Health-Care

When I started this blog, I was not planning on getting into very heavy subjects like politics, religion, etc. but I still left the door open to that possibility. It appears the hot topic of the day is health-care in the U.S.A. Having heard, read about, worked in, and experienced the current health-care system, I decided it was time to stop playing it safe and begin a series on this blog about health-care in this country.

To start with, as I have previously stated, I am a white, Anglo-Saxon, protestant living in the suburban Midwest of the United States. I was born in this country, as were my parents. I grew up in a lower-middle to middle-class household that was a) loving, b) protestant-Christian, and c) Republican. I have a college-plus formal education, am married, and have one very cute little girl. I began working in health-care part-time in 1985 and have continued to work in health-care since that time in a variety of capacities from health-care worker, professional, educator, researcher, consultant, provider, and in the corporate sector of health-care products. There, now you know my background.

The health-care issue in America is not a new one. I have heard comments about it since I was a little boy, and they have grown in frequency and harshness since that time. Generally speaking, the majority of comments I’ve heard and read about our health-system is that it is broken. Perhaps severely broken. Perhaps even irreparably broken. Having witnessed what the health-system has done to strangers and family alike, my leaning is to agree that health-care in this country is woeful and badly in need of change.

A Country in Trouble: the U.S.S.R.

The health-care issue currently facing our country and how we choose to tackle it is, in my opinion, the single most important thing citizens of this nation will face now and in the next 5-10 years. To put the issue into perspective, let me use an analogy:

For decades in the 20^th century, the “great enemy” of the United States was perceived to be the Union of Soviet Socialists Republic, i.e., the Soviet Union. Beginning in the late 1970’s and early 1980’s, the Soviet Union’s commitment to their military increased at a larger rate. The invasion of Afghanistan and the continued problems within the Eastern bloc European countries led to a greater need for money for military support. And there was also the need to maintain the arms-race with the United States. According to one source, the decline and fall of the USSR began in 1985. As stated in this summary on the Wikipedia website:

”After years of Soviet military buildup at the expense of domestic development, economic growth was at a standstill. Failed attempts at reform, a stagnant economy, and war in Afghanistan led to a general feeling of discontent, especially in the Baltic republics and Eastern Europe.”

And

“To match the USA's military buildup, the Soviet Union increased its own military spending to 27% of its GDP and froze production of civilian goods at 1980 levels.”

As another web-author states:

“… their economic planning failed to meet the needs of the State, which was caught up in a vicious arms race with the United States.”

And to summarize

“By 1990 the Soviet government had lost control over economic conditions. Government spending increased sharply as an increasing number of unprofitable enterprises required state support and consumer price subsidies to continue. Tax revenues declined as republic and local governments withheld tax revenues from the central government under the growing spirit of regional autonomy. The anti−alcohol campaign reduced tax revenues as well, which in 1982 accounted for about 12 percent of all state revenue. The elimination of central control over production decisions, especially in the consumer goods sector, led to the breakdown in traditional supplier−producer relationships without contributing to the formation of new ones. Thus, instead of streamlining the system, Gorbachev's decentralization caused new production bottlenecks.”

And so, a number of factors, largely economic or with economic repurcussions led to a people and economy that could not sustain itself. Deficit spending being one of them. Opening up free-markets didn’t help. Bottlenecks on production of outgoing goods like oil helped to starve the economy. And so, bye, bye Soviet Union. Information can be found at these and many other websites and books:

http://www.fsmitha.com/h2/ch33.htm

http://en.wikipedia.org/wiki/History_of_the_Soviet_Union_(1985%E2%80%931991)

http://www.coldwar.org/articles/90s/fall_of_the_soviet_union.asp

So what lessons might the U.S. learn from this history lesson? If recent quote figures are accurate, health-care in the U.S. currently makes up approximately 17-20% of the gross domestic product (GDP). Here is what the National Coalition of Health-Care has said:

In 2008, total national health expenditures were expected to rise 6.9 percent -- two times the rate of inflation.¹ Total spending was $2.4 TRILLION in 2007, or $7900 per person¹. Total health care spending represented 17 percent of the gross domestic product (GDP).

U.S. health care spending is expected to increase at similar levels for the next decade reaching $4.3 TRILLION in 2017, or 20 percent of GDP.

1. Keehan, S. et al. “Health Spending Projections Through 2017, Health Affairs Web Exclusive W146: 21 February 2008.

To add some comment and perspective to these percentages, here is one author’s comment (from The Book titled "Solving The American Health Care Crisis" to be published in 2009) http://www.eyeuniversal.com/eyeuniversal/HealthcareSolutions/summary.html:

Per dollar America spends much more and gets much less in return than other affluent Western nations when it comes to health care spending. It is time for the American policymakers to stop bragging about their health care system and start acting on their hollow promises to find real solutions to health care crisis. It is expected that the United States health care spending would reach nearly 20% of GNP within next 10 years, which is unsustainable.

Commentator Mark Pauly has this to say about the percentage of the GNP that is made up of health-care costs http://content.healthaffairs.org/cgi/reprint/12/3/152.pdf

The key point, however, is that high medical services cost even if it should account for 14 percent, or 20 percent, or even 24 percent of GNP–is not bad per se. A problem arises if and only if medical services are worth less than the forgone consumption of other goods and services.

To Mr. Pauly’s comment I say, all well and good. But given how the rise of health-care costs out-paces inflation in the United States by at least double, then one has to question is the health-care being provided in the United States worth it? Are average American citizens getting twice the bang in their health-care for their buck? If you are reading this, then I surmise a good majority of you are saying “no”.

How It Began

One question that often comes to mind at this point is “who is responsible for such a rapidly rising costs of health-care in the United States?” I am not sure at this point that looking for blame is a worthwhile exercise. Time is too short for such activities. But I will endeavor to briefly summarize what I think led to the current state of affairs with runaway health-care costs, and believe me, there is plenty of blame to go around. These include:

• Health-care providers: Physicians, hospitals, and other health-professionals who are given a license, and thereby a monopoly, to practice and charge whatever they think is right. What is ‘right’ is a relative concept. Basically, since everything runs a fee-for-service system, what is ‘right’ is whatever the market may bare. This includes visits to physicians’ offices, medications and other medicinal products, all kinds of procedures, and basic overall patient care.


• Insurance providers: They are for-profit companies designed like any for-profit company – to make a profit. And, as with all entities in a capitalistic, free-enterprise system, more profit is always better. The insurance companies have been gaining much attention in more recent times. Although they have blame to share in the result of health-care costs, they cannot bare all of it. There is plenty to go around.


• Lawyers: Law-suits and the resulting amount of insurance protection an average physician has to pay in the United States is staggering. There have no doubt been many lawsuits brought against health-care providers for their negligence that were justified. But at the same time, there have probably been as many lawsuits that were frivolous or unfair to the health-care provider. And what made these lawsuits so plentiful? One big reason is the cost of health-care on the part of the provider. A patient might be more willing to forego such action if the damage were not permanent and costs them very little. When the costs of even routine procedures today run in the tens-of-thousands-of-dollars and above, coupled with a health-care provider’s can-do-no-wrong attitude, then patients are more inclined to want to sue.


• Patients: No one is exempt from blame on the issue of rising health-care costs, even John and Jane Q. Public. In the United States, the average citizen expects the best because of the amount of money that is poured into health-care every year. Labor unions and their employers have long used health insurance as a big negotiating tool from which to bargain with. Also, new technologies and therapies for diagnosing and treating diseases receive news attention every day, giving rise to the typical American’s attitude of deserving the best, whatever that may be. Dealing with failure or death in the United States is not accepted. Health in the United States is treated like another other obstacle in an American’s life: it is to be dealt with and overcome. Failure is not an option, not for the patient nor the provider. And despite expert opinions on individual patient cases, laws and lawsuits force the issue over in favor of whatever the patient wants and generally is more expensive. I suggest that such attitudes have led to an unhealthy outlook and approach to dying and death in this country. Given my time spent in health-care with other professionals and being married to a hospital chaplain, I know I am not alone in this thought.


• Politicians and Lobbyists: Some are elected, some are simply hired guns, but in the end, the bureaucracy does its best to avoid major changes. Making small changes to placate the masses is what it’s all about in politics. Big changes run the risk of a) failure of themselves, and b) getting you voted out of office. Is it any wonder previous presidential administrations have failed at some form of universal coverage for the nation’s citizens? Also, with the plethora of paid lobbyists on capital hill these days, it pays to follow an axiom which I find has served me well in recent years: follow the money. Or as the famous Bobbi Fleckman once put it: money talks and bullshit walks.

The Argument

For decades, Americans have been arguing the virtues of universal health-care versus the current fee-for-service system. The original health-care system put into place in the United States ran pretty much the same as any other business. The advent of health insurance made it possible for people who could not pay out of pocket at the time services were rendered to engage a third party into the mix to pay on their behalf. And so it went. The capitalistic free-market system would allow for competition and therefore pricing would be kept in line, just as with any other good or service. But what once was a nice added benefit to most jobs has become a major important, if not the factor to all employees: health care benefits. As the years have rolled on, benefits for the majority of people who still have health insurance have dropped while co-pays have dramatically increased, along with the general cost of doing business in the health-care system.

As Americans began living longer, and Medicare and state Medicaid programs became more utilized, costs for health-care services became so out of control that the government enacted a system for Medicare recipients in 1983 called DRGs: diagnostic related groups. The system was designed to curb the vast differences in charges being levied against the Medicare system for all types of treatments for diseases. Standardization became the norm for medical treatment. Your patient has bronchitis? You get $50. Outpatient pneumonia? That’ll get you $100 for treatment. Knee-replacement? That’s worth $1000. If the service provider (physician, hospital, etc.) had fees that were higher than what the DRG paid, too bad. You’ll have to talk to the patient, you're not getting anymore from us.

Since that time, private insurance companies have adopted similar methods of reimbursement for health-care services and materials. However, given the number of different insurers in the U.S., the criteria and other parts of such a strategy vary from provider to provider. These different sets of rules for each player in the health-care provider arena has necessitated health-care providers (hospitals, long-term care facilities, individual physician practices) hiring on more individuals who can navigate the various systems and help to expedite payment, thereby further adding to the cost-burden of the health provider. And of course, they often try to pass this additionally cost back on to the customer, i.e., the patient, thereby further increasing the economic burden on Joe Public.

The vast majority of changes that have come to the American health-care system have been under a fee-for-service mentality and strategy. That is to say, in most cases, health-care providers and their patients are not rewarded for getting or staying well. They are only rewarded (monetarily) when someone walks in who is sick. All money is generated based on use of services and products to treat an already present illness, not in preventing that illness. In more recent years, health insurers, health-care providers, and employers have tried to come up with creative ways of providing incentives to people to maintain a healthy life-style. To be fair, on a national scale, I am not aware of what impact these incentives have had, if any.

The Best Money Can Buy?

One group with an axe to grind regarding health-care in the United States and advocating for universal health-care is the Connecticut Coalition for Universal Health-care. Look at the following website for some information they provide: http://cthealth.server101.com/the_case_for_universal_health_care_in_the_united_states.htm

Here is a sample of what they have to say:

1. Myth One: The United States has the best health care system in the world.

· Fact One: The United States ranks 23rd in infant mortality, down from 12th in 1960 and 21st in 1990

· Fact Two: The United States ranks 20th in life expectancy for women down from 1st in 1945 and 13th in 1960

· Fact Three: The United States ranks 21st in life expectancy for men down from 1st in 1945 and 17th in 1960.

· Fact Four: The United States ranks between 50th and 100th in immunizations depending on the immunization. Overall US is 67th, right behind Botswana

· Fact Five: Outcome studies on a variety of diseases, such as coronary artery disease, and renal failure show the United States to rank below Canada and a wide variety of industrialized nations.

· Conclusion: The United States ranks poorly relative to other industrialized nations in health care despite having the best trained health care providers and the best medical infrastructure of any industrialized nation

One could argue they have a particular bias towards Universal Health-Care, however, they are certainly not the only ones to point out the failings in access and quality of health-care in America. For checking their facts and figures, I suggest checking out a few other readily found sources and you likely will find the Connecticut Coalition has been even conservative in some estimates:

The Central Intelligence Agency’s Factbook data:

http://www.indexmundi.com/united_states/infant_mortality_rate.html

https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html

A Wikipedia summary:

http://en.wikipedia.org/wiki/Infant_mortality

The Centers for Disease Control and Prevention (CDC):

http://www.cdc.gov/nchs/data/databriefs/db09.pdf

http://www.cdc.gov/nchs/data/hus/hus08.pdf#026

CNN:

http://www.cnn.com/2009/HEALTH/06/11/life.expectancy.health.care/

Other sources:

http://www.infoplease.com/world/statistics/life-expectancy-country-2009.html

Therefore, if the United States continues on a path of spending towards health-care that continues at an increased rate and does not provide any better quality, then one would have to logically conclude the United States economy will be completely bankrupt within the next 4-8 years, especially given the current overall economic downturn in the country and the increased spending on the part the federal government to maintain life-support for the nation. Lest we forget, the baby-boom generation (1946-1964) is going to begin retiring soon in 2011 and there will be plenty of elderly adults who will be needing, wanting, and expecting some amount of health-care. And according to some sources, rising, not flat-lining is what is expected for the rate of health-care costs, and logically so:

http://www.concordcoalition.org/tabulation/why-health-care-costs-will-continue-rise

http://wallstreetblips.dailyradar.com/story/report_health_care_costs_to_rise_9_pct_in_2010_yahoo/

With that in mind, and the preponderance of data to support a need in change of the US health-care system, one must conclude that change is not only necessary, it is inevitable. Change is hard thing for most people. As uncomfortable as we may be with a situation, human tendency is to be even more fearful of change to the unknown.

A History of Universal Health-Care in the United States

Lest anyone think this topic is something new in this country, I invite you to check out the following websites:

http://www.pnhp.org/facts/a_brief_history_universal_health_care_efforts_in_the_us.php

http://www.businessweek.com/bwdaily/dnflash/jan2006/nf20060123_1965_db013.htm

http://www.politifact.com/truth-o-meter/statements/2009/mar/05/barack-obama/Obama-goes-back-to-his-Republican-roots-on-health-/

As part of the Progressive Movement in the early part of the 20^th century, Theodore Roosevelt, a Republican, was the first U.S. president on record to support some form of national health insurance. Health care was the 11th issue listed under "Social and Industrial Justice," after occupational safety, a child labor prohibition, a minimum wage, "one day's rest in seven" and other progressive ideas which we now take for granted in the United States.

Franklin D. Roosevelt, a Democrat, was the next president to try and attempt health-care coverage for citizens. But with the Great Depression and greater concern about unemployment, Social Security, and the New Deal, propositions were removed or strongly opposed right up to World War II.

Harry Truman was the president who followed FDR and was perhaps the most in favor and tenacious of supporting a form of universal health-care in the United States. Here is an excerpt from the first weblink above:

Truman’s plan for national health insurance in 1945 was different than FDR’s plan in 1938 because Truman was strongly committed to a single universal comprehensive health insurance plan. Whereas FDR’s 1938 program had a separate proposal for medical care of the needy, it was Truman who proposed a single egalitarian system that included all classes of society, not just the working class. He emphasized that this was not “socialized medicine.” He also dropped the funeral benefit that contributed to the defeat of national insurance in the Progressive Era. Congress had mixed reactions to Truman’s proposal. The chairman of the House Committee was an anti-union conservative and refused to hold hearings. Senior Republican Senator Taft declared, “I consider it socialism. It is to my mind the most socialistic measure this Congress has ever had before it.” Taft suggested that compulsory health insurance, like the Full Unemployment Act, came right out of the Soviet constitution and walked out of the hearings. The AMA, the American Hospital Association, the American Bar Association, and most of then nation’s press had no mixed feelings: they hated the plan. The AMA claimed it would make doctors slaves, even though Truman emphasized that doctors would be able to choose their method of payment.

In 1946, the Republicans took control of Congress and had no interest in enacting national health insurance. They charged that it was part of a large socialist scheme.

Therefore, the idea that universal health care coverage for Americans is an idea that began with Democrats Barak Obama, or Bill and Hillary Clinton, is wrong.

How and why did these previous attempts fail? Look back at 1946 and Harry Truman's opponents. Largely due to lobbying on the part of people who thought they had the most to lose (i.e., money and control), namely the physicians and folks in health-care who had made a fine living off of the status quo. The American Medical Association, along with others, created a great deal of uproar and pushback to the idea of national healthcare over the last century. Even lawyers know it would mean a severe decline in lawsuits, just as it does in the Veteran's Administration system. In addition, conservatives then, as now, used campaigns aimed at invoking fear in the public, particularly with the use of the words “socialism” and “communism” to derail any attempt at such a system.

One of the burning questions that people in this country must put out on the table and get out of their system is the following: is health-care of all citizens of this country an individual right, or a privilege? Other countries of this world have seemed to answer with an obvious answer of "it is a citizen’s right". Within all of this, though, in my opinion there is something more at stake than politics and the economy. There is the age old question of “Am I my brother’s (or sister’s) keeper?” Do we as human beings, first and foremost, have some kind of duty or obligation to help our fellow human beings when they are in need, particularly when it comes to their own health? Do we let laws, rules, and profit-motive divide us and not address the basic issue of health for our fellow mortals? As I said before, I was raised and am a protestant Christian. Even with the bumper-sticker religious question of "What would Jesus do?", I think it should be clear to most people we cannot simply let things go on as they have. I, for one, would not want to look Jesus (or Moses, or Buddha, or Mohammed) in the eye and say, "Well, we didn't help our fellow human beings because it was their fault anyway, we couldn't afford it, and besides our Constitution didn't really make allowances for it." I have news for folks who keep invoking the US Constitution over moral issues of justice for ALL: the Constitution does not guarentee a lot of things, including a public library system, freedom from being incarcerated, the presence or absence of a social security system, and a host of other things. Justice for all means just that ... for everyone. Not just ourselves or the people we favor over others we don't like.

I am not necessarily a proponent of universal health-care for the United States. Other countries have found their own ways to deal with the issue of health-care for their citizens without using that model and I think this country could do it also, with proper input and dialogue.

Now that I have provided some background and set the stage, I think I’ll stop here. Maybe I'll add more to this review and discussion as the situation in the United States moves along.

Midwest Pizza Pilgrimage Overall Assessment

My overall rankings for the 5 pizza’s I sampled on our trip are as follows:
1. Marty’s Pizza - Brookfield, WI
2. Bordenaro’s Pizza – Des Moines, IA
3. Glass Nickel Pizza – Madison, WI
4. Joe’s Pizza – Dixon, IL
5. Happy Joe’s Pizza – Coralville IA

I will say that I would eat pizza from any of these establishments again if I am ever in the area, with a couple of exceptions. For Glass Nickel, I would try different toppings, but basically it was good pizza. For Happy Joe’s, I would be willing to try another location again and just see how it compares to the pizza I had in Coralville. I will say that HJ’s still was better than if I had ordered delivery from Pizza Hut or Dominos. Next time, if I am in the Iowa City area, I will brave the weather and find a completely non-chain pizza parlor to put to the test of my tastebuds. Thanks for sticking with me on this journey. I had fun and would like to try this again sometime in other towns and cities.

Ciao,

-ME

Day Six - Happy Joe's Pizza, Coralville, IA

Day Six - Happy Joe’s Pizza

The final stop on our trip back home was originally going to be Davenport, IA, but we decided to press on and ended up in the land of the Hawkeyes. We actually ended up staying in Coralville, right next to Iowa City. I had originally thought about Happy Joe’s Pizza & Ice Cream as a final stop on our trip. Although it is a regional chain, there has not been a Happy Joe’s in the Kansas City area since 1987, so it still met our criteria. I found out the Happy Joe’s restaurant in Iowa City had been demolished courtesy of a tornado that came through the area in spring of 2006. http://en.wikipedia.org/wiki/Easter_Week_2006_Tornado_Outbreak_Sequence

So, since it was raining pretty heavily outside, I decided not to try and brave it all the way to downtown Iowa City anyway and just find something close to our hotel. The answer came in the form of the remaining Happy Joe’s Pizza in the area – a delivery and carry-out only place.

I decided to pick up the pizza just so I could have a glimpse of the operation. The Happy Joe’s in Coralville, IA is pretty Spartan, as one might expect. I did see a big Hobart mixer in the back, indicating they probably make the dough on site rather than get it shipped frozen. However, the mixer could just have been leftover from a by-gone time. The oven was one of those conveyor types, which I am not particularly fond of. Give me a good Blodgett deck oven any day. One thing I noticed as my pizza was coming through is there was a little door on the side of the oven where the cook could stick a long hooked metal rod through and punch down any bubbles that crept up. I am sure I have seen this done before in other places using similar types of crusts and deck ovens but it looked kind of funny to me seeing it done with a conveyor oven. Once the pizza was ready, I took it back to our hotel room. By this time my wife was rebelling against the whole pizza thing, going on about something called vegetables. Although I offered to let her choose whatever toppings she wanted, she was adamant about something other than pizza. So I purchased a medium pizza, this time half Italian sausage & mushroom and half Canadian bacon and pineapple.

It has been at least 25 years since I had an authentic Happy Joe’s pizza, so my memory may be a little off. One thing that struck me was how the look of the pizza reminded me of Round Table pizza from the West Coast. I don’t recall the taste being completely the same, but the thickness and texture are the same and certainly appearances are worth noting. I also noticed the HJ guys had docked the pizza, as evidenced from underneath.My overall impression of this pizza was a letdown. I’m not sure if my memory had failed me, or if this Happy Joe’s did, but the taste was not there. There needed to be just a little more sauce. And the sauce that was there tasted different than I remembered. It needed something, but I’m not sure what. The cheese was good, and they clearly use a blend (probably mozzarella, cheddar and provolone). The toppings were okay. The Italian sausage was not as good as Marty’s, the mushrooms were canned instead of fresh, but the shredded Canadian bacon and pineapple were fairly good. I couldn’t finish the whole thing, nor did I want to. I’m not certain if my taste buds were off at this point, or the pizza was, but overall I would give this HJ pizza 3 of 5 pizzas. It was okay, but probably not worth going back for. I might be willing to try a different HJ’s in the future just to compare and not totally fault the brand, but the one in Coralville was lacking, in my opinion.

As an aside, I have been to a pizza place in Independence, MO called Tim’s Pizza which does a kind of Happy Joe’s clone. http://www.roadfood.com/Restaurant/Reviews/3352/tims-pizza

I would say Tim’s does a better job in all categories, both in replicating my memory of Happy Joe’s Pizza and just in general taste than the pizza I had in Coralville, IA.

Day Five - Brookfield, WI

Day Five - Marty’s Pizza and Subs

The fifth evening of our trip put us in the western suburbs of Milwaukee, Brookfield to be exact. We spent a good part of the day at the Milwaukee Zoo and planned to cap it off with some local pizza. I knew there were a variety of local places from which to choose. As a kid living in New Berlin in the 70’s, my family tended to choose either the Shakey’s on National Avenue (closed a year ago) or the Pizza Hut on S.108th Street, both in West Allis. So, since Shakey’s was long gone and Pizza Hut violated our rules (and my personal taste these days), I went searching for a local mom-and-pop type pizza place. It was a tough choice, but I decided on one close to where we were staying: Marty’s Pizza, Pasta and Subs located on W. Bluemound Road (Hwy 18): http://www.foodspot.com/martys/martyspizza/

Right from the time we pulled into Marty’s parking lot, I could tell this would be more reminiscent of our stops at Bordenaro’s and Joe’s Pizza. The sign said in business since 1957 (I assume at this location). They have one other location in Delafield, WI according to their website.The place was hopping when we arrived. Most of the tables were full, including what appeared to be a couple family get-togethers with masses of bodies. We were seated at a booth and presented with menus. My wife was still on a pizza-aversion kick, so she opted to go with a calzone (it would prove to be far more than she bargained for). I, of course, returned to my staple of Italian sausage and mushrooms, medium size. We each ordered salads and had the typical 20-25 minute wait for our pizzas to arrive.On first inspection, what makes Marty’s Pizza unique is that it is square (or rectangular if you order an x-large pizza or bigger). Marty’s boasts pizzas (not pies) that go up to 14” x 60”. I, personally, would like to see one of those animals live just to witness it. Their medium pizzas are 12” x 12”.

Where do I begin? Well, the crust was more cracker style than any of the other pizzas we had tried so far. In fact, it was not only thin and appeared to be cracker style in texture, but also in taste. The edges were narrow but crisp and had almost a soda cracker-like taste. Looking underneath, they do appear to dock their dough. I liked the taste quite a bit, actually, but I was disappointed the rest of the crust was not as crisp and crunchy as the outer edge. The inner crust where all of the toppings lay was soggy.

The sauce was excellent: tangy, a little sweet, with just the right amount of seasoning (oregano, a little garlic and probably onion powder; not hot at all); just the right amount of sauce, also, not too much or too little.The cheese was superb. Hard to beat Wisconsin mozzarella for a Midwestern kid. I know there are more expensive mozz cheeses with richer flavors out there, but it’s hard to go wrong with this cheese from the Dairyland. By the way, that was another plus for Glass Nickel Pizza. I didn’t detect any blend of cheeses with Marty’s pizza.


What really aced this pizza for me were the toppings. Get this: REAL Italian sausage! In beautiful little tasty globs! The flavor was perfect. Just the right amount of spices, including fennel. And the mushrooms were spot-on, too. Fresh mushrooms were used, not canned.

As for the calzone, not only awesomely delicious, but it would have fed our entire family, easily. My wife had opted for some veggie fillings and she made it through maybe one-third. I have to say, Marty’s pizza blew me away. After some letdowns on the trip so far, I was impressed. I am going to give Marty’s Pizza, Pasta, and Subs 4½ out of 5 pizzas. The only letdown was the softer, soggier crust outside the cornicione. I would most definitely go back and tell my friends. This is the place for all of the other pizza restaurants to beat on our trip so far.

Last stop: back to Iowa.

Pizza Pilgrimage - Day Four

Day Four - Glass Nickel Pizza Co.

Our journey on Day 4 was not over until we arrived in Madison, WI. I had been trying to scout the area via the internet to see what our possibilities might be for pizza that evening. We were due to meet up with some friends of ours the next morning. After letting them know we arrived and our intention was to go out and eat pizza, they invited us over to their house and ordered pizza to be delivered. So our third (or fourth) stop for pizza would not be at a restaurant. No matter.Glass Nickel Pizza Co. sounds like a place that you would find in a college town, but if you go to their website and read their history, it will make more sense: http://www.glassnickelpizza.com/

Glass Nickel had been one of the choices I was contemplating on our pizza road-trip. Reading the various comments about it on the web, it appeared to fall into one of those “you either really like it or really don’t” categories. It is a small chain, found only in Wisconsin, so it met our criteria for pizza sampling. I had originally thought about going out to dinner at Picaso’s Pizza in nearby Verona, WI, but Glass Nickel was offered and I had no strong feelings on the matter.

The pizzas that were ordered were cheese, chicken, and a Fetalicious®, so no Italian sausage or mushroom this time around. Glass Nickel appears to be one of those places that experiment’s with toppings in the California tradition. If you go to their menu on their website, you’ll see good examples of their finished products (I forgot to take the camera so I don’t have any personal pics of the pizza): http://www.glassnickelpizza.com/Menu/menu.html

This was definitely a different animal than our 2 previous pizza samplings. The crust was thicker and chewy, so I can only surmise they use bread or high gluten flour. In that sense, the crust was somewhat reminiscent of a foldable New York pie, but the crust was thicker, even a little bit more than a Pizza Hut Hand-tossed pie, with a nice thick cornicione. I also suspect they use some wheat flour in their pizza dough, although my friend and their website could not confirm it. The taste was very good. The closest we have in our neighborhood to what this pizza crust reminded me of would be Wheat State Pizza: http://wheatstatepizza.com/

The cheese pizza had their typical red sauce. Like our previous samplings, it was still on the sweet side but had more of an herby flavor to it. The sauce was not as abundant on these pizzas and was not as big a player in the flavor factor.The cheese was plentiful on all of the pizzas. The chicken pizza was more bland and the chicken pieces were a little on the dry side, but overall it was still good. The Fetalicious was interesting. As you can tell by the name, they used feta cheese along with tomatoes, onions, spinach, and mushrooms. I’m usually not a big fan of feta cheese on pizza, but it seemed to work on this one. Perhaps it was the particular blend of cheese they used.

Overall, I give Glass Nickel Pizza Co. 4 out of 5 pizzas. I’m glad we were able to sample it. I would order it again but would probably skip the foo-foo toppings and go straight to my standard 2 toppings to see how it really measured up.

Our next stop: the Milwaukee area.

Day Three-to-Four - Freeport, IL

Day Three-Four

We ended up staying in Dixon, IL on May 23 without a pizza visit, so by May 24th we were headed north to Freeport, IL. Our intended stop was Cannova's Pizzeria on Empire Street. Unfortunately, it being a Sunday, we found out that Cannova's did not open until 4 PM and we were there for an early lunch! So, we went about our Memorial Day weekend business in town and found some place else to eat. By this time, my wife was beginning to regret the agreement to eat pizza anyway, so we did not choose a different restaurant in search of some place that served anything but (although we regret choosing the one at which we did stop to eat lunch).

Here is the website for Cannova's http://cannovaspizza.lbu.com/

The pizza looks rather upscale for the town that it is in, so it intrigued me. It has received mostly consistently good comments on the web. Alas, I will have to report on Cannova's some time in the future. If anyone on the forum has ever eaten pizza from there, I would be interested to hear your opinion. That brought us down now to only 5 potential pizzas to sample.

Our next stop ... Madison, WI.

Day Two - Primo Joe's Pizza, Dixon IL

Day Two

We arrived in Dixon, IL on May 22. After joining up with some of my extended family, we began the decision process of which pizza place we would sample for dinner. Dixon has a few independent pizza parlors and they have all been around since the 1960's. We settled on Primo Joe's (or just Joe's) Pizza. I may have eaten there once or twice before, but if I had, it had close to 3 decades, so the memories were all faded.

Arriving in the parking lot in back, we were greeted by a wonderful painting on the back outer wall of the restaurant. Heading in through the side (dining) entrance, we were told we could sit wherever we wanted. Pulling a few tables together, we sat down and began to check out the wares. I looked around and felt another wave of nostalgia, just like at Bordenaro's. Red plastic tablecloths, a juke box, brick arched doorways, old stackable chairs for seats - I loved it! After pulling a few tables together and putting in our drink order and a few things to sample, we chatted and waited the usual 20-25 minutes for our pizzas to arrive.

In addition to my prerequisite choice of Italian sausage and mushrooms, we also ordered an Italian sausage with green peppers, green peppers with onions, and a plain cheese pizza. As you can see from the photo, these were traditional Midwestern party (square-cut) pizzas. I was immediately transported back to Bordenaro's in Iowa upon seeing the pies. And also, to a certain extent, in tasting them. The crust was similar in terms of its biscuit/cracker texture, but perhaps just a little less flavor than Bordenaro's. The sauce was very different: much more the traditional sweeter pizza sauce with little heat and more of a little herby zest to it (probably mostly oregano). The cheese was once again abundant and appeared to be a typical Wisconsin mozzarella type. Also, once again, my Italian sausage turned out to be pork sausage, which disappointed me again. I was wondering whatever happened to the Germanic and Italian brethren that headed west from Chicago. The mushrooms were once again the canned variety. Everyone seemed to enjoy their pizzas and thought it was a good meal.

As I was paying the bill I was able to get a look at the kitchen. Typical equipment you would expect in a place that's been around since the mid-60's: big Hobart mixer, sheeter, Blodgett deck ovens. I couldn't see much else from where I stood.

Overall, I thought Joe's Pizza was another good choice. It didn't carry the flavor(s) I had been looking for, and it was even slightly more disappointing than Bordenaro's. So, I give Joe's Pizza in Dixon IL 3 ½ out of 5 pizzas. Still good, and I wouldn't mind going back, but I would like to try a couple of the other mom-and-pop places in town before returning here.

Day One - Bordenaro's Pizza, Des Moines, IA

On May 21, 2009, I took the family on a trek from our home in suburban Kansas City back to the land of my father and mother: Dixon, Illinois. This was to be a rather somber family occasion over the Memorial Day weekend, with some added stops thrown in. To add more fun to the 6-day trip, I proposed the following: we eat at different pizza restaurant in every town that we make a major stop.

The rules were stated in my previous post.

The cities we would be stopping at stretched across the Midwestern corn-belt from Des Moines, IA all the way up to Milwaukee, WI. I chose a different pizza restaurant from each city. The basic toppings would be my go-to standards, 1 meat and 1 non-meat item: Italian sausage and mushrooms. Beyond that, other pizzas could be selected but were not required for the purposes of this trip. By the end of the trip, I planned on ranking the 6 places of their delectable delights that we sampled. As an aside, you will probably notice that most of the pizza restaurants we tried served a particular style of pizza pie. I call this version a Midwestern bar pizza style. Some people refer to it as south-side Chicago style, but the style expands well beyond the windy city. It is typified by the following:

1) thin crust (but not necessarily paper-thin or cracker-style),

2) lots of cheese using predominantly mozzarella, but often incorporating a blend of cheeses,

3) a fair amount of toppings, and 4) party-cut (that is, cut in squares instead of slices).

This style seems to have gotten its start or became very popular first in bars as something to eat while guzzling down pints of brew. It later expanded to more family-style pizza parlors where beer was still an oft seen and mentioned accompaniment, but was served well with other beverages and typical Italian-American restaurant fare like garlic bread, salads, and spaghetti with meatballs.

Our first stop was in Des Moines on May 21. The place: Bordenaro’s Pizza As they say on the Chicago Pizza club blog, where it went down: http://www.bordenaros.com/

As for the pizza, as you might be able to tell from the pictures, it is a standard Midwestern party cut pizza. The crust was on the crunchy side, but not as crunchy or as dry like a cracker. I suspect some form of fat in the way of shortening, butter, or oil. As you can probably see from the turned over square/slice, they use pizza screens. I saw a few deck ovens going hot and heavy in back with restaurant, take-out, and delivery orders.

Overall the taste of the crust was good, but more like a biscuity texture than a cracker. I had asked for Italian sausage but the flavor was not quite what I was expecting. I suspect they use pork sausage lightly seasoned to pass as Italian sausage or they simply make their sausage without fennel. The mushrooms looked like the canned variety. The sauce was good but after a few bites, both my wife and I detected some added heat. It tasted to me like some form of pepper. I noticed on the menu they offer a milder sauce, which I would like to try if I ever make it back.Overall, the flavors mixed together well and I generally liked this pizza quite a bit. As for our daughter, well, she had her own ideas as to the flavor and what would make it taste better.

The house salads were unremarkable - the bagged variety.

Their cheesey garlic bread was very good - plenty of cheese and greasey flavor.

Overall, I am going to be generous and give Bordenaro's in Des Moines 4 out of 5. They made the 4th pizza-star by a hair, but it was our first stop, it was getting late, and our hunger probably added to my judgement. I would say it is certainly worth a stop if you are in the Des Moines area. You can see these and other pictures on my Flickr site: http://www.flickr.com/photos/38582842@N07/

Next stop ... Dixon, Illinois

Pizza Pilgrimage and Family Trip

During the Memorial Day weekend 2009, I took the family back to the Mother- and Father-land: Illinois. We also added some days and went up to Wisconsin to visit some friends. Along the way, to add some fun to the trip, we decided to visit a different pizza place in every town we stopped in. That would mean roughly 6 different pizza places in 6 different Midwestern cities/towns over 6 days. Starting with Des Moines, IA, we chose our sites carefully and set a few basic rules:

1. No pizza places that we would be able to find in the Kansas City area, and preferably, mom-and-pop places.

2. No repeats.

3. Pick the same toppings for at least 1 pizza in order to make a comparison

4. Have fun

In the coming days, I will be posting the places we visited on our journey from Shawnee, KS up to Milwaukee, WI and back and give some reviews and photos of pizza from the Heartland along the way. Stay tuned.