We finally realized a long-term dream and bought an espresso machine! It just came in this weekend and I spent most of Sunday wired on caffeine from trying it out. I am very surprised at how fast the thing heats up - that's probably the most unexpected thing about it. I think my shots are underextracted but am excited to practice and keep dialing them in. It's so nice to have stuff we normally have to go to a coffee shop for in the comfort of our own home.

That is true, the general trend of the area will be towards a more liberal stance. However, will that make the conservative-but-ashamed, "oh I don't watch the news it's not edifying" crowd vote Democrat? The skinheads certainly won't be changing their affiliations. And our binary voting structure seems to preclude any sort of change aside from R --> D or R --> no vote.

FWIW I have little exposure to truly rural areas outside of the South.

I hope so. But my experience with people who have moved to smaller municipalities is that they tend to be pretty conservative - granted, most of those interactions were before the pandemic.

I am reminded of Mackinder's Heartland theory, which talks more from a purely geopolitical standpoint and also feels a bit outdated in the modern setting.

That thread is a good read

Interesting. If someone tries to distill an explanation of the current structure of the world into one theory predicated on a single variable, I guess control of money is as good as any to use. Or maybe I skimmed that Wiki article too quickly lol

I just read that! Had trouble with the dialogue throughout, and with the pacing during the later half. He sure loves Switzerland a lot though. And some of the ideas were neat.

Hey all! Been a while. I've had this on repeat for about a week now.

Banjo Guzheng Pickin' Girls

Damn, you beat me to it. Turns out telling other nations to dig up dirt on your political rivals is not allowed, who knew?

Snuck in these cute air plants into the deliberation room. Let’s get some life in here as we contemplate death. What are other mindful ways y’all deal with the burden of proof?

Well, if I'm not mistaken the prescription pad is still out of the domain of nurses. Urgent care is expensive and inefficient in comparison to Europe's model, but are their community care clinics run by NPs? Genuine question. I don't know much about European healthcare.

In terms of being able to run an urgent care facility without doctors, I think the majority of centers in the US still keep a physician on site. Nurse practitioners, in our current model, function best to help multiply care access but are still linked to physicians. Whether we should change this is a different discussion, though.

I'm not sure if you're saying that primary care physicians are too expensive or something else, but I think there's a theoretical model that ensures high pay for all medical professionals (nurses, doctors, technicians...) while keeping costs low for the patient. It involves drastic moves in the world of admin, insurance and pharma, though, so - not gonna happen.

Right on about Halstead, dude was crazy. It's a ridiculous model that definitely contributes to the rate of errors and burnout. So the obvious solution is easing the burden of care currently on US resident physicians, which will require hospital systems either to supplement heavily with midlevel practitioners or take on more residents. Midlevels still have to get physician oversight in most states, so even a solution pursuing strict midlevel expansion will require more residency spots. And after residency positions are expanded, there has to be some sort of incentive to ensure that the new attending doctors get to areas where they are needed, i.e. poor and rural communities. This will be a multi-decade transition process, and only tackles a part of the train wreck that is the American healthcare system.