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Medical credit cards can mean aches and pains for patients

The Free Press WV

Few people look forward to a trip to the doctor or dentist, especially if they’re not sure how they will pay for it.

Some choose to use a special kind of credit card offered by medical professionals to pay for care at certain locations or networks. Often pitched by office assistants, they can seem like a quick fix for pricey procedures not covered by insurance including dental work, cosmetic surgery or laser vision correction.

Nearly a third of Americans report trouble paying their medical bills and many have taken on credit card debt to pay the expenses, according to a recent survey by the Kaiser Family Foundation.

But consumer advocates warn medical credit cards can saddle patients with unexpected penalties and sky-high interest rates.

CREDIT CONFUSION

One of the biggest dangers is that patients often don’t understand the financial terms or even that they are signing up for a credit card, according to lawyers who have represented customers.

“There is a lot of misunderstanding. Patients think they are just setting up an installment plan with the dentist,” said Gina Calabrese, co-director of St. John’s University School of Law’s Public Interest Center in New York. “They don’t understand they have opened a new line of credit and all the risks involved with that.”

Most cards feature a “zero interest” promotional period of up to 18 months. But then the interest rate can jump to 25 percent or higher. Those details can be glossed over or skipped entirely when patients sign up.

In cases cited by U.S. authorities, some consumers never received a copy of the credit card terms and had to rely on spoken explanations from staffers who had little training on the card details.

SURPRISE INTEREST

Another potential pitfall is something called deferred interest. That means if consumers don’t pay off the entire procedure during the “interest-free” period, they can be retroactively charged for interest dating back to when they first signed up.

For example, a patient might pay off $900 of a $1,000 procedure during a card’s promotional period. But because the amount wasn’t fully paid off they now owe interest on the entire bill, often at a double-digit interest rate.

“The way these companies make money is on the consumers who don’t pay off the entire balance during the promotional period,” said Chi Chi Wu, an attorney with the National Consumer Law Center.

Additionally, paying the card’s minimum monthly fee usually won’t pay off the expense before the retroactive interest kicks in.

For patients who decide to take on medical credit, advocates say it’s essential to pay off the entire borrowed amount within the promotional period.

TRUST ISSUES

The rate hikes on medical credit cards are not unique. Credit cards issued by department stores and other retailers often have similar terms. But advocates say consumers tend to be less wary of products offered by medical professionals.

“One expects a higher level of care from a health professional than, say, a car salesman,” said Calabrese. “People don’t think your dentist is going to encourage you to enter into a financial agreement that is oppressive or unfair.”

The cards are good for medical businesses because doctors can charge patients for procedures they might not otherwise be able to afford. And the medical provider is promptly paid by the card issuer.

STEP BACK

Before signing up for a medical credit card, experts suggest researching other options. In some cases, medically necessary procedures might be available for a discounted rate or even for free at a hospital, many of which provide some level of charitable care.

If the procedure is not urgent, consider waiting until a later date and paying cash. If you must use a credit card, consider using a regular one instead — with terms and conditions you understand.

CHEESY PULL-APART WHOLE CAULIFLOWER

The Free Press WV

Years ago, I was attempting to reverse my daughter Valentine’s disdain for cauliflower. She was always my veggie-loving kiddo, so I was stumped by her dislike of one my favorites. Who doesn’t love roasted cauliflower florets, with those crispy caramelized golden edges?

She loved artichoke - pulling apart the leaves and scraping them on her teeth. So, why not create a pull-apart version of cauliflower? I roasted it whole on a lower temperature (about 350 F) for nearly an hour, and then pumped up the heat to 400 F for some browning. I then seasoned the whole head of cauliflower with a little lemon butter or cheese. The idea worked: all four of my kids had fun pulling apart the cauliflower, eating little florets like finger food.

Over the years, cauliflower morphed from dinner table favorite to movie night snack food, right alongside popcorn. The recipe has changed a little: I’ve found that steaming the cauliflower a few minutes first cuts the cook-time in half and the florets are easier to pull apart.

And, I’ve upped my seasoning, for example slathering on a garlicky cheese mixture spiked with just a touch of hot sauce to remind me of the buffalo wings of my college days, when I thought nothing of downing a half-dozen fried wings, skin and all.

With today’s recipe for Cheesy Pull-Apart Whole Cauliflower, the high-cal buttery and cheesy coating packs a garlic punch, even though each serving has relatively little of it, so healthy eating goals stay on track. And while we’re enjoying movie-time or game-time nibbles, it’s nice to know that we’re actually getting a little nutrition in our bodies, too.


CHEESY PULL-APART WHOLE CAULIFLOWER

Servings: 8

Start to finish: 30 minutes

1 medium head of cauliflower (about 1 1/2 pounds), trimmed of leaves

1 tablespoon unsalted butter, softened

2 tablespoons mayonnaise

1/4 cup grated parmesan

2 cloves garlic, pressed or finely minced

1 tablespoon hot sauce or buffalo sauce

Preheat the oven to 400 F.

Turn the cauliflower upside down and gently cut out the bulk of the core, leaving a triangle-shaped indentation at the bottom of the cauliflower. Add an inch of salted water to a large pot and bring to a boil. Place the cauliflower right side up in the pot and cover the pot to steam the cauliflower until tender, but still firm (not mushy), about 7-10 minutes, depending on the size and age of the cauliflower. Test with a slim sharp knife.

Once the cauliflower is done, remove it from the pot and place on paper towels to cool. Meanwhile, in a small bowl, mix together the butter, mayonnaise, parmesan cheese, garlic and hot sauce. Blot the cooled cauliflower with paper towels. Coat the outside of the cauliflower with the cheesy mixture, using your hands to coat the whole head. Place the cauliflower on a baking tray lined with foil or parchment. Bake until the cauliflower is golden brown, about 15 minutes. Let cool a few minutes before serving. Serve with forks or as finger food.

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Nutrition information per serving: 67 calories; 42 calories from fat; 5 g fat (2 g saturated; 0 g trans fats); 7 mg cholesterol; 136 mg sodium; 4 g carbohydrate; 2 g fiber; 2 g sugar; 2 g protein.

Dan Dan Noodles

The Free Press WV

Dan Dan Noodles are a classic Chinese dish originating in the Sichuan province. Noodles have been part of Chinese cuisine for over 4,000 years, and long strands symbolize longevity, one of the nicest things you can wish for on the Lunar New Year (on February 16 this year).

Dan Dan Noodles are essentially long skinny noodles topped with a flavorful sauce built on ground pork and seasoned with pickled vegetables, chilis, soy sauce, and a bit of Chinese wine and vinegar. This dish was originally a street food. The name Dan Dan refers to the pole on which street vendors in Sichuan would carry the pots of food: one for the noodles, another for the sauce.

A few of the ingredients might take a little work to find unless you live near a great Asian market. Seek them out if you want to approach authenticity, but otherwise use these easy substitutions: If you can’t find the Chinese black vinegar, substitute even parts of rice vinegar and balsamic vinegar. Really any vinegar would be fine, but that combo gives you the closest approximation. Dry sherry is a fine substitute for the rice wine.

If you have access to a great Asian market, or want to find a source online, then buy ya cai, zha cai or Tianjin dong cai, which is a preserved vegetable mix, or sometimes just pickled mustard root. It’s available in cans or jars. Otherwise jarred pickles work just fine.

There are many versions of this dish, as there are with any classic recipe. Some are brothier than others, some have peanut butter or sesame or ginger, or Szechuan peppercorns. Sichuan cooking is often quite spicy, and these noodles are no exception. If you’re feeling a little timid about the amount of chili paste, you can always dial it back a bit — these noodles definitely pack a kick.

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DAN DAN NOODLES

Serves 4

Start to finish: 30 minutes

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Sauce:

1/4 cup chili garlic paste

1/4 cup vegetable, peanut or canola oil

2 tablespoons Chinkiang or Chinese Black vinegar

3 tablespoons soy sauce

1 tablespoon sugar

4 scallions, minced

Pork and Noodles:

1 tablespoon vegetable or peanut oil

1 pound ground pork

1/4 cup chopped, jarred, Chinese pickled vegetables or small diced pickles

1 cup roughly chopped arugula (optional)

2 teaspoons finely minced garlic

2 tablespoons Chinese rice wine (which might be called Shaoxing, or a Japanese version is called Mirin), or use dry sherry

1 cup chicken broth

16 ounces fresh Chinese wheat noodles or 8 ounces dried Chinese noodles, or substitute spaghetti

To serve:

1/4 cup crushed roasted peanuts

1/4 cup thinly sliced scallions

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Bring a large pot of salted water to a boil.

Meanwhile, make the sauce. Combine the chili paste, 1/4 cup oil, vinegar, soy sauce, sugar and minced scallions in a large bowl and stir to mix well.

Heat the 1 tablespoon vegetable or peanut oil in a large skillet or wok over high heat. Add the pork and saute until browned, about 3 minutes. Drain if there is any liquid in the pan, then return to the pan. Stir in the preserved vegetables or pickles, arugula (if using) and the garlic, and cook for another minute. Add the rice wine and stir until it is evaporated, about 1 minute. Add the broth and bring to a simmer, then remove from the heat.

Add the noodles to the boiling water and cook according to package directions (fresh usually take about half as long as dried). Drain.

Stir the sauce to re-combine, then add the noodles to the sauce and toss to coat. Add the pork mixture and toss again. Serve hot, in shallow bowls, sprinkled with the peanuts and sliced scallions.

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Nutrition information per serving: 687 calories; 261 calories from fat; 29 g fat (8 g saturated; 0 g trans fats); 76 mg cholesterol; 1628 mg sodium; 73 g carbohydrate; 4 g fiber; 9 g sugar; 28 g protein.

Leftovers make tasty Spinach and Feta Burgers

The Free Press WV

Leftovers! Some folks love them, others happily scrape them into the trash. Me, I’m on the love team. Leftovers speak to me. I’d always rather start a meal with a fridge full of tasty bits of this and that than have to confront a blank canvas of raw ingredients. This recipe tackles one particular challenge: how to repurpose leftover cooked chops, steaks, or roasts.

The answer? Turn them into burgers. “Wait a minute,” you say. “They’ve already been cooked once. Won’t they be dry as dust if you turn them into burgers and cook them again?” Nope, not if you combine the leftover meat with some moist ingredients, such as the spinach and feta cheese listed here.

For Spinach and Feta Burgers with Cucumber Yogurt Sauce, start with 12 ounces of cooked meat — pork, beef or lamb — trimmed of excess fat and any sinew. Cut the meat into cubes roughly 1 inch per side, then pulse in a food processor to chop it to burger consistency. (Be careful not to leave your finger on the pulse button for too long; you don’t want to end up with baby food.) Add the moist ingredients, along with an egg and a bit of panko to bind it all up. If you’re no fan of spinach and feta, you can substitute other cooked (and finely chopped) vegetables and/or cheese.

If you have time, make the burgers early in the day and chill them for a few hours before cooking. This will help them to hold their shape. If you don’t have the time, don’t worry. Just take care to turn them gently as they cook.

One last note: The sauce is a wonderful complement, but you’re welcome to lose it if it doesn’t appeal to you. The burgers are plenty tasty without it.

This recipe’s true miracle is transforming a mere 12 ounces of meat into six full dinner portions, allowing you to save money as well as food. And the new dish is so different from the original that no one will pipe up to say, “What, leftovers again!?”


Spinach and Feta Burgers with Cucumber Yogurt Sauce

Start to finish: 50 minutes (30 hands on)

For the sauce:

A 6-inch piece of English cucumber (the long, thin kind)

Kosher salt

1 cup plain Greek yogurt

1 teaspoon minced garlic

For the burgers:

3 tablespoons extra-virgin olive oil, divided

5 ounces baby spinach

Kosher salt

1 teaspoon minced garlic

1/4 teaspoon hot pepper flakes, optional

1 large egg

12 ounces trimmed cooked lamb or pork chop meat or cooked steak, or leftover roast meat

3 ounces coarsely crumbled feta cheese

3/4 cup panko bread crumbs

6 pita halves

Shredded romaine lettuce and sliced tomatoes for garnish

Make the sauce: Peel, halve lengthwise and seed the cucumber. Coarsely shred it and in a medium bowl toss it with a pinch of salt. Let the cucumber stand for 10 minutes and then add the yogurt, garlic, additional salt to taste; stir well.

In a large nonstick skillet heat 1 tablespoon of the oil over medium-high heat until hot. Add the spinach and a pinch of salt and cook, stirring, for 1 minute. Add the garlic and hot pepper flakes, if using, and cook, stirring, until all of the spinach is wilted, 1 1/2 to 2 minutes. Transfer the mixture to a shallow bowl and cool to room temperature in the refrigerator. Wipe out and reserve the skillet.

In a food processor, process the egg until it is lightly beaten. Cut the lamb into 1-inch pieces and add it to the food processor. Pulse 6 to 8 times or until the meat is chopped into medium-fine pieces. Add the feta, cooled spinach mixture and 1/4 cup of the bread crumbs and pulse two or three times or until just mixed.

Shape the mixture into six burgers. Spread out the remaining bread crumbs in a soup or pie plate. Heat the remaining 2 tablespoons oil in the reserved large skillet over medium heat until hot. Dip the burgers into the crumbs to coat them lightly on all sides; shake off any excess crumbs. Add the burgers to the skillet and cook until golden and heated through, about 3 minutes a side.

Transfer the burgers to the pita halves and spoon some of the sauce over each burger. Garnish with the lettuce and tomatoes. Makes 6 servings.

Nutritional information per serving: 331 calories; 141 calories from fat; 16 g fat (6 g saturated; 0 g trans fats); 50 mg cholesterol; 593 mg sodium; 26 g carbohydrates; 2 g fiber; 2 g sugar; 19 g protein.

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