Monday, August 24, 2009

Swiss Chard Saute (poriyal) and Healthcare debate visited

Having read and heard so much (controversy) on TV about health care reform, I had to read to be better informed. It is hard to differentiate between spin and what was being proposed. You can imagine the confusion when people like Palin get involved and bandy about phrases like "death panels". Another loud group shows its loud self in Town Hall meetings all worked up about turning this country into a Russia in other words a socialist country, forget the fact that Russia is no more a socialist country.

I started researching about the President's proposal. Health care was one of President Obama's top priorities when he was campaigning.

From what I have read so far a gist of what Obama wants is as follows:
1. Reduce overall health care costs
2. Offer health care coverage for all Americans
3. Eliminate denial by health insurance companies on the basis of pre-existing conditions
4. Offer choice of providers
5. Training for health care providers.

Offering health care will get the government more involved in the health care business. This will introduce what is called the public option or government sponsored option by which the government would provide low cost coverage for those who are not able to get insurance through private health care providers. More info here.

We all know that the President can only propose, it is upto Congress to enact them into law and approrpriate the money required. So I started reading what the Congress (House of Representatives) has proposed.

The House sponsored America's Affordable Health Choices Act called the H.R.3200 summarises the provisions under these broad classifications:
1. Coverage and Choice
2. Affordability
3. Shared Responsibility
4. Controlling Costs
5. Prevention and Wellness
6. Workforce Investments

The much controversy creating government sponsored public option falls under the Coverage and Choice. The broad categories are more or less self-explanatory and details can be read in the link above.

Nobody denies that health care reform is urgently needed and every body is in total agreement of that fact. But the disagreement which is sometimes loud and scary starts when talk goes to actually implementing something. If you are not covered under Medicare/Medicaid you are pretty much left to the impulses of your employer and the choice of coverage that the company you are working for provides. There are many reasons why a good health care coverage provided by an employer is a good enough reason to stay in a job even though the work itself is killing you(no pun intended). During the course of my many jobs I have had several kinds of health insurances offered, where the premiums were high, premiums were moderate and where there was no premium or co-pay with a choice of doctors of your choosing(you ask why I quit that job, crazy perhaps!!). We also have had individual insurance and HSAs. A HSA by itself is not sufficient, so we end up getting a very high deductible insurance and the HSA and that is as complicated as it can get. Instinctively since the cost is borne by us we do not rush to get a doctor's appointment instead check out all ways to see if a visit to a doctor is really necessary. It helps that we have close relatives as doctors both here and back home.

Most blurb written compares the public option with those of countries like France, Germany and Canada whose population are respectively 64, 83 and 30 million respectively. Here in the US the scale is 40 million uninsured people so none of these countries would offer a realistic view of what to expect in a public option wouldn't? The population demographic of the US compared with the population of these countries is also dramatically different so their experiences would not truly represent what is going to happen here would it?

I would not have the same level anxiety if I were living in India. Even with no insurance the cure for an expected illness is not going to bankrupt you. The access for care remains affordable for most people.

As a premium paying, forced insurance company dependent citizen,
1. I hate the fact that my health insurance is strongly linked to my employer.
2. My health care is dependent on the whims of the people employed by profit seeking insurance companies. (Not for a minute do I care if the US has the best and most advanced care available, when I cannot afford it all the time by choice)
3. I do not want to carry the burden in the form of increased premiums because of the millions of uninsured who flood the ER(who cannot turn away these patients even if they have a minor illness, thanks to a Clinton era health care provision/loophole)
4. Last but not the least the thought of aging at a time when the government run health care programs might run out of money we are personally responsible to bank a large chunk of money for those twilight years has to keep a lot of us awake.

So the health care bill in its present form does nothing for me. I will still be a slave to my employer provided health care plan. That is what I wanted changed badly, simply put I should be able to pay into a insurance pool that can be used if I am employed or not as long as I don't miss the monthly payments.

With health care being the mess it is, the only thing I can do is to follow a healthy lifestyle and eat right. Adding Swiss Chard to the diet is definitely in that life style. I was able to get a large quantity of Swiss Chard and a bit of Amaranth leaves from the garden that would be enough for a saute. The greens shrivel in size to about a fourth of the fresh leaves.

Swiss Chard Saute
1. 6-8 cups of loosely packed Swiss Chard and Amaranth leaves chopped roughly
2. 1/2 red onion chopped
3. 5 dried red chilies split and seeds removed
4. seasonings: mustard seeds and cumin seeds
5. salt to taste
6. 1 tsp oil

1. Heat oil in a pan and add the seasonings when the mustard splutters, add the onions and red chilies and saute till the onion turn translucent.
2. Add the chopped up greens and in medium high heat cook till the leaves wilt and are cooked (10-15 minutes)
3. Add the salt and cook till the water evaporates.

Serve with rice and sambhar.


  1. Hi ISG,

    Your overview and summation of the current health care proposals is a most excellent read.

    I shamefully admit to being somewhat complacent due to the fact that we are fortunate to have excellent insurance. My husband is not self-employed but works for a family company, and the cost of that excellent insurance comes straight out of our pockets at about $1500/month.

    Nonetheless, we are one of the families who utilize it to the max. His transplant, M's autism, m's diabetes and now she's got the same kidney disease too -- these are just a few of the reasons I thank God every day for good insurance, and wish the same for everyone else.

    I am sure that what you say is true -- many stay employed in certain jobs just for the insurance. I imagine some people stay married for it, too.

    On a lighter, happier note -- your chard poriyal looks completely yummy -- did you grow amaranth too!? :)

  2. Such a healthy poriyal!

  3. Thats a great post Indo...I should try that poriyal once the chard comes out well...

  4. The mediclaim which was a fancy word when introduced here is no longer the same. People many time tend to skip it as it is such a nagging and fristrating process. The poriyal looks simple and tasty!

  5. Indo, I just made a big pot of dal palak with swiss chard. Your proiyal looks delicious.

  6. Hi ISG

    Very nice summarization. I was initially not too much of a supporter of the plan. I felt that the quality of care might go down with the gov sponsored option.

    D vehemently opposes me and supports the reform.In fact he even sent mails and the reply he got from White House does nullify my fear.

    However I am still not confident. I am thinking that employers might not really give the other insurance options when the public one is available. For baby A we do have to go to several docs and with our plan I can pick and go for 2nd and 3rd opinions when I am not comfortable with the 1st ones verdict. I do not know if I will have so much liberty with a gov plan.Purely selfish reasons makes me think this way though and I agree that the health reform will take care of all the points you have mentioned.

    And BTW health care in India no longer comes cheap. My Ma-in-law had knee replacement surgeries and they were wayyyy expensive

  7. Poriyal looks simple and delicious!
    I frankly dont have much idea on the healthcare topic so cant comment..

  8. There are two things.

    a. Good Healthcare in India is not affordable as we think it is. We were all upper middle class probably and that is why. We do have Govt hospitals, but we know the care there. We do need insurance in India for major illness and yes it makes people go bankrupt.

    b. US doesnt have the best healthcare as we think. On many health lists, it stands worst just comparing with the other European countries. Just compare the WHO charts and you will even be shocked to find.

    c. The doctors are a big lobby in US. For everything else US imports workers but on on doctors, This drives their salaries up, long waiting Q's and lesser care.
    But If you even touch the immigration issue for doctors into US, all hell will break lose since they are an influential lobby just like gun control.

  9. Indo - I always liked your spinach recipes, they are unique and simple and delicious. Thanks for this one too :).

  10. Inji, thanks for your comment.

    Few words about a) in your comment, what you say is true depending on the situation and not the truth for every single case.

    I do happen to know a little something about care in government hospitals especially in TN. I had 3 family members work in different cities. The care is good or bad depending upon the doctor on call but the options for care is available and that is the point I am trying to make. You cannot completely write them all off. Moreover I also have family members in private practice who accomodate payments of different kinds and abilities to treat patients, so depending upon the doctor you choose you are not going to lose the shirt on your back.


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