pot.  Saute the mixture in olive oil.  Be generous with the olive oil - it's the only fat component in this dish and it's necessary for transmission of the herb and spice flavors.  I use at least one quarter cup, maybe more. 

Do you see how this is a huge fraction of vegetables?  This is a white rice dish and I need to minimize the overall glycemic index in my eating plan.  I achieve that in this dish by rigging very high fractions of vegetables and beans. 

Cookware note:  I have experimented with every available mega-pot over the past two decades, and my favorite is a 14-inch flat-bottomed wok.  They are extremely rare in the consumer marketplace (most are 12 inches which is not large enough for batch cooking).  Even rarer are the ones that have one straight handle, as this one does.  This is a 4-year-old Anolon which doesn't currently appear in my internet searches, so it may not be available any longer.  If I were going to buy a new one today, I'd probably choose this Circulon (but as of today, it was listed as out of stock until June 2013 - do you see how rare this item is??). 

Note how my Anolon has a good width across the bottom.  Many flat-bottomed woks have very little bottom surface area, which means they don't work as well on a consumer-grade cooktop (conventional woks are round on the bottom and set in ring stands). 

Actually, if I had my choice, I'd prefer a 16-inch flat-bottomed wok, but trying to get one of those is like searching for the Holy Grail.  I've never found one. 
After sauteeing, add about 2 tablespoons of each of the following:
Ground turmeric
Oregano (chopped fresh or dried)
Spice Lady's steak seasoning.

Turmeric has powerful anti-inflammatory properties and is believed to contribute to the prevention of disease

As for Spice Lady... may be wondering why I'd include "steak seasoning" in a beans and rice dish.  I do it because this is such a well-balanced spice blend that I put it in many different things.

Spice Lady doesn't seem to have a web presence right now, but here's some contact information in case you'd like to avail yourself of her wonderful products:  She's occasionally at the Clear Lake Shores Farmers Market (check the Facebook page or get on their email blast list so you'll know which dates she's there).  The internet also lists an address of 609 Bradford Avenue #104, Kemah Texas and phone 832-563-6908. 
After you've stirred in the turmeric, oregano, and steak seasoning, you need to add four cups of broth plus two cups of water to the pot.  You can make this dish as either vegetarian or non-vegetarian, depending on your broth choice.  I usually use chicken broth. 
Salting this dish is difficult because the broths usually come with some salt already in them and it can vary from brand to brand.  I start with about a tablespoon added to the water at this point so that it will disperse well, and then maybe add a bit more later if it needs it. 
Action shot #1:   Add three cups of uncooked rice.

Now you see why I need such a large cooking pot.  I'm making a ton of this stuff at one time. 

I used Texmati rice, grown right down the road in Alvin Texas (locavores rejoice!!).  It's very expensive compared to many other brands, but every time I substitute another product, I'm not happy with the way this dish turns out.  Give me Texmati or give me death (of taste buds). 
Immediately after adding the rice, cover and simmer.  Do not remove the cover or stir until the rice is at least 75% of the way toward being totally cooked.  It'll take about twenty minutes. 

Cookware note:  Most 14-inch woks are not sold with their own covers.  I bought this one for one dollar twenty years ago at a yard sale. 
The main skill in getting to this part is in carefully stirring that rice so that the top portions get exchanged with the bottom without being made mushy by stirring.  The upper layers stay cooler due to the massive size of this pot - the top is much farther from the flame. This is where having a wok (as opposed to a straight-walled pot) comes in handy.  With a wok's sloping sides, I find that I can gently "fold" the sides of the rice into the center and stir it that way without mashing it.  The horizontal distribution of the food also means that the rice doesn't weigh too heavily on its own self while cooking. 

Once the rice is 90% cooked, I add beans, either all black if I want a more earthy-tasting dish, or part black, part pinto if I want a more refined dish (pinto has a milder taste).  In this case, I added those four cans of black beans and none of the pinto.  Sometimes I do half and half. 

I have tried for years to find an organic bean of optimal quality, but I haven't found one that suits me.  Bush's beans are simply the best on the market, in my opinion.  And I've tried every other product, like, for the past twenty years.  I'm not a big fan of large-scale modern agriculture, but I can't find an acceptable alternative here. 
Action shot #2:  Rinse the broth off the beans so that it will not dull the colors of the dish.  Part of this dish's appeal is its natural bright colors. 
Action shot #3:  Add the beans and again, "fold" them into the mixture gently.  Don't squish the rice.  Then allow it to heat gently, cover removed, for about fifteen more minutes.  That will allow all the tastes to blend. 

And again, note the ratio of the ingredients visible here: a LOT of vegetables and a LOT of beans so that the higher glycemic index of the rice is balanced out. 
And there she is!!!

As a final step, I sometimes add just a pinch of ground chipotle pepper.  Just a pinch, though, because too much will start overwhelming the turmeric and oregano. 
Here you can see nine Pyrex storage dishes (photo right) filled with the beans and rice and stacked in our massive freezer.  I use what Pyrex describes as their "basic glass" line of storage dishes.  I need them to stack neatly and so I don't want any air release buttons or other frou-frou on the lids. 

Because we freeze such massive quantities of food, we actually own somewhere between 50 and 100 of these Pyrex dishes (update note:  I went back and counted, and we have ninety-three Pyrex dishes, mostly in the range of 2 to 6 cup storage capacity).  I've accumulated them gradually over the past ten years.   They need to move efficiently between freezer and microwave and conventional oven and table without me messing with inter-container transfers, so they have to be high-quality tempered glass.   
Many Americans experience a brain freeze when presented with the idea of freezing their food. They associate the process of freezing with cheap "TV dinners" and assume that freezing will seriously reduce food quality.

 To be sure, some dishes do not freeze well - but many do, including this beans and rice recipe. To the left of it in this photo above, you can see three Pyrexes of a mint quinoa/garbanzo bean dish, and spaghetti sauce at the far left. All of these recipes go through a freeze-thaw cycle without significant loss of taste, texture, or quality.  The secret is to make them with the highest-quality ingredients to start with.

This is the main strategy by which we carefully control our eating plans in my home. My husband and I both have jobs. We can't come home and prepare fresh meals every evening - we have neither the time nor the energy for that.   Instead, on weekends, I make massive quantities of our favorite dishes and freeze them like this so that they can be taken out and microwaved in a matter of minutes on work days. It's much healthier and a much more efficient use of my time than any of the other approaches I've tried over the years. And much tastier, too. 

So there's an example of my first push-back against the bitter pill of a broken medical system.  Ultimately, none of us know whether we'll succumb to that system, but by developing healthy counter-strategies such as this one, at least I'll be able to know that I tried my best to avoid such a scenario. 

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