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If you can live stream movies, why not live stream medical care?

Insurance company UnitedHealthcare will start covering visits to the doctor's office — via video chat. Patients and physicians talk live online — on smartphones, tablets or home computer — to get to a clinical diagnosis. This move to cybermedicine could save insurers a ton of money — or have unintended consequences.

Cybermedicine has been long-discussed by the experts. Now, Eric Neiman, father to a little girl in San Francisco, can explain how it works — from personal experience.

"So I'd gotten a text from my wife earlier in the day," he says. "One of our daughter's eyes was a little bit red and she was rubbing it."

A few hours passed and it got more red and started oozing. "Well, unfortunately that sounds like it could be pinkeye. So we would look at it together when I got home," Neiman says.

Which was close to 8 p.m. — too late to see their regular pediatrician. And kind of late to see any doctor. If they went to the local urgent care center, they'd get back home at 10 p.m. or 11 p.m.

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Then, Neiman remembered something, from his Instagram account, a post for an app called Doctor On Demand. It pairs users up with doctors who are licensed in their state for a video screening.

Neiman decided to log in. "The pediatrician came on, introduced himself, and then asked to see our daughter, asked to hold the iPhone up to her eye, checked her throat, everything that he could see via the phone."

Within minutes, the doctor called in a prescription for pinkeye. The visit cost Neiman $40.

Neiman was so impressed, he says, he used the app just a few days later for himself. He thought he was getting a sinus infection, and logged in from his car.

"I was sitting on the side of the street. It's not the first time I pulled over to use my phone," he says. "But to actually go to the doctor — I was just hopeful nobody was watching!"

Save On Cost Or Break The Bank?

UnitedHealthcare's move to cover all or part of the cost of these e-visits — for up to 20 million customers by 2016 — is big. A major company is putting its stamp of approval on a process that, until now, has been largely experimental.

Three mobile-doc startups – Doctor on Demand, NowClinic and Amwell – are the initial providers.

Karen Scott, who directs innovation initiatives at UnitedHealthcare, says the company is studying cost: "What happens if somebody is more likely to use virtual care? Maybe they would have gone in to urgent care. How many of them will choose the virtual visit instead?"

It could be that people grab a doctor online for skin rashes, colds and coughs — and by getting care early on, they prevent an expensive catastrophe. Or maybe people wait too long when they really just need to see a doctor in person. Or it could be this service brings out the inner hypochondriac in us and leaves the insurer with a bigger bill to co-pay.

"Those are the sorts of health care economics and actuarial questions that our experts will be watching," Scott says.

Convenience For Doctors

This move has big implications for physicians, too.

Dr. Tania Elliott, an allergist with Doctor on Demand, says that through the app, patients with a rash show her their symptoms in the moment — not a week later. She takes virtual tours of people's homes to search dust mite sources. Instead of tedious planning, she gives patients a ballpark of when to do a follow up visit.

"They have access to essentially my schedule. And so when they log into the app they can see when I'm online," she says.

The doctor has even gotten to work remotely — from a hotel room in Hawaii.

UnitedHealthcare

telemedicine

Doctors

Chipotle is trumpeting its renunciation of ingredients derived from genetically modified organisms, or GMOs. The company says that using GMOs — mainly corn in its tortillas and soybean oil for cooking — "doesn't align" with its vision of "food with integrity." According to Chipotle spokesman Chris Arnold, it represents "our commitment to serving our customers the very best ingredients we can find."

Here at The Salt, though, we've been hearing from people who think Chipotle's stance shows little integrity at all. Rather, it shows a double helping of marketing hype, they say. Greg Jaffe, the expert on GMOs at the Center for Science in the Public Interest, calls it "hypocritical" and based on "smoke and mirrors." The Washington Post, meanwhile, accused the company of joining a "global propaganda campaign."

Why? Here are five reasons.

1. Soda

Way, way down at the bottom of the page that announces Chipotle's new policy, far below the headline that says "Food With Integrity; G-M-Over It," you'll find this sentence: "Many of the beverages sold in our restaurants contain genetically modified ingredients, including those containing corn syrup, which is almost always made from GMO corn."

Well. It appears that Chipotle is making a massive exception to its GMO-free policy when it comes to selling sugary drinks.

2. The "superweed" double standard

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A sunflower greenhouse in Fargo, N.D., where Brent Hulke is breeding plants that produce oil that's dramatically lower in saturated fat. Dan Charles/NPR hide caption

itoggle caption Dan Charles/NPR

A sunflower greenhouse in Fargo, N.D., where Brent Hulke is breeding plants that produce oil that's dramatically lower in saturated fat.

Dan Charles/NPR

As an example of the ways that GMOs can damage the environment, Chipotle points to the problems caused by herbicide-tolerant GMO crops and how they encourage farmers to use a single herbicide, usually glyphosate, or Roundup. This, in turn, has led to the emergence of herbicide-resistant weeds, which Chipotle calls "superweeds."

Chipotle's answer to this, per its new non-GMO policy, is to switch from soybean oil to sunflower oil.

The problem is, many sunflower varieties, while not genetically modified, also are herbicide-tolerant. They were bred to tolerate a class of herbicides called ALS inhibitors. And since farmers starting relying on them, many weeds have evolved resistance to those herbicides. In fact, many more weeds have become resistant to ALS inhibitors than to glyphosate.

Why should Chipotle bemoan the emergence of weeds that are resistant to glyphosate, yet not to other weedkillers?

3. Salt

The Salt

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The top reason to back away from GMOs, according to Chipotle's web site, is uncertainty about the long-term safety of growing and consuming this food. Yet the company apparently has no problem with salt, a substance that poses risks that are far more clearly documented, Jaffe points out. A recent survey by the New York Times showed that the typical meal consumed at Chipotle contains close to a full day's recommended allowance of sodium, along with 1,070 calories.

For CSPI's Jaffe, the company's highly publicized move away from GMOs serves merely to distract consumers from "the real problem with Chipotle food, which is that it's just not healthy."

4. Science

Chipotle can't quite make up its mind what to say about the safety of GMOs. In an email, Chipotle spokesman Arnold told The Salt that "we didn't say we were doing this because we think GMO foods are not healthy." Yet the company's website casts doubt: "While some studies have shown GMOs to be safe, most of this research was funded by companies that sell GMO seeds and did not evaluate long-term effects. More independent studies are needed," it says.

The fact is, scientific studies have shown ill effects from eating lots of things on the Chipotle menu, if you eat them to excess. At the top of the list, of course, are sugar in those sodas, the refined carbohydrates in the white rice and flour tortillas, and salt. There's no such evidence about GMOs.

5. Meat

Chipotle says it wasn't too difficult or expensive to remove GMO ingredients from its burritos. It simply had to find new suppliers for corn flour and cooking oil.

It would be much harder, and presumably more expensive, to use only meat from pigs, chickens that consumed a non-GMO diet. Because the amount of corn or soybeans required to feed Chipotle's animals is vastly larger than what's needed for its tortillas or cooking oil. Find a new supply of animal feed would raise costs, so Chipotle isn't doing it.

Chipotle

Rapeseed, an oilseed known in North America as canola, has a mild reputation as a cooking oil. Maybe that's because the version that most consumers know is a pale, neutral-flavored oil used for frying and baking.

But in the U.K., a more colorful and flavorful version has made its way onto store shelves: cold-pressed rapeseed that goes for 5-7 per 500 milliliters (about $9 to 12 for 17 fluid ounces)

This vibrant, mustard-colored oil goes by names like Farrington's Mellow Yellow, Sussex Gold and Summer Harvest. Some products are touted as "extra virgin," and there's a Cotswold Gold rapeseed infused with white truffle. You'll find them at London's Fortnum and Mason food hall. Even chefs like Jamie Oliver and Nigella Lawson have embraced the "national" oil, which is grown, processed and marketed by British farmers.

Third-generation farmer Algy Garrod uses it on his popcorn, to give it "a nice, creamy flavor," he explains while driving me through his bright yellow fields in Norfolk, in the east of England. In late April, they're in full bloom.

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Cold-pressed British rapeseed oil with asparagus. Anne Bramley hide caption

itoggle caption Anne Bramley

Cold-pressed British rapeseed oil with asparagus.

Anne Bramley

After harvest, all that rapeseed will be transformed into a golden, nutty oil a few miles away at Crush Foods, the family business started by Brendan Playford and his father about five years ago. They bottled their first cold-pressed oil at the kitchen table. Now, with Playford's university friend, Stephen Newham, Crush is run from the environmentally-minded Salle Park Estate.

But long before rapeseed became a cooking oil, it was an industrial oil used as a lubricant in Victorian steam engines and World War II ships. Back in those days, it wasn't even edible because it contained such high levels of erucic acid, which is toxic, and glucosinalates. Rapeseed, after all, is a brassica – a genus of plants that includes Brussels sprouts, mustard and broccoli – and it had a particularly high quantity of glucosinalates, which impart a flavor often described as "cabbagey," according to Paul Williams, a plant pathologist at the University of Wisconsin.

In the 1970s, Canadian scientists brought these levels of erucic acid and glucosinalates almost to zero through plant breeding. And they were so proud of their creation, which also had the lowest level of saturated fat (7 percent) of any vegetable oil, they gave it a new name: canola, a contraction of Canada and ola, meaning oil.

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This type of "double low" rapeseed is what we eat on both sides of the Atlantic, explains University of East Anglia's crop geneticist Rachel Wells.

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Top Five Myths Of Genetically Modified Seeds, Busted

But there are three key differences. The Europeans never adopted the name canola. And once genetically modified, herbicide resistant canola seeds were developed in 1995, North American farmers started planting mostly those, while European farmers stuck to the non-GMO rapeseed. (Today, 80-90 percent of the canola sold in the U.S. is GMO, while GMO rapeseed is banned across the European Union.)

Another key distinction of the artisanal — and more flavorful — rapeseed now available in the U.K. is how it's processed.

According to Playford of Crush in Norfolk, most rapeseed oil maintains its consistency by being processed and filtered in an intensive way that erases the muddled flavors resulting from seeds sourced from a range of different farmers. This is also true for the pale oil that dominates the American canola market.

But Crush and many other companies springing up around the U.K. and in other parts of Europe are cold pressing the seeds, just as with a high-quality olive oil. "When you cold press all you're doing is squeezing the oil out of the seeds very slowly at a temperature of no more than 40 degrees Celsius [104 Fahrenheit]," says Playford. "That keeps all the vitamin E, all of the flavor, every constituent compound that is in the oil completely intact."

And whether farmers are planting GMO or non-GMO rapeseed, most choose the "double low" varities that produce the greatest yield. But those aren't necessarily the ones that will create the best-tasting oils.

Crush's Playford and Newham think like single-malt whisky distillers and pay a premium to farmer Algy Garrod to get a rapeseed variety with a unique and appealing taste. Varieties "can range from tasting like fish to tasting like grass to tasting like cabbage," Playford tells The Salt.

"It's taken a lot a lot of time and research to find a seed variety that tastes like ours does," adds Newham. "We pride ourselves on the fact that it's a single variety." That allows Crush to keep a more consistent taste than if they would have to rely on a blend. And it keeps home cooks happy as well as the chefs who have to turn out hundreds of plates all tasting the same.

Many feel it keeps the British farm economy happy as well. In an era of local food love, rapeseed is celebrated as the new "British olive oil."

With the U.K. general election just days away, the National Farmers Union has created the "Great British Food Gets My Vote" campaign to encourage a commitment to domestic products. British culinary rapeseed oils provide a domestic alternative to imported olive oils from Italy, Greece and Spain.

The high-end rapeseed oils "are very important to farmers," says Guy Gagan from the NFU. "It's a local product, more or less in every town in England. It's a way for farmers to add value to their crops, so it's important to buy them rather than importing from outside the U.K."

Anne Bramley is the author of Eat Feed Autumn Winter and the host of the Eat Feed podcast. Twitter: @annebramley

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cooking oil

United Kingdom

The protest over a free speech award to Charlie Hebdo continues to grow.

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Earlier this week, six authors withdrew from the PEN American Center's annual gala in response to the organization's decision to give the French satirical magazine its Freedom of Expression Courage Award.

Former PEN American president Francine Prose was one of the original six. She tells NPR she's now been joined by more than 90 other writers — such as Junot Daz, Lorrie Moore and Rick Moody — who've signed on to an open letter critical of the decision.

"It is clear and inarguable that the murder of a dozen people in the Charlie Hebdo offices is sickening and tragic," the letter reads. "What is neither clear nor inarguable is the decision to confer an award for courageous freedom of expression on Charlie Hebdo, or what criteria, exactly, were used to make that decision."

It continues:

"Power and prestige are elements that must be recognized in considering almost any form of discourse, including satire. The inequities between the person holding the pen and the subject fixed on paper by that pen cannot, and must not, be ignored.

"To the section of the French population that is already marginalized, embattled, and victimized, a population that is shaped by the legacy of France's various colonial enterprises, and that contains a large percentage of devout Muslims, Charlie Hebdo's cartoons of the Prophet must be seen as being intended to cause further humiliation and suffering."

Current PEN American President Andrew Solomon told NPR on Monday that Charlie Hebdo deserves the award. "There have been very few places where people have consistently and constantly been willing to say the things that are offensive and to defend them as part of free speech," he said.

And some authors are speaking up in support of PEN American. Simon Schama took to Twitter this morning to defend the award:

The anti-Charlie Hebdo PEN protesters blame the victims, make satire defer to religion; gag freedom and contextualise away murder.

— Simon Schama (@simon_schama) April 30, 2015

Salman Rushdie, famously the subject of a fatwa after publishing The Satanic Verses, also came to PEN's defense in a letter to the organization. "This issue has nothing to do with an oppressed and disadvantaged minority," he wrote. "It has everything to do with the battle against fanatical Islam, which is highly organised, well funded, and which seeks to terrify us all, Muslims as well as non Muslims, into a cowed silence."

The gala is set to be held May 5. Charlie Hebdo editor Grard Biard is expected to accept the award, along with the magazine's film critic Jean-Baptiste Thoret.

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Charlie Hebdo