Archive for December, 2008

Human health care

Pills coming out of a bottleLast time I talked about health care, it was because I’d gone to the vet and seen how much health care can cost for animals. Today, I went to the doctor and physical therapist with my friend Nathan.

Nathan has been on crutches for three months now, ever since a bad bicycle accident. Initially, the doctor diagnosed a fracture near the knee, but a specialist examined Nathan’s MRI and recognized that he had torn one ligament and ripped another. They used surgery to fix the torn ligament and replace the ripped one. The ripped ligament, the PCL, is much more rarely damaged than its twin, the ACL. Unfortunately, it’s also harder to fix. Maybe that’s why the replaced PCL failed after four weeks and Nathan had to go through a second pass of surgery. So far, the new PCL replacement seems to be working out–the swelling is down and Nathan’s knee is recognizable again.

Nathan has incurred incredible expense getting this far, and there are months of physical therapy ahead. Based on Anthem’s cost estimations, the two MRIs cost $1,500-3,000 each. The first surgery probably cost between $15,000 and $20,000, while the second surgery cost $4,000 to $10,000 (outpatient surgery is significantly cheaper). The initial emergency room visit might have cost as much as $1500. So far, physical therapy has cost $600 and will cost at least that much in the coming year. That means that Nathan’s medical bills for 2008 total over $25,000.

Most people in the US get their health insurance through their employer. It’s a common non-salary benefit because employers are avoid paying taxes on their portion of the health insurance premiums. Maggie tells me that you normally get to pick from between one and five plans (based on the size of your employer) from one provider. Being self-employed, Nathan’s situation–and mine–is a little different.

As owners of the business, we don’t get additional tax breaks, which makes a group policy less attractive. The premiums for a group policy were actually higher too, because once we start paying the premiums, our provider would have to cover anyone who worked for us, regardless of health.

Our first step was to do lots of research. There are lots of plans out there that cover lots of different things in different ways. Do we want an 80/20 copay? An HSA? A high deductible with low premiums? A low deductible with high premiums?

Eventually, we decided to open individual high deductible health plans along with health savings accounts (HSAs). Each year, you can put up to $2,800 (in 2008) into an HSA fund, which can earn interest (currently, mine is earning 4%). This money is tax-free as long as it’s spent on medical expenses. HSAs can only be opened in conjunction with certain health plans, basically those with a deductible over $1500. Given the fluctuating nature of our business at the time, it made sense to us to get the very basic health coverage, which would be cheap, and flesh out our coverage by putting money into our HSAs during better months.

Once we picked the type of account (HSA-compatible), we got quotes for appropriate plans from dozens of providers. In addition to deductibles and premiums, some plans had percentage or fixed-amount co-pays (where you pay a portion of the bridge between your deductible and a larger deductible). Others had co-pays for drugs but covered treatment entirely once you got beyond the deductible. Presumably, there are also service differences between companies, but it proved impossible to figure out which were bad. Nobody likes their health insurance provider, so poor word-of-mouth was the norm.

Although we used an insurance agent, who is a salesman representing multiple providers who gets a cut of every premium you make, we found the best quote through our own search. Many large providers will give you online quotes for multiple types of plans, which makes comparisons a little easier.

In the end, we got catastrophic coverage, a $5,000 deductible. The plan only cost about $50 a month, which was worth it for the peace of mind. Once business picked up, we could get a better plan with a smaller deductible.

Unfortunately for Nathan, his accident happened before business got good enough. Still, of the approximately $25,000 in costs he’s incurred, Nathan will only have to pay about $5,600 between this year and next year. If his second surgery had happened only two weeks later, in 2009, he’d have been on the hook for another $5,000.

Nathan’s accident pushed me and Maggie into reevaluating our own insurance recently. Once again, we did a lot of research, although we did stay with the same provider. Instead of two $5,000 individual policies, we now have a $5,000 family plan (which is the equivalent of a $2,500 individual plan). In addition, our policy includes $1,000 in a “health incentive account” which is basically a pool of money managed by our provider that covers any initial costs each year. If we only have major medical expenses every couple of years, this could cover most or all of our deductible. Of course, this plan–plus a maternity rider–costs $380 a month, much more than the $130 we were spending together before.

Going through this process–twice–has really cemented my desire for a single-payer system. Even if you’re insured, it’s a crapshoot whether or not you picked the right plan when you signed up. You also have to reevaluate regularly to make sure that it’s covering what you need covered as your life changes. I’m also lucky in that I was able to spend quite a bit of time on the Internet and talking with an insurance agent to figure out which plans might work for me. If I were poorer, and without Internet access or the ability to get an agent, it would have been even more random.

Here’s hoping that two thousand and nine ends with some major changes to our health care industry!

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Handmade Christmas

Will and Maggie wearing their Christmas hatsWe tried to keep Christmas pretty laid back this year so there has been a lot of emphasis on simple gifts that are light on the environment – consumables, gifts of time, and handmade gifts. I was thoroughly delighted to receive a beautiful handmade hat from my sister-in-law, Angel. I have been laboriously knitting hats for myself but am not yet advanced enough to add on ear flaps, which is what I really wanted. It’s also totally awesome that she made a coordinating hat for Will although he’s a little concerned about ruining his manly image.

Other awesome gifts include a handmade tote bag for groceries featuring pockets for six bottles of wine (or other bottled products), reusable nylon bags for bulk items from the health food store, a beautiful set of handmade greeting cards, and of course the traditional Emigh handmade caramels. Yum. Admittedly, I was also delighted with the non-handmade very cool book from Will’s mom entitled “The Carbon-Free Home” which has thirty-six projects that can help you make your home more carbon neutral. (To her credit, she knows the authors so you could say it was handmade by her friends.)

Several of their projects are things we have already written about such as making a potato barrel, building with slip straw, and conducting an electrical consumption analysis. The rest are projects I’ve either dabbled with or thought about doing but didn’t know where to start so I’m super excited to try out projects like converting a nothern window to a cold box or installing a humanure toilet.  I am most excited about building an active solar air heater but we should probably start with sealing all the drafts in our house.  It’s a little alarming to lie in bed and feel a 30 degree breeze coming from the windowsill.  I guess I know where to start my list of New Year Resolutions…

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Snow is awesome

Will and I have arrived in Los Alamos, New Mexico to spend the holidays with his grandparents and other family members.  We’re still reeling a bit from the time zone change and the altitude and just the general stress of traveling.  It is suprisingly warmer here than it was at home but still cold enough to have plenty of snow, which is super exciting.  I love snow, especially around Christmas, although we’re a little concerned we may be snowed in by tomorrow morning.

Christmas is almost here and we’re ready for a low key, minimal consumption lifestyle with a few thoughtful gifts and an emphasis on simply hanging out with friend and family.  I’m sure we’ll still end up eating way too much sugar and fatty foods but that’s a holiday tradition I can handle.  We’re both looking forward to some time to unwind and relax and spend a moment planning for 2009.

Happy holidays.

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Three wise mice

Our second mouse leaving the trapMaggie is on a women’s camping retreat this weekend, so instead of a podcast, I’ll give you an update on our mouse problem. After getting lots of good advice about getting rid of mice, Maggie and I went to the hardware store and got a live mouse trap and an ultrasonic device.

We haven’t used the ultrasonic device yet. As Gini mentioned in the comments, mice can get used to the sound and stay in the area. It also doesn’t penetrate cabinets. Although they’re mostly getting into things left on the counter, they’re coming up through one cabinet and have access to another. When we’re out of the house for more than a day or two, we’ll plug in the device to keep any remaining mice from making a mess on the counters when we can’t deal with it immediately.

That’s right, I said “remaining.” Hopefully, we won’t have twelve days of mice, but we caught our second today on our fourth day of using a trap. We use the Tomcat brand live catch mouse trap. It catches multiple mice, but doesn’t kill them like the Tomcat that Emily recommended. It’s a brilliant design that doesn’t even need bait. You put the entrance along the wall and when they walk into it, the entrance acts a bit like a see-saw and closes up behind them, trapping them in a large holding pen.

We’ve been releasing them near the park at the end of the street. There’s enough space there that we hope they won’t come back. We’re also trying to figure out exactly how they’re getting from the crawl space into the house so that we can plug up that entrance. Just getting rid of two mice has made a measurable difference, though. There’s a lot less food pilferage and a lot less scat.

On a more holiday appropriate topic, Maggie and I recently received an email from the owner of World Christmas Tree. Their idea is to get people to post pictures of their decorated Christmas trees so that they can donate money to save old growth forests. Maggie’s parents decorate a living tree they have in their front yard, but this might be a good second-best solution.

We also received an email hawking organic bug spray. They’d like us to give some to a random commenter, but we’re not sure if that’s reasonable even though we’re not getting anything from it. What do you guys think?

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Vilifying Vilsack

A field of cornToday, Obama revealed that he’d picked former Iowa governor Tom Vilsack as his Secretary of Agriculture. There’s been a lot of opposition to this choice among the blogs and websites I read. For example, arduous dislikes Vilsack because he’s more of the same, despite Obama’s commitment to change (as an aside, change for change’s sake is silly, so it makes sense to me that Obama would continue some policies). Unfortunately, I don’t know much about Vilsack. Why don’t people like him?

Since Vilsack’s most vocal opponent in this arena has been the Organic Consumer’s Association (OCA), I visited their website to find out what their opposition was all about. They provide six reasons Vilsack is a bad choice. In their latest press release, they also suggest that Vilsack has done some good, namely restricting livestock monopolies. Vilsack’s problems are listed as:

  • Supports pharmaceutical crops
  • Supports the biotechnology industry
  • Supports animal cloning
  • Originated Iowa’s seed pre-emption bill
  • Has a reputation as a shill for Monsanto
  • Supports corn and soy based biofuels

Some of these reasons speak to me more than others. I’m not sure why supporting biotechnology or animal cloning is inherently bad. There are a lot of cool technologies in the pipeline that are fueled by biotechnology and cloning. The example that jumps to mind is human genome project, whic is pure biotechnology and promises future miracle cures. As far as I can tell, the item “supports pharmaceutical crops” is based on one incident where Vilsack questioned a voluntary industry-based moratorium on growing genetically modified corn in states where other corn was being grown. Vilsack’s concern that this is throwing the baby out with the bath water resonates with me better than the moratorium itself (which seems to be primarily a PR move). If corn can produce cheaper insulin, that’s something that should be studied. I’m not sure that Iowa, among other states, should not do such research just because other corn is grown in the state.

I’m less sanguine about Vilsack’s support of Iowa’s seed-preemption bill. Basically, this state-wide bill makes it illegal for localities within Iowa to ban genetically modified (GM) crops. I can see how Vilsack arrived at this bill, since it’s a clear progression from his position on pharmaceutical crops. On the other hand, although it doesn’t make sense to avoid genetically modified corn in an entire state, it might make sense to restrict it on a local level. As a simple example, small farmers might want to be able to create a GM-free zone so that they can market their food as GM-free.

Vilsack’s ties to Monsanto are worrisome, as are any ties elected officials have to companies that can benefit from their position. However, I haven’t seen any evidence of wrong-doing (the OCA links to an animated video made by an activist–not the least biased of sources). I would expect the governor of a breadbasket state like Iowa to have some contact with large bio-companies like Monsanto. I wouldn’t want him to ignore the issues of regular people, but ignoring the issues facing large companies also seems shortsighted.

I’m most concerned about Vilsack’s support of biofuels. Personally, I don’t think it’s as promising a source of energy as other areas we can focus on, like power generation, fuel efficiency, and new types of vehicles. However, Obama is a firm believer in biofuels, at least in the short term, so it’s not surprising that Vilsack mirrors this.

Although I’m not overjoyed by Vilsack as Secretary of Agriculture, I don’t hate him as much as many others seem to. Partly, I think now is a bad time to be making vast changes to our agricultural system. There are lots of problems with the American agriculture industry, but it’s definitely great at producing cheap food. Heading into a recession and possible depression, that might not be a bad trade-off to make.

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updates in haiku form

Snail

Foster dog Kelly
Found a new permanent home
We’re happy but sad.

It’s getting quite cold
We’re ready to freeze our buns
Well, at least a bit.

We caught a brown mouse
He was quite adorable
But we let him go.


Sorry no podcast
We will be back with more soon
Plus cool sound effects.

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Christmas mice

A mouse next to a Christmas ornamentMaggie and I have a mouse problem. I’ve never seen them, but sometimes you can hear them in the kitchen when you’re in the living room. We weren’t sure what the noise was until they chewed through a plastic container to get at some granola (maybe they’re hippie mice). Since then, we’ve found lots of mouse droppings on the counters. Luckily, they don’t seem to have gotten into the cabinets where we keep the food. Instead, they’ve contented themselves with wandering through our drying dishes.

The only mice I’ve had contact with before have been in cages, so I’m not really sure what to do. Even discounting any moral problems, traditional traps seem messy and problematic with a dog in the house (she’s definitely not a ratter). Poison is right out for similar reasons. The catch-and-release traps seem neat. I ran across one with a cracker barrier so that you don’t even have to touch in when you let it go. On the other hand, that’s a lot of plastic and I don’t really know where we’d let them go.

I did some research and found a bunch of homemade repellants and traps. An easy homemade traditional trap is to get “mouse glue” at your hardware store and put it at the bottom of a paper bag. Put some food in there as bait and the mouse will get stuck. It’s not very humane, though, since you can’t unstick them. About.com had an interesting alternative: a peanut butter bucket. Basically, you smear peanut butter on the inside of a bucket and create stairs up to the outside. The mouse goes up the stairs and into the bucket to get the peanut butter and then can’t get out, so you can pick the bucket up and release them somewhere else.

They also suggest putting peppermint oil on cotton balls and placing them along the mouse paths. If peppermint oil seems too simple to work, there’s also fake bobcat urine! We’ll probably try the peppermint oil to keep them away from the counters, but that seems unlikely to get rid of them entirely.

If we could find out where they’re coming in, we could plug those spaces with steel wool. Unfortunately, the crawlspace is pretty open to outside and there’s only the flooring between it and the main house, so there are lots of possible ways to get in. We’ve plugged up the holes we can find, but it hasn’t helped.

The ultrasonic mouse repellers sound cool, but I don’t know how well they work. $50 is quite a bit to spend on something that might not work.

Have any of you had mouse infestations? How did you deal with it? If you have any tricks for figuring out where the mice are coming from, that would be especially appreciated!

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Rebuilding our Local Food System

Maggie in Local Growers Guild shirtI work for the Local Growers Guild, a cooperative of small farms (and the restaurants and community members who buy from them), working to strengthen the local food economy.  We want to make small, sustainable farms viable, we want to shrink our community’s carbon footprint by encouraging the consumption of locally grown food, and we want to rebuild our local food distribution system.  There was a time when communities sourced a large percentage of their food from farms in the region and had things like a local dairy, a local butcher, a local baker, and a local produce market where farmers could bring their goods to be sorted, washed, packaged, and sold.  Nowadays that local infrastructure is pretty much gone (with the exception of our most excellent farmers’ markets).  We have restaurants and hospitals and schools that say they are interested in using more local food but no good way to connect them with the growers.  There’s also that chicken-and-egg challenge of the fact that growers don’t really want to grow more if they don’t see a market but institutions don’t want to buy food until it’s available in quantity.  What’s a cooperative to do?

Well, our current plan is to conduct a feasibility study evaluating what resources are available now, what challenges are preventing the effective distribution of local food, and what steps we can take to make it happen.  Today we took a field trip down to Louisville to see some of the projects they’re working on.  Kentucky is actually very progressive in the local food arena thanks to a non-profit group called the Community Farm Alliance (CFA).  Kentucky is well known for horses, booze, and tobacco and that really was the vast majority of their agricultural production until the late 1980’s when the world suddenly decided that tobacco was bad.  Tobacco farmers got very nervous about what was going to happen when their farm product became illegal.  CFA started bringing farmers together to talk about how to deal with the change and also to lobby their state government to direct funds from the tobacco settlement money into retraining tobacco farmers into sustainable food production.  Well, they were quite successful and managed to get something like $1.7 billion over twenty years allocated to developing a sustainable food system.

They have done a lot of cool projects so far.  Initially, they focused a lot on connecting rural small farmers with fresh vegetables and urban residents of West Louisville who live in a “food desert” where there are no good grocery stores and there is no access to fresh, nutritious fruits and vegetables.  It has been a challenge to find ways to get the food to the urban communities in a way that is profitable for the farmer and appealing to the urban residents, who may not have any experience cooking fresh vegetables.  They have had a few attempts that have floundered but are currently working on a model that will consist of specialized vans that can drive to a neighborhood and then open up to become produce vendors.  Sort of like an ice cream truck but healthier.

Our main destination was Grasshoppers Distribution, a farmer-owned warehouse and distribution system that buys food from local farmers and resells it to restaurants, groceries, and institutions as well as running a CSA (Consumer Supported Agriculture) program.  Each week they contact the fifty-ish farmers they work with to find out what products are available.  They compile the list and send it out to their buyers, who then place orders.  Grasshoppers then contacts the farms to place the orders.  The next day, they drive around to pick up the produce, bring it back to their warehouse, sort it into orders, and deliver it all.  It’s a lot of logistics and they have to work hard to keep communication channels open but it seems to be going pretty well.  We are considering a similar model for Bloomington but the overhead costs are rather steep (real estate and trucks are not cheap).

A somewhat simpler model is City LIFE Local Food which strives to “deliver fresh local food to the busy professional.”  Subscribers log on to a website once a week and order a box of fresh produce, which is then delivered to their workplace.  This way they can pick exactly what they want and skip a week or two if they’re not interested.  I think the group also includes other food products like meats, cheeses, and honey.  Their system appeals to me because it has relatively low overhead and is a great way to deliver to a large group of people at once (one of the companies they work with has 9,000 employees).

Louisville has been thinking about local food a lot a couple years ago the city hired a consultant to do a thorough study.  One of the recommendations was to build a year-round farmers’ market, which is now starting construction.  The plan is to develop an entire city block with an assortment of retail spaces for food businesses including the local chef’s warehouse Creation Gardens, a local Buffalo company, some smaller indoor permanent market booths (perhaps a butcher and a baker?), some more temporary outdoor market booths (for farmers to use in for three seasons), and a little gathering space outdoors where there can be bands or other entertainment.  It’s going to be pretty impressive but talking with the developer made me realize how intimidating these sorts of large projects can be – beyond the money, there is also a ton of politics and negotiations with other property owners and struggles to get timing and commitments down.  Crazy.

I’m still digesting it all and thinking about what would be the logical next step for Bloomington.  I really like the idea of having a warehouse space that could be used to consolidate produce from different farms and distribute it through a CSA or as restaurant deliveries.  But warehouse space is expensive (especially if you have coolers or freezers) so it seems like there would need to be a major commitment for use before it would be worthwhile.  Hmmmmmmm.

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Podcast: 5 green business ideas

Today, Maggie and I discuss the feasibility of 5 of her top 10 green business ideas.

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Making tooth powder

Toothpaste and tooth powder in front of their boxesIt’s been almost 3 months since I switched from tooth paste to tooth powder, which seems like a good time for an update.

My teeth feel as clean as they did when I used toothpaste and I’ve gotten used to the salty taste. I’ve brushed with regular toothpaste once or twice when I was worried about bad breath (and didn’t have any mouth wash) and it now amazes me how much it foams! After getting used to the powder, toothpaste seems needlessly messy and strong-tasting. I highly recommend tooth powder over toothpaste. It’s cheaper, especially if you make your own, and involves some very simple ingredients. I also haven’t had trouble with canker sores since starting dropping toothpaste.

According to Wikipedia, pre-made toothpaste didn’t become popular until after World War I. Before that, toothpaste was considered snake oil and many people made their own tooth powder. In part, the popularity of tooth powder must have been due to convenience. Without the now-ubiquitous collapsable tube, toothpaste would have been difficult to use, especially when you were running low.

Once toothpaste caught on, tooth powder basically disappeared. I haven’t been able to find any tooth powders in regular stores like CVS (a drugstore) or Kroger (a grocery store) even though they have entire aisles of slightly different toothpastes. Luckily, the small container that I got in September is still going strong. I’ve used about a third of it, including some waste figuring out how to get it on the toothbrush. I recommend wetting the brush and then just tapping some powder on. The water makes the powder stick to the bristles, so the powder doesn’t fall off when you start brushing.

If you’re worried about bad breath, I’d also use mouth wash. I’ve heard that gargling with salt water can replace mouth wash, but it doesn’t sound very fun. Beyond bad breath, another potential concern is fluoridation. If you drink city water, you’re probably getting plenty already.

I found some recipes online for toothpaste made by mixing tooth powder (bought or homemade) with flavorful oils and hydrogen peroxide. In general, I think that’s probably overkill. If you don’t have any major dental problems, you can make simple tooth powder by mixing one part baking soda with one part sea salt (the larger crystals in sea salt help it stick to your brush and act as an abrasive). You might want to start with buying a small container of tooth powder so that you’ll have the bottle. The little spout at the top helps get the tooth powder onto the brush and not all over the counter.

If your water isn’t fluoridated (because you drink mostly bottled water or have a well) or you have a history of tooth problems, you could try mixing sodium fluoride into your tooth paste with a ratio of 1 part of sodium fluoride to every 10 of your tooth paste. This emulates the amount of fluoride in US toothpaste (between 1000 and 1100 ppm). However, be aware that fluoride is mildly toxic and can cause staining of the teeth if you get too much.

If you try it out, let me know how it works for you!

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