ComplexityCare

For most Americans, complexity in government is like apples in apple pie. Many of us accept that we must purchase a complex computer program to do our taxes, or verify our identities by way of state-issued drivers’ licenses that require extensive documentation and a long wait in line. When we retire, we cash in our 401-Ks cobbled together across our various jobs, and managed without much expert help. We make sure our long-term care plans are in order, and decide on whether to purchase a supplemental Medicare package, or go with an all-private Medicare Advantage plan. All of the complex rules and programs we navigate in our lives ensure that relative to our peers in other countries, we shoulder immense amounts of risk in hopes of fostering innovation, and we tolerate immense levels of complexity in the name of preserving some notion of personal choice.

How did we get here? From a global-historical perspective, when doctors couldn’t do much beyond prescribing chicken soup and leaches, we paid cash. As it became possible to routinely survive a surgical procedure, or recover from serious illness through medical intervention, health care got more expensive, so people came up with all sorts of clever ways of spreading the risk. Guilds of artisans, unions, and charities helped people to pool their money for the next time someone needed an amputation, or a case of tuberculosis required months in a sanitarium.

Then our fates diverged. Some nations began a slow process of nationalizing the finance and delivery of all health services, while others codified their existing complex arrangements into laws that ensured some level of help for the weakest. In America, in the name of non-interventionist choice preservation, we left health care up to employer, leaving the poor or elderly free to choose chicken or split-pea soup as they pleased. Eventually, feeling bad for the elderly and poor, we created Medicare and Medicaid. Eventually, for the poor people’s kids, we created CHIP, or the children’s health insurance program. Somewhere along the way we passed ERISA, or the employee retirement income security act, which, despite its name, also had a lot to say about the average working stiff’s insurance plan. There was also COBRA and HIPAA, which are important but tedious.

Over the years, mostly in the name of choice and innovation, we variously delegated some responsibilities to states or the private sector through a series of waivers and demonstration projects. In hopes of saving money, we placed a greater share of the costs on the individuals, so they’ll shop around for chemotherapy, or in any case, no longer be part of someone else’s budget. Every year, open enrollment allows us to pick from a smorgasbord of health insurance policies that are significantly more expensive than the year before, with higher fees, and smaller networks of providers. We’re thankful for what we have, and we count the days until we’re old enough for simple, cheap, national Medicare.

The Affordable Care Act did nothing to change anything I wrote above. It added some regulation to make health insurance available to (almost) all through existing mechanisms, and paying insurance companies to cover those for whom a plan would cost more than roughly 10 percent of their income. Its means testing guaranteed a rough interaction with our already byzantine tax rules, and its diffuse market approach ensured that there would be 52 sets of rules for 78,000 individual health plans, another 52 for Medicaid (poor people) plans, and all sorts of tax credits, market incentives, and options for employers to offer coverage (or not). The people who are trained to help others enroll are called Certified Application Counselors, Navigators, In-Person Assisters, and non-navigator personnel. And those are just the ones operating in the 36 federally-run health systems. The other 16 have their own set of terminology.

But we don’t have to start over. We can and should build on what we have. If I was the God of US Health Care, here would be my ten commandments for a new bill (in no particular order):

1. Start negotiating for prices. Mandate national negotiations for a medical fee schedule with any necessary geographic adjustments, similar to Medicare. Negotiations would be between medical societies and insurance providers, with a government-chartered but independent panel of public citizens and experts as final arbiter of any decision. Allow providers and insurers to create their own fully comprehensive regional networks of care using any payment structure they want, as long as it costs the same or less than the national one. Let them keep most of the difference. Inside a network, this puts the people who pay for care, and the people who provide the care on the same side. Outside a network, this frees insurers to charge a little more to those who want maximum choice, while ensuring that insurers compete on quality of customer service, and the ad hoc coordination of care.

2. Federalize Medicaid. Giving Medicaid to the states was a political compromise that has long outlived its usefulness. Today, state budgets are often upwards of one-third devoted to Medicaid. Its waivers and exceptions are unfair and incomprehensible, and it is massively expensive to run dozens of programs instead of one. Since states typically cover half the cost of Medicaid now, to pay for it, cash transfers would have to flow from the states to the federal government, or other transfers from the federal government could be reduced to offset the difference. In either case, the net change in funds the state would owe could be significantly reduced through administrative simplification and economies of scale. Medicaid plans can be distributed through the newly established health insurance exchanges.   

3. Open the insurance exchanges to all, and make us all use them. Retaining several different types of markets and risk pools is an actuary’s nightmare, and only adds to costs. Also, if competition is really worth anything, then we should all have the maximum choice possible and the freedom during open enrollment to deep-six any insurance company that gives us the run-around. Employers would also be freed from the costs associated with benefits decisions, reducing an administrative burden while retaining a protection people depend on.

4. Roll Medicare into the exchanges too. On one hand, Medicare beneficiaries would have the option to purchase private plans under the same rules as everyone else (eliminating Medicare Advantage and other complexities). On the other, everyone else would be allowed to buy Medicare. For this to work in the context of the other ideas, Medicare rates would have to be negotiated under the same rules as the other plans, as described in point 1. The only difference would be whether a plan is publically or privately administered. It's concievable that private plans could offer lower premiums compared to Medicare through carefully negotiated networks or alternative payment strategies.

5. Opt out instead of opt in. If someone chooses not to purchase insurance, they should be automatically assigned to minimum coverage. If they choose to be uncovered, they must actively do so. This removes the actuarial need for the hated “insurance mandate.” Insurance premiums should be payable through a payroll withholding, similar to income taxes. That’s how most places do it (even Canada). Payroll withholding also simplifies employers' contributions to employees' premiums.

6. Develop a truly universal claim form, and a universal format for insurance cards. Doctor’s offices often employ several people just to chase insurance claims, and it’s often unclear whether a service will be covered and in what ways. Patients should be able to scan their card and get a coverage determination on the spot, and claims that follow the rules should be paid out without delay or confusion.

7. Reform medical malpractice. Caps on fees don’t really work, as evidenced in Texas and California. Courts or expert panels are necessary to address complex litigation and make fair judgments. Suits deemed frivolous should result in penalties for those who file them. Malpractice coverage should be nationalized, with some measure of risk rating in the premiums.

8. Get everyone primary care. It’s not enough to give everyone insurance. We need standards for primary care that ensure access and quality. People with access to good primary care are healthier and cheaper, regardless of insurance status. Payment priorities, grants, and provider licensure rules can make this a reality.

9. Allow policies to be sold across state lines, but federalize the rules. States should not be involved in regulating insurance plans. If we want real competition, then insurance plans should be better able to conform to the natural catchment areas they operate under. In other words, insurance plans could be regional or national, and offered across state lines, but without the concern that one state or another would be encouraged to lower its standards to the detriment of consumers. 

10. End tax writeoffs for insurance. Right now, large employers are far better served giving people expensive insurance plans over paying them more in cash. Take away the tax write-off, and employees will see a gain in net pay, though there will also be a gain in net taxes owed. The added taxable income could go towards subsidies for insurance. A dedicated payroll or other tax might also be needed to finance the vast new group eligible for subsidized coverage and make up for the loss of tax-advantaged coverage employers offer today. A payroll tax could even replace premiums altogether if the rate is pegged to a combination of employee income and their plan selection. For example, an employee making $50,000 a year and buying a plan that costs $5,000 a year would have a 5 percent payroll deduction (resulting in a 50 percent subsidy, perhaps split by the employer and the government), while an employee making $100,000 a year and buying the same plan would pay a 10 percent payroll deduction.

This isn’t about public-versus-private, conservative or progressive policy. It’s about creating a system that is a little more understandable to most people, and easier to access, and with fewer interruptions to coverage. For me, universal coverage is an absolute priority. It trumps nearly all other considerations when it comes to health care, but we have to do better than what we managed to get passed in 2010. For all nations that have taken on this problem, it’s required a series of laws, each with their own setbacks and controversies.

America’s market orientation and culture of innovation is responsible for a disproportionate share of the world’s medical advances. We need to preserve the unique incentives present here to bring new drugs and equipment to market. At the same time we need to make sure that our own citizens can afford it. It’s not fair to say that the United States has done nothing until now to address people’s concerns about their health care. We’ve passed a number of laws to help make health care more widely available and affordable, but when it comes to a universal system, we’re only just beginning. Let it be the beginning of something great.

Paging Doctor America

The concept of "duty to act" is one of the central tenets of medical ethics. If your medical skillset has a reasonable chance at improving a dire situation, you must use it. Someone who's trained in first aid is legally obligated to help if someone isn't breathing. With our nation's bolus of strengths and a seeming lack of alternatives, we face a similar obligation to the world. But even if the ethics are similar, a civil war is not a human body.

Again and again, Doctor America sees herelf as the only doctor in the house, or lifeguard on the shore. The good doctor has mighty military and massive diplomatic and economic clout, but unlike a person whose heart has stopped, the clinical signs that present themselves in geopolitical conflicts are often vague and conflicting. She gets some things right, messes other things up, and sometimes interferes where she isn't wanted. She also has her own self interests to consider. But for the better part of a century the world has turned to us for help.

With the power we have, we face stark moral choices. Here's one: 1,400 civilians were gassed by a tyrannical regime in the middle of an existential battle that has now killed over 100,000. In the tickertape of atrocities that continue to pile at our feet, this one is pretty bad, at least by recent standards. What do we do? There are people dying in an interminable civil war. There are international laws to consider, regional allies, rivals, and foes. The world and our own consciences scream, "we have to do something."

Another central tenet of medical ethics is "do no harm," but again, even if the ethics are similar, a civil war is not a human body. Assad is a nasty illness, but he's present in the essential organs of the nation, and he isn't the patient's only problem. Diplomacy was going nowhere. An airstrike against certain targets may or may not improve the situation for the Syrian people. We aren't willing to engage in a full-scale war, and even if we were, there are serious doubts if it would help. With the muddle surrounding major strategic decisions there is seldom a clear diagnosis or treatment plan. We look at a country at war and understand the history fairly well, and we measure our decisions based recent experiences. Even after all is said and done, we can't know the counterfactuals. We never can be sure if we made the right decisions.

This case is different than any one I can remember. For the first time in my memory Doctor America is coming to believe that the weight of the world doesn't rest on her shoulders alone. She isn't Doctor Quinn, practicing her basic medicine and shooting wolves to keep the patient safe. She is part of a team of trained physicians who must coordinate themselves between conflicting interests, massive egos, and differential diagnoses. She is part of a geopolitical health system; with institutions that are supposed to help smooth out the bumps between these powerful people and arrive at a consensus. For the first time ever, those systems appear to be doing their jobs. The United Nations has provided a valuable forum for decisionmaking between the US, Russia, Syria and its neighboring states. Allies like France have stepped up to offer their own solutions. Syria's neighbors and family are pitching in where they can. Suddenly we are saved from the terrible decisions we felt we had to make on our own.

The prognosis in Syria is a long, long way from improving, and our responsibility for its eventual recovery is far more limited than a doctor's to her patient, but something fundamental has changed in our approach. Maybe we're realizing the limits to our skills. Maybe we're trying some new approaches. And maybe, for the first time in a long time, we feel like we have help.  

Whatever Happened to Peace?

Our country's been at war for a long time now. The longest time in our history. At the time of writing 6,735 American troops have been killed in Iraq and Afghanistan. The official numbers say that over 50,000 American troops have been wounded in those conflicts. They won’t even tell us how many civilians have been killed.

There is an eerie acceptance of all this; a tacit understanding that no cost is too high, no burden too great, and that more fighting is a sad inevitability. There’s a missing reluctance to engage in warfare. This massive apparatus of destruction, once created, demands a purpose. We may try to hold back, but there never seems to be an end. Syria, Iran, Pakistan, and most of North Africa, including Egypt, are all smoldering candidates for US military intervention. There is no end game, just the next fire to put out, too often caused by the fanned embers of the last.

Whatever happened to peace? I don’t mean putting flowers into the barrels of guns, or frolicking morons in the sun. Those are too often the images that come to mind when the word is invoked, after the defeat of the non-interventionists in the Bush years, and the many years of war that followed. Whatever happened to there being some realistic image of what peace would look like, here or abroad? People raising kids in relative safety, going to work, building and prospering? Why is this not even mentioned as an objective to all this destruction?

Whatever happened to the “peace dividend,” the idea that out of conflict and suffering come new business opportunities, or that the skills and assets acquired in wartime can be retooled to benefit everyone? Instead of thinking about how all its energy can be put to use, we worry about the impact that demobilization of our military would have on the economy as if there were no substitute activity for all our restless young. Instead of thinking about all the other investments that could take place with the money spent on war, we think about the losses to defense contractors who have profited massively on something that used to be considered the world’s greatest evil. Only war pays a dividend now.

We can’t imagine peace today because we have built ourselves around war. Any sporting event coast-to-coast has at least one patriotic moment where we honor our troops. We stand and cheer their bravery, and that’s important. But these displays have a dual function. They not only honor people who have sacrificed tremendously for their country, they also leave us unable to question why they do so in the first place. How can we be uncomfortable with war and avoid insulting someone whose legs were blown off in its service? We may mutter to ourselves about how all this is no good, but surely we can’t take it out on him. For this and many reasons, we can’t even begin to think about peace and patriotism coexisting.

Even as the Iraq and Afghanistan conflicts wind down, related conflicts demand our ongoing vigilance. Sectarian violence, religious extremism, fallen dictatorships and emergent nationalists all beckon in different settings, all tied together as a larger trend, but each with its own potential for conflagration. War profiteers stand at the ready with tailor-made solutions to each of these possibilities, and sage advice on when to deploy them.

Nobody stops to consider what peace would look like across the entire region, or how it could be achieved. There are no multi-national solutions to our involvement. We’re tired of mass efforts. We don’t believe in diplomacy. It is now about small-bore policy with short-term goals, each with its convenient unit cost. Stop the fighting in Libya. Take out an Al Qaeda sect in Yemen. Send arms to Syrian rebels. Dance around the overthrow of the Muslim Brotherhood in Egypt. Ally with the Saudis and the Gulf States against the Iranians. Support some insurgents, but not others. One conflict inevitably leads to the next. How does this ever end?

We will be involved in Middle-Eastern conflict, but it’s time for a strategic re-evaluation of the why they are happening at all, who is responsible, and how to end them once and for all. We need to revisit our most basic assumptions on how we involve ourselves. What are the major divisions? Sunni-Shia, Secular-Islamist, Democratic-Dictatorial, proxy wars between oil-rich princes who dare not dirty their hands. There are other realistic approaches to consider. How can we approach these problem on as a whole, instead of our unending piecemeal approach? What must we demand of our allies? What are we willing to sacrifice in order to cripple our enemies? How can you neutralize or coopt extremists instead of endlessly incurring their wrath? What about putting the restless unemployed to work building their nation? Who can we call out for not doing their part? What can we control, and what are we best off avoiding?

We need to ask our enemies and ourselves alike, how can we once again make peace more valuable than war?

Can't Buy Me Omnipotence

(Or He's Got a Ticket to Ride)

I’ve followed the Edward Snowden case without having much personally to say. It’s hardly revelatory to learn that the NSA is combing through the world’s communications. All you have to do is look at the $10-odd billion in shadow budgets and the hundreds of thousands of people who scrupulously maintain high security clearances to stay on that particular gravy train. If they’re not spying on us they’re wasting our money. Whatever the case, right or wrong, this cat-bites-mouse story is about as enlightening as an episode of Tom and Jerry.   

What is interesting to me is the elemental weakness it reveals. In 2011 we spent over $1 billion on criminal and civil background checks, drug tests, polygraphs, interviews with thousands of people’s neighbors, colleagues, exes, and old roommates, along with mountains of paperwork. But no screening can uncover a quietly held opinion, a change of heart, or a random act of rebellion or revenge. In the end, no system can prevent Edward Snowden, Bradley Manning, Daniel Ellsberg, or Mark Felt from deciding to submit the damning things they know to the judgment of the public.

None of this is to say that I particularly like knowing that there’s a massively powerful organization with unknown authorities and abilities checking through everyone’s Facebook accounts for references to fertilizer and diesel fuel (think of the farmers). Something about Snowden really rubs me the wrong way too. We can argue on the merits or we can argue about the optics, but we're not covering any new territory. The potential for a crazy bastard or bastards to cause arbitrary harm on innocent bystanders probably merits some system of finding and arresting them. Even if Snowden is an arrogant self-interested jerk, he may have done some good. Even if there are serious breaches of the public’s trust, some of what the NSA does is probably a good thing. Some of what the KGB did was probably good in some sense too. The world's complicated and all sorts of people do all sorts of things for all sorts of reasons.

But power is limited by other factors aside from the odd disillusioned contractor. Snowden showed up in Hong Kong with information showing that Chinese systems had been compromised by American intelligence. Conveniently, the extradition paperwork was held up on technicalities, and Snowden flew off to Moscow before the Americans could get near him. When he arrived in Moscow he remained in the pre-customs holding area, complete with its own hotels and restaurants. Russia, still sore from both the cold war and our ongoing wars on their allies, told US officials that there was nothing they could do since he was never checked by their customs officials. Now Snowden is off to a small Latin American country with a left-wing government, a chip on its shoulder for past American transgressions involving intelligence personnel, and favorable extradition treaties for political dissidents. When you do things people don't like, they don't forget.  

In the end, American power is constrained by forces far above or below what can be bought from a defense contractor or launched from an aircraft carrier. American power can’t buy omnipotence. Even with our colossal military, legal, and diplomatic force in play, what real choices remain for American authorities to place Snowden in their custody? What stops some anonymous intelligence analyst with information and an agenda from sharing what he knows?

To be certain, it would be a logistical flick of the wrist for Obama to order a special forces team and a couple of drones to track down, capture, and forcibly relocate Snowden from his Wikileaks-funded beachfront villa to a Supermax facility in Kansas. But political considerations like the sovereignty of our allies, or the ugly precedent set by such tactical escalation take that option away. To paraphrase someone with wisdom on the subject, the more we squeeze, the more things slip through our fingers.

No number of lawyers, diplomats, soldiers, spies, or assassins can bring Snowden to justice. No amount of computer programming, viruses, or hard drive erasures can take back the information that is out there for the public to see. If we have any level of moral standards or even practical considerations beyond the immediate, we can’t do anything. And the heroic dissident is sitting on the beach. Consider that precedent.   

Day 7: Could it be...

Seitan!?

Why yes, it is special

No, not that kind of protein, whatever it is you're thinking. 

The Vegan Age is coming to an apocalyptic end. 

And why not go out with a little flourish? 

Tonight I invited Seitan into my life.

Seitan is known by many names,
including Wheat Meat.

Seitan is a weird asian industrial food product. For some reason, lots of people think this kind of thing is good for them. I don't know, but it cooks into something meat-like, and it got a nice char on the grill pan.

Since I've been talking about hell and paganism all week, it had to be seitan Greek-style. Those guys know their sin. Opa!

Hey, that's not lamb!

Pseudo Souvlaki

Grilled seitan

Caramelized onions and red peppers
Roasted garlic-dill aioli (vegannaise base)
Red romaine lettuce
On flatbread

with tabouli, assorted olives,
and pickled peppers

But I don't care!

Week's Recap:

Eating vegan for a little while really isn't a punishment. I didn't challenge myself by trying to eat out, but what I made at home was great. After a day or two, all these oddball proteins actually tasted meaty and satisfying. A little soy sauce and you're there. 

Takeaway:

I had fun cooking and writing about rabbit food, and I lost a couple of pounds along the way. Right now, I could go for a little dairy, but I really don't miss meat. All I can say for sure is that it's possible to eat vegan and eat very well.
                                                                                       I'd even do it again.

S. Pacific Volcano Mt. Cilantro Erupts

50 supertasters still missing.

Embassy Officials: "no comment."

The green guy upstairs is happy

Day 6: The Vegan Basin 

"Boom!
"Nobody saw it coming. There was cilantro everywhere. Our chief leaves the island and 6 days later, Boom! Our Cilantro is furious!" said a local man.

"But then we offered our coconut-peanutbutter-noodles-with-tofu-and-veggies to the mountain spirits. They thought it was awesome." and the island was saved.

Locals are advised to take cover

Stir-fried Offerings

Ginger-garlic tofu

With bok choi, onion, red pepper, and rice noodles

In peanut-coconut milk broth

Cilantro

Day 5: Approaching Balance

Asceticism has a way of becoming routine. At some point, any exercise in restriction becomes plain old life as we know it. All the discipline it took to hold back goes to waste. We slowly regress to the mean of our old way of living. We're all tied up to cycles of abundance and scarcity, our fat times and lean times. Finding a way to live through both fat and lean is a challenge for everyone. Finding some way to change where the balance lies between the two is even harder.

"Whosoever would undertake some atrocious enterprise should act as if it were already accomplished, should impose upon himself a future as irrevocable as the past."

---Jorge Luís Borges



 Borges wasn't much of a rice-and-beans guy, but the yin-yang thing with the white rice and black beans was too much fun.

Arroz y Habas "Yin-Yang"

El Yin

Refried black beans

Green chile and sauteed onion

Spices

La Yang

White rice

Served with fake cheddar, corn tortillas and pico de gallo, alongside a dram of Red Breast Irish Whiskey. So much for asceticism.  

Day 4: Is This Scurvy?

One of the best ways to make yourself write is to start a series of something. When you count day 1, 2, 3, etc. you start feeling obliged to add more. Even if you don't really feel like cooking or showing it off. Even if nobody ever reads it.

Vegan Week would be as incomplete as the proteins I'm eating it didn't get a full run of 7 days.

Here's all I could come up with on Day 4.

Back to basics. A typical pasta-and-sauce, with a few added tricks. Fresh oregano, mushrooms deglazed in grappa. Then you pour in a bunch of Textured Vegetable Protein and presto, you have an ersatz bolognese. It did the job.

The dog didn't beg tonight

Rotini Bullshitnese
San Marzano Tomatoes
Soy flakes
Mushrooms
Herbs

Day 3: Our Future, the Triple MMM

It tastes like just like a Manwich or Sloppy Joe, I swear.  Manly, yes, but wearing drag and strutting with crabby Maryland flare. Here in the land of pleasant living, we call it a Sloppy Josephine (Jehws-ephine, as spoken here). Or a Maryland Marshy Mushwich. Or a "Triple M."

Counting down

We're entering the middle of Vegan Week. It's no longer feeling like a penance for December's sins. More like a taste of the future instead. A sampling of the kind of food they'll make you eat if you ever go to space. The Triple M is full of protein and vitamins, and easily reconstituted with water. It wouldn't go bad in storage, and would stick to the plate even in weightlessness.
Just sayin'.

The Triple M is spicy, tangy and hearty, with a strong Old Bay flavor warming up the background. The sweet potatoes have a good desert herb aroma, along with a nice sweet-salty balance.

No green here. No meat either.
It's delicious. The future is MMM.

It tasted much better than my webcam let on

Triple M
Soy flakes
Red pepper-vidalia onion puree
Fire-roasted tomatoes
In Gator Ron's Original Bloody Mary Mix

Sweet Potatoes
Rosemary and sage
In olive oil

with
Gotham
2010 Shiraz
Barossa Valley




Shout out to Steve and Debbie Paderofsky! 

They're my cousins, and the people behind... 

Gator Ron's Zesty Sauces and Mixes
Ron was their close friend. He cooked all sorts of amazing sauces for barbecues, wings, bloody marys, and lots of other things until ALS made it impossible. Ron's wife and Debbie got together and remade all Ron's recipes in his memory. 

All money that they can squeeze from their operation goes to research to find a cure for Amyotrophic Lateral Sclerosis. 

They're all awesome. That goes for the sauce too! And it's showing up in restaurants and grocery stores around the DC-Baltimore area. Check them out. 

http://www.gatorrons.com/

Day 2: Mid-East Madness

I love to make generic middle-eastern food. Stuff that could be passed off as Greek, Lebanese, or maybe Moroccan on a bad day. Doing it vegan makes me feel like I was cooking with the best stuff I could find outside my cave without getting spotted by a drone. But it was pretty good.

The hummus, tabouli, and baguette did the job nicely. The lentil burgers were more like a well-fried corned beef hash, and that's a good thing.

Maybe I'm just hungry, but this tasted good. I'd even make it again. 

The Sheik's Lentil Burgers 
Roasted garlic and shallots
Carrots and peas  
Natural flavor and/or... 

Tabouli 
Parsley, tomatoes, and  onions in bulgar wheat 
With mint, lemon juice and  olive oil 

Traditional Hummus  

Toasted Soft Baguette  

Day 1: Post Holiday Repentance

Get out your sack cloth and ashes everyone!  

It's 

Vegan Week! 

He hates carrots but he's been a bad boy  

For many of us January is a time to lay low, curl up by the fire, and sweat out the habits of gluttonous December. This year, part of my self-administered purgatory is a week of veganism.

Not bad. 

Still hungry. A little gassy too. 

But not bad. 

Day One: 

Massaman Kale
with carrot-celery-shallot mirepoix

Curry Tofu
fried with hoisin sauce

Long Grain Brown Rice
prepared with vegetable broth